Every person who is enrolling themselves in the Medicare program must choose between one of the two different ways to get benefits from Medicare:
The Original Medicare is also known as traditional Medicare and this option includes Medicare Part A and Part B. This traditional Medicare is regulated by federal law.
Part A Medicare deals with health care services in a hospital, providing coverage for hospital inpatient treatments, specialized nursing facilities, nursing home care (that isn’t custodial or long-term), hospice care, and home healthcare.
Part B Medicare covers necessary medical services that are required to diagnose or treat the medical condition. And preventive services like healthcare to prevent illnesses, and detection of illness at an early stage.
Part B deals with clinical research, ambulance services, durable medical equipment, mental health, inpatient and outpatient care, partial hospitalization, and limited outpatient prescription drugs.
The Medicare Advantage Plan is another Medicare health plan that includes a ‘Plan C’ offered by private companies that have been approved by Medicare. A Medicare Advantage Plan will pay companies who offer Medicare a fixed amount every month to cover your treatment bills. These private insurance businesses have contracts with Medicare to combine both Part A and Part B coverage into a single policy.
Some of these plans also offer Part D (prescription drug) coverage, including added benefits like coverage for vision, hearing, dental, and/or health and wellness programs.
As of 2022, there are 57 Medicare Advantage plans available for eligible enrollees in Connecticut. To ensure you’re in the know about any new Connecticut Medicare Advantage plans before applying, browse through the Medicare website to learn more.
On the Medicare website, enter your ZIP code into the Medicare plan finder tool to check how many Medicare Advantage plans are available in your area.
Health Maintenance Organization (HMO)
The Health Maintenance Organization is an insurance structure that is very popular in Connecticut since it provides coverage through a network of physicians for a monthly or annual fee.
The HMO is a conglomeration of medical insurance providers that offers comprehensive health insurance plans with coverage to medical care provided by your doctors and healthcare providers who are under a contract with them.
Since the healthcare providers have patients directed to them, these contracts allow the costs and premiums to be significantly reduced. To be eligible for the HMO, you must have a primary care physician (PCP), a specialist’s referral, and approvals for certain treatments and drug prescriptions.