What is Health Insurance?

Health insurance is a complex part of the healthcare system in the United States. In order to get the most out your insurance, you need to: 

  • Know your healthcare needs - What services do you use most?
  • Understand plan types - Each works differently
  • Learn key terms - Deductible, copay, coinsurance
  • Set a realistic budget - How much can you afford monthly?Know your rights - What you're entitled to under your plan

Important: No plan covers everything. Even services required to be "free" under the Affordable Care Act may have different rules depending on your specific plan.

It is very important that you receive a copy of your Subscriber Agreement from the insurer. That document, however lengthy, is the contract that specifies all of the terms of your coverage, as well as the responsibilities of all parties, including you and the
insurer

What plan is right for me?

Select the option that best describes your situation

Best for: Most working adults and their families who have access through employers or need individual coverage.

Learn more

Best for: Low-income individuals and families, pregnant women, children, and people with disabilities who meet income requirements.

Learn more

Best for: Adults 65+ and certain younger people with qualifying disabilities or conditions.

Learn more

Connecticut has established Access Health CT (AHCT), the insurance marketplace for Connecticut health insurance.

Learn more

Best for: People who recently lost employer coverage and want to maintain the same benefits and providers while transitioning to new insurance.

Learn more

Best for: Active duty military personnel, military retirees, National Guard and Reserve members, and their eligible family members.

Learn more

Coordination of benefits

Coordination of Benefits (COB) is a provision in most health plans that allows families with two wage earners covered by health benefit plans to receive up to 100% coverage for medical services. COB rules determine which plan is primary for you, your spouse, and your dependent children.

How Coordination of Benefits Works

When you have coverage under two health insurance plans, the coordination processfollows these steps:

Primary Plan Pays First: The primary plan pays your claims as if there were no other insurance. 

Secondary Plan Fills Gaps: Your secondary plan then pays for what your primary plan did not cover, provided it's a covered benefit under the secondary plan.

Learn how coordination of benefits works

Get information for employers

The Office of the Healthcare Advocate offers  resources and assistance to help employers  navigate health insurance options and address employee benefit concerns

Learn About Dual Coverage

Having dual health insurance coverage means  you're covered under two health insurance plans  simultaneously.

Learn About the Birthday Rule

For children covered under both parents' plans, the  "Birthday Rule" determines which plan is primary.

Additional Health Insurance Information

Using preventive care benefits and understanding your bill are two ways you can save money.

Health Insurance Terms

Consumers usually make monthly premium payments to have insurance coverage (or employers do). But what are all those other out of pocket costs we pay when we use our insurance for our health care?

Preventive Care

If you have health insurance coverage, you can probably get free preventive services, with no deductible or other out of pocket expenses

 

Insurance mandates and contract negotiations

It s important to understand the laws and regulations for health insurance.

Health Insurance Mandates

These are laws and regulations that require health insurance plans to cover specific treatments, procedures, services, or health conditions, ensuring consumers have access to essential healthcare and that coverage is comprehensive and consistent

Health Insurance Contract Negotiations

Time and time again, health care insurance and provider contract negotiations threaten to upend the lives of Connecticut residents who are caught in the middle. 

Request OHA assistance

doctor and patient filling out form

Have a question or need help?

To get help from OHA, fill out our online form, send an email, or call us. The quickest way to get help is via email.
  • Call OHA 
    Call: 1-866-466-4446 Our phone lines are staffed Monday through Friday from 8:00 a.m. to 4:30 p.m. by knowledgeable advocates ready to assist with your questions and concerns.
  • Email OHA 
     Email: Healthcare.Advocate@ct.gov Email is often the quickest way to receive assistance. Include your contact information and a brief description of your issue for the fastest response.
  • Release form (PDF) 
    Online Form: Submit Request for Help Complete our online inquiry form and any appropriate authorization forms to initiate the assistance process. An advocate will contact you within 1-2 business days.
  • Appointment of rep. form (PDF) 
    If you have Medicare, fill out a Medicare Representative form.