Healthcare costs comprise insurance premiums, deductibles, and copays - which together can be substantial. Most Connecticut residents get health insurance one of three ways: from their employer, Medicare, or Access Health CT (which also connects to Husky programs). Medicare covers most residents over 65 and some younger people with disabilities. The 750,000 Medicare enrollees in CT must make some important choices by Dec 7th. Below is brief description.
1. Medicare enrollment/premiums for 2024 - Open enrollment for 2024 started Oct 15th and ends Dec 7th - this is the period when enrollees can choose health insurance plans for the following year. For 2024, the standard Medicare premium for Part B (physician and outpatient services) will increase by about $10 per month to $175 per month, and the deductible will increase by $14 to $240. Beneficiaries who earn above $103,000 a year pay higher premiums. Click HERE to see changes in their premiums.
2. Medicare Advantage (MA) vs. Traditional Medicare - The critical choice facing Medicare enrollees is whether to keep the traditional Medicare OR enroll in a Medicare Advantage program (also called Part C) managed by a third party like United, Humana, etc. More than half of CT Medicare enrollees choose MA plans. The plans vary but often include prescription drugs, dental, or vision benefits, have lower deductibles, and cap out-of-pocket expenses - overall they save money - that is why the are so popular. However, MA plans may have coverage limitatiions like which physicians one may visit and may not be suitable for everyone. Click HERE for a comparison chart from Medicare.gov.
3. Prescription Drug Plans (PDP or Part D) and Medigap supplemental Plans - For those who choose traditional Medicare, shopping separately for Part D drug plans and additional coverage plans is essential since traditional Medicare has neither prescription drug coverage nor has any limit on out-of-pocket costs. Most Advantage plans have both drug coverage and out of pocket limits and do not require these additional plans.
4. Choosing the plan that works for you- Enrollees can shop for Part C, Part D, or Medigap plans on the Medicare website by clicking HERE. This site will allow you to compare various programs and enroll in the plan. Enrollees can also shop through brokers or insurance reps who might call you - click HERE for the list of rules that they are expected to follow. Ensuring the plan meets your needs is critical - it should cover your doctor, your prescription drugs, and your travel needs.
5. Medicare savings programs (MSP) / Special Needs Plan (SNP)- For individuals making under a certain income, Medicare Savings Programs administered by the state will pay for the Part B premium and other copays. Click HERE for eligibility and details of MSP plans. Special Needs programs are available for dual Husky-Medicare enrollees or those with special chronic conditions or need long term care with skilled nursing/psychiatric facilities. Click HERE to see eligibility and details for SNP plans.
Medicare is an excellent program, but it can get complicated. Please give yourself time to research and review various choices. There is help available from CMS and various state agencies. Feel free to email me; I can help connect you with the right resource.