Many Connecticut residents face annual enrollment choices in the fall. For most of us, it feels like we’re just spinning the wheel of chance for our health insurance coverage and payment in the year ahead. For the upcoming plan year, more than ever before, the Office of the Healthcare Advocate hears residents asking – how can we afford health insurance? Or can we afford to not have it? The weight of insurance costs is increasingly unbearable but the idea of going without health insurance is also a terrible burden, with no relief in sight.
Even if you have health insurance – affordable or otherwise - we are given so many confusing choices it seems logical to auto-renew the plan we currently have and ignore the annual opportunity we’re given to review our options and potentially save a lot of money, time, and frustration in the year to come. While it’s tempting to let our health insurance plans renew automatically, this year feels different, because more changes and limitations are coming to our plans in 2026.
Whether you have health plan choices this fall through Medicare, Access Health (the Connecticut marketplace exchange), or an employer, your health may have changed in this past year, or the plan you currently have may be changing next year. Rather than face all the daunting complexities in health care insurance choices, and try to predict our own unknown health care needs in the year ahead, let’s just focus on two important questions you can answer, given what you know as of today:
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Will your current doctors or other health providers be covered in 2026?
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Will your current medications be covered in 2026?
If you find the answer is “no” to either of these questions with your existing plan, and if you have options, at the very least you should look for a plan (or plans) that allow(s) you to answer “yes” to both questions.
How do you answer these 2 important questions, or even find the very best advice and options for you? Here are some recommendations:
If you have Medicare: (Enrollment for January 1, 2026, ends with the final choice you make as of December 7, 2025):
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Best: For free, unbiased, expert, individualized consultation on your insurance options, contact the Connecticut State Health Insurance Assistance Program (SHIP), known in Connecticut as CHOICES, administered through the Area Agencies on Aging. You can make an appointment by calling 1-800-994-9422. CHOICES can also screen you for any cost assistance programs you may be eligible for, including payment of Medicare premiums and out of pocket costs. But don’t wait, individual appointments can fill up as we get closer to the enrollment deadline of December 7.
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Better: Work with a trusted, knowledgeable broker who is licensed to sell all Medicare plans – private Medicare Advantage (MA) plans, Original Medicare supplement (Medigap) plans and Part D prescription drug plans. A broker should have your best interests at heart. How do you know? A rule of thumb: if a broker does not “sell” at least 20% Medicare supplement plans/stand-alone Part D prescription drug plans in their “Medicare book of business”, that’s a red flag that they may be more interested in their commissions than in finding the right plan(s) for you. (Private MA plan commissions are higher for brokers than commissions on Medigap supplement plans, or stand-alone prescription drug plans, but some of us are better off choosing Original Medicare.) Also, if you’re interested in stand-alone dental plans, brokers can help.
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Good: If you feel most comfortable going forward on your own and not seeking outside help, I have 2 pieces of advice:
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Use the Official Medicare.gov Plan Finder Tool Explore your Medicare coverage options to walk you through your best options for hospital/doctor/prescription drug coverages - but Connecticut residents should only use the Plan Finder tool to explore private MA plans or stand-alone prescription drug plans. If you live in Connecticut, do not use the Medicare.gov Plan Finder tool for Medigap supplement plans if you choose Original Medicare coverage. Instead visit the most recent Connecticut Medigap supplement Rate and Benefit Chart at CHOICES. In the case of Medigap supplement plans, they are standardized across insurance carriers so generally choose the least expensive option, call the number on the 2-page resource to sign up, and ask for any available discounts. Many offer a “household” discount, even if you are not related.
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Once you’ve narrowed your possible 2026 Medicare options down to a few, based on your work in the Plan Finder tool and with the Connecticut Medigap rate chart, call your doctor’s business office and ask them for any advice on your remaining choices (insurance plan responsiveness, service, etc.)
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Fair: Talk to your family, friends, neighbors. We all do it and it’s tempting to take their recommendations, but keep in mind that we each have our own personal health journeys, and we each take different medications. An insurance plan that seems best for a close loved one isn’t necessarily the right choice for you, so don’t let that rule your decision.
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Poor: Please don’t ever call the telephone numbers you see on Medicare TV or mailing advertisements. You could be tricked into thinking, “what could it hurt, the call is free, and I could learn something.” But, once you call in, these national call centers have your phone number which equates to your “permission” to hound you relentlessly for a year, or longer. They are slick salespeople and they are only interested in selling plans that give them the highest commissions as quickly as possible. Sometimes they even sign you up for plans you have not chosen, are not available where you live, and have questionable restrictions. There are no Connecticut regulations or guardrails for these options (because they are selling federal plans) and untangling yourself from their talons can be difficult.
Access Health CT Medical and Dental Plans: (Enrollment for January 1, 2026, ends on December 15, 2025. Enrollment for February 1, 2026, ends on January 15, 2026.
Acknowledging the current battle over extending enhanced premium tax credits, for many Connecticut residents, Access Health CT is the only place where you can qualify for financial help to lower your costs, and if eligible, enroll in low or no-cost coverage through HUSKY Health Programs (Medicaid and the Children’s Health Insurance Program (CHIP)) or the Covered CT Program at Access Health CT - CT’s Official Health Insurance Marketplace or 1-855-805-4325. All assistance is free.
Employer Based Health Plans
If you have health insurance through your employer, they are typically customized, with different coverage and different providers. If your employer gives you choices at this time of year for 2026, explore which plan has the most coverage for health providers you see and medications you take for what fits into your affordability tolerance. If you have an option for pre-tax health savings accounts, those may defray your out-of-pocket expenses. Check with your Health Benefits Department.
Help Available from the Office of the Healthcare Advocate