Connecticut is the southernmost state of the north-eastern United States that is named after the Connecticut River that approximately bisects the state. This third smallest state of the U.S. by area is also known as the “Constitution State”, “Nutmeg State”, the “Provisions State”, and the “Land of Steady Habits”. With its forest-clad hills, many beaches, and harbors, the state is a perfect blend of modern life, rustic landscape, and historic sites. Its personal income per capita is among the highest in the country, as it ranks among the top U.S. states in average annual individual salary. The state also ranks high in access to primary health care. Though amongst the most densely populated state, this Constitution State ranks third in terms of healthcare. Connecticut has a successful state-run health insurance marketplace called Access Health CT, which is used by individuals, families, and small businesses to purchase health insurance coverage.
There are several health insurance plans available in the state that help people receive the healthcare they need and secure the peace of mind that comes with the protection of health insurance. Connecticut residents are among the healthiest in the nation, as the state rank pretty high in terms of health rankings, and has one of the highest average lifespans. Still, residents of the state need to take care of their healthcare needs, and to keep themselves protected in the event of a medical emergency, they need to enroll in health insurance plans. By enrolling in a health plan they will not just have access to preventive services and a primary care physician that will help them maintain a healthy lifestyle.
Highlights and Updates on Connecticut Health Insurance
Individual and Family Health Insurance Plans in Connecticut
Health insurance is available and more affordable for everyone in Connecticut under the Affordable Care Act. Some of the ways through which residents of the state can obtain health insurance coverage are through the Connecticut exchange, employer’s plan, government programs like Medicaid, Medicare, and CHIP, and directly from a private insurance provider, or through health insurance portals. Finding the best and cheapest health insurance in Connecticut is not at all difficult, especially with so many options available. People can easily and quickly compare quotes before initiating their search for health coverage. The majority of the people in Connecticut obtain health insurance through their employers. However, the unemployed and self-employed individuals or people who are ineligible to obtain coverage through their job can buy an individual plan through the Affordable Care Act Marketplace. By having the best and affordable health insurance plan people will be saved from medical bankruptcy and their financial responsibility will be saved in case of a medical emergency. In Connecticut people will find the following individual and family health plans:
Health Maintenance Organization Plan
A Health Maintenance organization plan provides a comprehensive range of benefits covering the broad healthcare spectrum, that ranges from preventive care to physician care, and from surgery to hospitalization. The healthcare of the members of the HMP plan is managed by primary care physicians, specialists, hospitals, and labs that are included in the network. Though members of the HMO plan along with the premiums are required to pay co-payment for certain medical services or prescriptions. Members of the HMO plan need to choose a primary care provider and they need to stay within the plan’s network. The members will require a referral before seeing a specialist, and if they go outside of their network then they have to cover the cost from their pocket. This plan is focused on the health and wellness of the people and encourage them to have annual checkups and seek early medical treatment. HMO plans are considered the most affordable health insurance option, as these plans have monthly premiums and small co-payments for healthcare services and treatments.
Preferred Provider Organization Plan
A PPO is a network of healthcare providers having a contract with a health insurance company, or a group of employers to provide healthcare services at a discounted rate. Connecticut residents under the age of 65 are eligible to enroll in a PPO plan and can also include their dependents like a spouse, unmarried children under 26 years of age, disabled dependent children regardless of age can be included. Members of the PPO plan are required to pay for their healthcare services up to an annual deductible and are then reimbursed by the health insurance company. The bill of the medical service is sent to the health insurer by the doctor on behalf of the policyholders. After deducting the health plan’s co-payment and deductible, the doctor is reimbursed by the carrier. PPO plans provide quality healthcare to members at a lower cost. Members of the PPO plans are free to visit any healthcare provider listed in the PPO directory. Members of the PPO plans pay lower out0of-pocket costs while receiving healthcare because of the negotiated rate with the network providers. Members of the PPO plans are free to visit healthcare providers of their choice though they have to pay more out-of-pocket costs. PPO plans are costlier than the HMO plans mainly because they provide more flexibility to the members.
Members of POS plans are allowed to select a primary care physician from a list of participating healthcare providers, who manage all the medical care of the members. If there will be a need for a specialist, then the POS physician will refer members to other in-network physicians. Members of a POS plan are required to complete paperwork themselves and submit reimbursement claims to the insurance company. The members have the freedom to visit out-of-network providers but they will need to pay extra. A POS plan comes with the combined qualities of HMO and PPO plans. The benefits of the plan will vary depending on whether members decide to receive healthcare in or out of the health insurance company’s network of providers. Just like an HMO plan, members of the POS plan are required to designate a primary care physician who will manage their health care and also provide a referral if a visit to the specialist is required. A POS plan is perfect for individuals who are willing to abide by their plan rules and coordinate their healthcare through a primary care physician. If their preferred doctor is already in the network.
EPO or Exclusive Provider Organization plan allows members of the plan to use the hospitals and healthcare providers that are included within the EPO network, and they are not allowed to go outside the network for healthcare. If the members of the EPO plan go out-of-network for receiving healthcare then they will not receive any benefit. An EPO plan will suit individuals who do not want to obtain a referral to visit a specialist, and for individuals who wish to receive healthcare at a much lower negotiated rate compared to HMO or PPO plan.
An HSA is tax-favored savings account that not only allows individuals to save for retirement but also makes healthcare more affordable. This account can be opened in conjunction with a high deductible health plan, and the residents of the state can use the saved money to pay for the qualified medical expenses and can also use the account to save for retirement on a tax-deferred basis. There are several benefits of this account, as people can not only save money in the short and long term, but they can also deduct 100% of their HSA contributions from their taxable income, people don’t have to pay penalties or taxes when they use their HSA mount to pay for qualified medical expenses. Besides people having an HSA account have an HSA-compatible high deductible plan that typically has a lower premium.
Short-Term Plans in Connecticut
Currently, there are no short-term plans for sale in Connecticut, as the state has imposed strict regulations on short-term plans and requires them to cover essential health benefits. Though in 2018, the Trump administration relaxed the rules in terms of the duration of the short-term health plans but Connecticut imposed more strict restrictions, so no health insurers are offering short-term plans in the state. Despite the fact that there are no short-term plans available for sale in Connecticut but still the state does have laws in place to govern these plans in case any health insurer chose to offer these plans. Thus, the duration of the short-term plan is limited to six months in Connecticut and the plan cannot be renewed.
Dental Plans in Connecticut
Dental insurance plans in Connecticut works in the same way as health insurance plans. Individuals enrolled in a dental plan have to pay a specific monthly premium and they are entitled to certain dental benefits like regular checkups, cleanings, x-rays, and other dental care services that are essential to promote the dental health of the people. There are different types of dental plans available in Connecticut that offer comprehensive dental coverage. Some of the dental plans also provide coverage for dental implants, oral surgery, or orthodontia. The dental plans available in the state are generally categorized as either indemnity or managed care plans.
Indemnity Dental Plan
With indemnity dental plans residents of Connecticut have a wide range of dental care providers. The dental insurance carriers pay for the covered dental care services only after receiving the bill. This means that members of the indemnity dental plans have to pay upfront for the received dental care and later on obtain reimbursement from the insurance carrier.
Managed-care Dental Plans
Managed-care dental plans maintain a network of dentists and all the dentists participating in the network agree to provide dental services at pre-negotiated rates. The claim is usually submitted by the dentists to the dental insurance company on behalf of the members.
Some of the best dental insurance companies offering dental plans in Connecticut include Humana, Physicians Mutual, Cigna, Guardian Direct, AARP.
Vision Insurance Plans in Connecticut
Individuals who are not receiving vision insurance plans through their employers can buy an individual vision plan, after carefully comparing the cost and benefits of the vision plans. Vision plans available in Connecticut cover annual eye exams, glasses, contacts, and glaucoma screening. Some of the vision plans even cover laser eye surgery. Residents of Connecticut need to be careful while shopping for vision plans, as some plans can be extremely restricted in terms of benefits and they just pay for the annual eye exam or for some eye treatments and may not provide coverage for glasses or contacts. Some of the vision plans require members to directly pay the doctors and later on submit a claim to the carrier to reimburse. Some of the vision plans may pay directly to eye care providers.
Insurance Carriers in Connecticut
Health insurer’s participation in Access Health CT has reduced from 4 carriers in the previous year to two carriers offering health plan coverage in the year 2021. Two carriers offering health plans in Connecticut in 2021 are:
FAQ on Connecticut Health Insurance
Though a handful of states have passed their health insurance requirements Connecticut is not one of the states. So all the residents of the state are not required to have health insurance and will not have to pay any penalty for remaining uninsured in the state. However, if you are interested and wish to have health insurance coverage to protect yourself and your family from sudden medical expenses then the Affordable Care Act requires you to have minimum essential coverage.
Residents of Connecticut can enroll in health plans through a state-run health insurance marketplace, named Access Health CT. Even the two health insurance companies, Anthem, and Connecticare Benefits offer coverage through the state-run Connecticut health insurance marketplace.