Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
To give seniors access to comprehensive health coverage, Congress established Medicare, a federal insurance program designed for older adults and some younger adults receiving disability benefits. Originally, every Medicare beneficiary received the same coverage. That changed with the introduction of Medicare Advantage. The main difference between Original Medicare and Medicare Advantage is that Original Medicare is still a government-managed program, but Medicare Advantage is available through a network of private insurers.
Medicare Advantage gives Medicare-eligible residents of Connecticut access to additional coverage options, making it a more flexible version of the Medicare program. Medicare Advantage plans are closely regulated by the Centers for Medicare & Medicaid Services, so providers must follow stringent rules regarding benefits and coverage limits. Another key difference between the two types of Medicare is that Medicare Advantage plans are sold to residents of specific service areas. In contrast, Original Medicare is available to people all over the United States.
In Connecticut, the Medicare Advantage enrollment rate is much higher than the national average. More than 363,000 of the state’s 708,990 Medicare-eligible residents are enrolled in Medicare Advantage instead of Original Medicare, an enrollment rate of over 51%. This accounts for more than 1% of the 26.4 million Americans enrolled in Medicare Advantage in 2021. The following guide describes the Medicare Advantage program, including information on the top 10 plans in Connecticut, along with tips for choosing a plan and an overview of what’s included with Medicare Advantage.
The Top 10 Medicare Advantage Plans in Connecticut
In Connecticut, seniors have access to multiple Medicare Advantage plans. The table below provides details regarding the 10 most popular plans in the Constitution State, including cost and enrollment data. Total enrollment numbers were calculated based on the number of people enrolled in each individual Medicare Advantage plan. These numbers were added together to determine the total number of beneficiaries per single provider. Due to the availability of multiple plans from each provider, the column for monthly costs contains a range for each insurer. This information is current as of April 2022, but Medicare.gov has the most up-to-date data for Connecticut.
Anthem Blue Cross and Blue Shield
CarePartners of Connecticut
Blue Cross Blue Shield of Michigan
How Medicare Advantage Plans Work in Connecticut
Medicare Advantage providers are allowed to offer several types of plans in Connecticut. Although each plan covers most of the same services as Original Medicare, there are differences in how Medicare Advantage enrollees can access care and how much they pay for each service. Some plans have strict rules regarding in-network care, but others are more flexible. More information about the four most common types of plans is available below.
What Medicare Advantage Plans Cover in Connecticut
All Medicare Advantage plans must cover the same services as Original Medicare, with the exception of hospice care covered under Medicare Part A. This includes immunizations, doctor appointments, tests needed to diagnose a condition and treatments for many illnesses and injuries. One reason so many people enroll in Medicare Advantage is because each provider is allowed to cover extra services. Some plans are so comprehensive that they cover hearing aids, transportation to medical appointments and other services that aren’t covered by Original Medicare. Most Medicare Advantage plans also cover prescription medications.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Durable Medical Equipment
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Connecticut
Medicare Advantage is available to residents of Connecticut who have both parts of Original Medicare — Part A and Part B — and live in the service area of the plan they want to join. Medicare Advantage enrollees must also meet the general Medicare eligibility requirements. To enroll in Medicare, a senior must be at least 65 years old or under 65 with a qualifying disability. Medicare also requires enrollees to be U.S. citizens or lawful permanent residents of the United States.
Like other types of health coverage, Medicare has limited enrollment periods. Seniors who don’t enroll at the right time may have to wait to receive Medicare coverage. More information about the enrollment periods is listed below.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
Medicare Advantage Open Enrollment Period
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Connecticut
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
Connecticut’s Program for Health Insurance Assistance, Outreach, Information and Referral, Counseling, Eligibility Screening (CHOICES) has a range of services available to assist seniors with Medicare programs including Medicare Advantage. Certified counselors can provide information and objective advice to help individuals understand their health insurance options and make informed decisions. The program also includes eligibility screening and can assist individuals with applications for a range of federal and state benefit programs. CHOICES conducts presentations throughout the state, including at local senior and health fairs. The service is available to people aged 60 and over, and all people eligible for Medicare, including those with disabilities.
To speak to someone about the program or arrange counselling, contact the CHOICES office at 800-994-9422. More information about the program can also be found on the CHOICES website.
Office of the Healthcare Advocate
The Office of the Healthcare Advocate (OHA) assists Connecticut residents with their health care coverage. The service can provide explanations about benefits, coverage and programs, and offers assessments of the plans offered in Connecticut, including those in the Medicare Advantage program. Seniors who contact the OHA can also receive help with enrollment, understanding their rights and responsibilities and the internal and external appeals process. The OHA acts as an advocate for people who have complaints about their health care coverage and conducts outreach activities including presentations to community groups. The services of this independent agency are confidential and free for residents of Connecticut.
Seniors can contact the OHA at 866-466-4446 and speak to a counselor who can provide information immediately. Complaints and requests for information about participant rights and options can be submitted online through the OHA complaint form.
The Center for Medicare Advocacy is a nonprofit, nonpartisan law organization. Its mission is to improve access to quality health care and comprehensive Medicare coverage for older people and those with disabilities. The organization’s primary services are education, advocacy and legal assistance, and the Center represents people in appeals and pursues coverage for individuals. Information available on the website includes a Connecticut Consumer’s Guide to Medicare and the Center collects stories about Connecticut residents’ Medicare experiences to help them advocate for improved access. The Connecticut Medicare Maximization Project is aimed specifically at appealing denials for care to residents with dual eligibility.
Senior Medicare Patrol (SMP) offers one-on-one counseling to people enrolled in Medicare. This assistance is intended to help beneficiaries understand billing and other paperwork and read their Medicare summary notices. Counselors can also review cases and help beneficiaries report fraud if circumstances are suspicious. SMP has an education arm that delivers presentations and distributes educational materials at community events about types of Medicare fraud and how seniors can protect themselves.
Most Area Agencies on Aging have SMP volunteers available to speak with seniors. The SMP office can be contacted at 800-994-9422 for details on specific offices.
Local Medicare Advantage Resources
Community Choices, the Regional Aging and Disability Resource Center, has a system of information and access designed to support older adults and people with disabilities. The assistance provided covers a wide range of topics that may concern seniors, including options counselling and benefits screening. On the topic of health care, Community Choices provides information on Medicare, including Medicare Advantage, and other health insurance options. It also helps seniors communicate their needs, and assists people in navigating the system of local, state and federal programs. Assistance applying for programs can also be arranged. Community Choices can connect seniors with additional resources to assist them with Medicare and health care advocacy, including legal services.
Community Choices partners with local Agencies on Aging. Older adults can call 800-994-9422 to access their area’s AAA.
Agency on Aging of South Central Connecticut
The Agency on Aging of South Central Connecticut (AOASSC) has a range of services that assist seniors in the area. This includes assistance with Medicare, Medicare Advantage and other programs and benefits. There is an information library that includes information about Medicare, supplement rates, savings programs and other details seniors may need. The agency also has counselors available to help seniors apply for assistance. Trained Benefits QuickLINK volunteers offer advice on Medicare premiums and programs that can provide financial assistance to older adults.