Connecticut is home to over 3.5 million people.1 Over half of the state’s population gets health insurance through their employer, while 35% are insured through either Medicaid or Medicare. Connecticut has a low number of uninsured citizens; just 5% of the population goes without health insurance.2
If you’re one of the thousands in the state who doesn’t have health coverage, you’re taking a big risk. A single illness or accident could leave you with hefty medical bills, putting your finances in jeopardy.
If you live in Connecticut and are looking for a new health insurance policy, there are several options.
Health insurance options in Connecticut
In recent years, there have been major changes in health care in Connecticut.
Since the Affordable Care Act (ACA) was signed into law in 2010, it’s had a significant effect on Connecticut residents. Between 2013 and 2016, the number of uninsured individuals declined by 48.3%, from 333,000 people to just 172,000.3
Connecticut was also the first state in the country to expand Medicaid enrollment to low-income adults who earn up to 133% of the federal poverty level, or $16,971 in 2020. Under the expansion, it was estimated that 45,000 adults would become eligible for public health aid.4 Medicaid expansion in the state encouraged greater use of preventative health services and reduced the state’s uninsured rate.5
Thanks to these developments, you have several choices when it comes to health insurance. What kind of insurance plan you may qualify for is dependent on your age, income, and family size.
The Affordable Care Act
One option is to purchase ACA or Obamacare health insurance for you and your family through the federal Health Insurance Marketplace. Plans purchased through the Marketplace can’t exclude you based on preexisting conditions, so they’re an excellent option if you have a chronic health issue.
Health Insurance Marketplace plans are divided into four tiers:
- Bronze: The cheapest plans, the insurance company pays 60% and you pay 40% of healthcare costs.
- Silver: Silver plans are the next level up. Your insurance company covers 70% of healthcare expenses, and you pay for 30%.
- Gold: With gold plans, you pay 20% of health expenses, and insurance covers 80%.
- Platinum: The most expensive option, insurance pays for 90% of your health expenses, and you pay for 10%.6
You can only purchase insurance through the Marketplace during the Open Enrollment period (OEP); for 2020 coverage, the OEP ended on December 15, 2019.
However, you may be able to qualify for special circumstances. If you had a major life event, such as getting married, having a baby, or losing health coverage, you may be eligible for a Special Enrollment Period and can enroll in a health plan.7
Connecticut re-opened sign ups for health insurance due to the coronavirus pandemic. During this special enrollment period, qualified uninsured residents could purchase coverage between March 19 and April 17, 2020.
In Connecticut, a 40 year old purchasing insurance through the Marketplace would pay $570 per month, on average, for the second-lowest-cost silver plan (the benchmark premium). That’s a $95 increase over the cost of the average benchmark premium for 2019.8
If you don’t make a lot of money, you may be eligible for subsidies like the Advanced Premium Tax Credit (APTC) that reduce your health insurance costs.
For example, the average premium in Connecticut across all tiers was $625. But the average premium after subsidies was just $264.9
If you’re retired or qualify for low-income status
If you’re retired, disabled, or low-income, you may qualify for insurance through government-sponsored programs.
Older adults and people with disabilities can qualify for coverage through Medicare. If you or your spouse worked and paid Medicare taxes for 10 years or more, you may qualify for Part A (hospital and hospice coverage) without premiums. Otherwise, you may pay a premium for the coverage. Use the government’s eligibility calculator for more information.
Medicare covers basic health services, including hospital stays, physician services, and prescription medications.10
There are other Medicare services you should know about:
- Medicare Part B: Part B covers necessary medical and preventative services like ambulance transportation and medical equipment.
- Medicare Part D: Part D is an optional benefit you can add for prescription drug coverage. In Connecticut, over 296,000 people are enrolled in standalone Part D plans.11
In Connecticut, over 440,000 people are enrolled in Original Medicare, and over 233,000 are enrolled in Medicare Advantage plans.12 To get coverage, you can apply for Medicare online in as little as 10 minutes.
Private companies sell Medicare Supplement insurance. These policies are designed to fill gaps in Original Medicare, which covers for some, but not all, of health services and supplies. Medicare Supplement policies can help cover copays, coinsurance, and deductibles.13
Private companies contract with Medicare to offer health plans to provide your Part A and Part B benefits. As an additional perk, most Medicare Advantage plans also offer prescription drug coverage and other benefits, such as gym memberships.14
In Connecticut, Medicaid is known as HUSKY Health. It provides coverage to children, pregnant women, parents, older adults, adults without children, and adults with disabilities with limited incomes. As of December, 2019, 830,030 people were covered under Medicaid.15
Medicaid covers most health services, including hospital stays, lab tests, nursing care, prescription medications, and medical equipment.
Income restrictions do apply. How much you can make is dependent on whether or not you have children, are pregnant, or are disabled.16
For example, if you are an adult without minor children, the following income limits apply as of October 2019:17
|Family of 1||Family of 2||Family of 3||Family of 4||Family of 5|
|Income under $17,237||Income under $23,336||Income under $29,436||Income under $35,535||Income under $41,635|
For more information or to apply for HUSKY, visit www.ct.gov/husky.
Children Health Insurance Program
HUSKY B is Connecticut’s Children’s Health Insurance Program (CHIP). Children under the age of 19 can qualify for free or low-cost health insurance that covers medical, dental, and behavioral health services.
As of December 2019, approximately 20,000 children were enrolled in CHIP.18
Short-term health insurance
In some states, you can purchase short-term health insurance as an alternative to traditional insurance policies. Cheaper than most insurance plans, short-term insurance plans can be a cost-effective option for some.
However, Connecticut has recently enacted some strict regulations regarding short-term insurance policies that limits their availability.
In 2018, the state ruled that short-term insurance plans had to cover essential health benefits, including hospital expense coverage, medical-surgical expense coverage, major medical expense coverage, hospital or medical service plan contract, or hospital and medical coverage provided to subscribers of a health care center.
The law also said that short-term insurers couldn’t preclude individuals with pre-existing conditions unless the plan was less than six months in duration and was renewable.19
If you leave your job or are laid off, you have the option of continuing your current insurance coverage for up to 18 months thanks to the Consolidated Omnibus Budget Reconciliation Act (COBRA). You can keep your existing policy for you and your family, but you’re responsible for paying the entire premium. While expensive, COBRA can give you time to find a new job and other insurance coverage while providing you with essential health insurance.20
Getting health insurance
If you live in Connecticut and are one of the people who are living without health insurance, it’s important to know that there are multiple options available to you that can fit within your budget. Even if you have very low-income or special circumstances, it’s possible to find a health plan that will work for you.