How To Get Marketplace Health Insurance In Connecticut



In Spanish | Most Connecticut residents are eligible to purchase health insurance through CT Health Access, the states Affordable Care Act (ACA) Market. And you may be able to save money on premiums, thanks to the expansion of federal tax credits in the March coronavirus relief bill and the new Connecticut Covered Program. Due to the pandemic, the Access Health CT registration window is open until August 15.

Most people already enrolled in the ACA market plans will also see their premiums drop this year, as the recently passed US bailout increases tax credits for insurance premiums and increases the number of eligible households. Every household that pays more than 8.5 percent of its family income is now eligible for federal tax credits to help pay for Medicare. Before the new law, these tax credits were only available to people representing up to 400% of the federal poverty line (approximately $ 51,000 for one person).

The average American with a market plan can save $ 50 per month with the new help, according to the federal government. From now on, this additional federal financial assistance will only be available in 2021 and 2022.

Who is eligible?

  • Connecticut residents, including non-U.S. Citizens with worker or student visas, are eligible to purchase health insurance through CT Health Accesswhether they are currently insured or not. Inmates are not eligible.
  • You may also be eligible for state Medicaid programs, called HUSKY Health Plans, which offer free or low-cost coverage to singles and low-income families, adults 65 and over, disabled people aged 18 to 64, children and others.

When can I register?

  • Anytime until August 15, 2021
  • Those who have lost or will lose their health coverage and those who have experienced eligible life change – like the birth of a child, a divorce or marriage, or a move to Connecticut – can still register after August 15.
  • Those who qualify for HUSKY Health can register at any time, as can Native Americans and Alaska Natives.
Go to the Health CT home page

How do I register?

You apply for coverage and choose your plan at the same time. Once you are approved for a plan, you will need to pay your first monthly premium for coverage to begin. You can pay online or request to receive an invoice by mail. To apply and register:

  • By telephone: Call the Access Health CT call center at 855-805-4325 between 8 a.m. and 5 p.m. Monday through Friday. Support is available in over 100 languages. If you are deaf or hard of hearing, use TTY at 855-789-2428 or contact them with a relay operator.
  • By email: Call the Access Health CT call center at 855-805-4325 to receive the correct application form in the mail.

What is covered and how much will it cost?

Coverage and cost will depend on where you live, the type of plan you choose, your estimated household income, and your age and disability status and that of your family.

If you are eligible for HUSKY Health, you can get free or low cost coverage and not have to worry about premiums or co-payments, depending on your income level.

All Access Health CT plans cover 10 “essential” advantages, comprising:

  • Emergencies and hospitalization
  • Pregnancy, maternity and newborn care
  • Mental health services (including counseling)
  • Chronic disease management and pediatric care
  • Prescription drugs

Insurance companies cannot refuse coverage due to pre-existing conditions. When you apply, you can identify your medical needs and choose a plan that is financially beneficial for you and your family.

All Access Health CT plans cover basic dental services for those 18 and under, including cleanings and exams. HUSKY plans also offer dental coverage for adults. But the adults who want dental coverage must add it to their Access Health CT plan. Deductibles and reimbursable expenses vary from plan to plan; joining a family plan can reduce costs.

What about the new federal assistance for premiums?

Every qualifying household that pays insurance premiums that exceed 8.5 percent of annual income is now eligible for federal tax credits for insurance premiums. For example, a 64-year-old single taxfiler earning $ 51,000 per year could potentially save more than $ 8,000 with the new tax credits, according to the Kaiser Family Foundation.

Are there other financial aids?

Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction (CSR) that would help pay for personal expenses such as deductibles and co-payments. You must sign up for a Silver level plan to get this assistance.

The state is also offering $ 0 health insurance plans for some families thanks to its new Connecticut Covered Program. Under this program, the state pays monthly premiums and cost-sharing amounts (deductibles, co-payments, coinsurance, and maximum fees) for families who have at least one dependent child in the household under the age of 19 years old (children age 18 must be a full-time student in high school) and an annual household income above 160 percent, and up to and including 175 percent of the federal poverty level . Read the full eligibility conditions.

If you’ve received unemployment benefits this year, even for just a week, you can get a premium health coverage option of almost $ 0 / month, thanks to the American Rescue Plan. This grant will be available in July. If you have already received unemployment benefits this year while enrolled in a market plan, you will be able to apply for the additional grants for the months leading up to July when you file your 2021 tax returns. This additional financial assistance will expire at the end of 2021.

What packages are available?

Access Health CT plans are organized in categories:

  • Bronze packages have the lowest monthly premiums and highest deductibles and co-payments, and cover approximately 60 percent of the cost of care. They are designed to help you with serious illness or injury.
  • Silver packages have moderate monthly premiums, deductibles and co-payments. They cover between 70 and 94 percent of the cost of care, depending on the cost-sharing reductions you’re entitled to.
  • Gold packages have higher monthly premiums and lower deductibles and co-payments, and cover about 80 percent of the cost of care.
  • Platinum Packages have the highest monthly premiums and lowest deductibles and co-payments, and cover approximately 90 percent of the cost of care. These are intended for people with significant health care needs who are willing to pay the highest premiums. Currently, there are no platinum plans offered on the Access Health CT marketplace.
  • Catastrophic plans are available to Connecticut residents under the age of 30 or those who have been granted a hardship or affordability exemption from Access Health CT. They offer low premiums and cover three primary care visits per year. You are not eligible for financial assistance for these plans.

Access health scanners Package comparison tool helps you estimate the costs and benefits of various plans and see if you may be eligible for financial assistance.

Access Health CT also offers the Independent Certified Broker Program, which helps clients find a local broker to help them choose a plan or ask questions. You can also call 855-805-4325 to speak to a broker.

What if I already have health insurance?

If you’re already covered by your employer, you can upgrade to an Access Health CT plan until August 15. Income. Premiums should be greater than 9.83% of your household income for single coverage or more than 8.27% for family coverage in order for you to be eligible for tax credits.

If you are covered by a plan outside the exchange, you can also enroll in an Access Health CT plan until August 15. such as deductibles and reimbursable expenses covered, should be postponed. Contact your insurance company to confirm and ask questions about changes to provider networks and prescription drug benefits for Access Health CT plans.

If you get coverage through the 1985 Consolidated Omnibus Budget Reconciliation Act (COBRA) Because you were made redundant or put on reduced hours, you should receive a temporary COBRA premium subsidy that covers 100 percent of the cost of your monthly premium. This premium assistance, made possible by the US bailout, extends until the end of September or the end of your last month of COBRA eligibility, whichever comes first.

If you are on COBRA, you may want to sign up for a market plan that begins as soon as your COBRA coverage ends. If you are not sure whether this change makes sense to you, you can seek free advice from a licensed insurance broker.

Will I need a new doctor?

Perhaps. Not all doctors accept market plans. You can talk to your primary care doctor or use the Package comparison tool to see if a doctor or practice is part of the plan network. You can also consult the websites of the insurers Access Health CT Anthem and ConnectiCare to find covered suppliers.

Will my family members be eligible for the same health insurance plan as me?

It depends. You can register as a family. But in some cases, certain family members may also be eligible for grants or other programs, depending on age, income and disability, or caregiver status.

HUSKY Health plans have their own provider networks, but there is a lot of overlap between their providers and those in Access Health CT plans. This often allows family members with different plans to see the same doctor or health care provider.

This guide, originally published on June 16, was updated on July 29 with new information about the state’s new Covered Connecticut program.

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