Have you lost your health coverage? There are options.
Highlights and links to further information are below. Also, if you want free, expert advice in considering your options in Connecticut, the State Office of the Healthcare Advocate has case managers who can provide free help.
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Check to see if you or your kids qualify for free coverage under HUSKY (Medicaid).
This is excellent coverage, and virtually free if you qualify. There are no premiums and very few out-of-pocket costs, and no annual or lifetime limits. Not all doctors accept this coverage, which is Connecticut’s Medicaid plan. However, you should check with your doctor, because even if they don’t accept new HUSKY patients, they might allow existing patients to use HUSKY. The Affordable Care Act expanded eligibility for HUSKY to households with moderate incomes: for instance, the children in a Connecticut household of four with an income up to $83,172 may qualify for HUSKY B benefits. Your eligibility depends on your income. If you are not eligible for HUSKY, you still may be eligible for subsidized coverage if you buy your own plan through the Access Health CT Exchange You can find more more information about HUSKY here, and OHA can provide help with your decision. To check if you are eligible, you can go to the Access Health CT website.
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Continue with your job-based insurance, if you had coverage through your job.
This option is called COBRA, and one advantage is that it keeps you on the same insurance with the same network of doctors, and most conditions and illnesses are covered (although you probably will have a deductible to pay before insurance kicks in). The insurance companies cannot refuse to cover you, and there will be no annual or lifetime limits. One disadvantage is that the premiums can be expensive. But you may still find this is the best option, especially if you have paid off all or part of your deductible for the year. More information here, and OHA can provide help with your decision.
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Coverage through a spouse, partner or parent
If your spouse or partner's (or parent's, if you are under 26) employer offers health coverage, you will likely have the right to join their plan if you have lost coverage. Your spouse or partner's (or parent's) premiums will likely increase, but the cost may still be less than other options. If they are getting their insurance through work, most conditions will be covered and there will be no annual or lifetime limits. There will probably be a deductible, and you may have to switch doctors.
You can find more information about switching to your spouse or partner's coverage here, and OHA can provide help with your decision.
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Buy your own insurance on or off the Marketplace
This is the Affordable Care Act, or Obamacare. Many people qualify for federal subsidies, but if not, it can be expensive. All the plans have pretty high deductibles, but the coverage is pretty good, and the insurance companies cannot refuse to sell to you. There are no annual or lifetime limits, but you may have to switch doctors.
This insurance is sold through Access Health CT, Connecticut’s official health insurance marketplace where individuals, families & Small Businesses can shop, compare, and enroll in quality healthcare plans from brand-name insurance companies.
If your income is low or moderate (for instance up to $104,000 for a family of four), you may qualify for reduced premiums or deductibles, which are only available through the Access Health CT Marketplace. The Marketplace will also check whether you or anyone in your family is eligible for free Medicaid/HUSKY coverage. (Sometimes one or both parents may have to buy their own insurance, but the kids can get free HUSKY). More information about HUSKY is found in the first section of this page.
You can see more information about individual coverage here, and OHA can provide help with your decision. Access Health CT also provides free help, including referrals to enrollment specialists and certified insurance brokers who can assist with plan selection both on and off the Exchange.
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Learn whether you should enroll in Medicare
Older people and people on dialysis or with certain disabilities may qualify for Medicare. People 65 or over or in other specific groups may qualify for Medicare. Medicare has several choices, and is pretty complicated, so you should seek expert advice before signing up. And you need to be prompt – there are certain penalties if you do not get covered at your first opportunity. You have to pay premiums for Medicare. And, unless you buy additional coverage called MediGap, you will be responsible for 20% of most medical expenses, which can get very costly. There is no cap or limit on your out-of-pocket expenses. One advantage is that almost every doctor in America accepts traditional Medicare. However, not all doctors will be covered if you choose to get your Medicare through a private insurance company through a program called Medicare Advantage. You can find more information about Medicare here, and OHA can provide help with your decision.
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Further information and helpful links
Here are links to additional reliable resources and guides to coverage options and plan selection:
- FamiliesUSA - What You Need to Know about Finding Coverage, Getting Tested, and Getting Care
- HealthInsurance.org - How to Buy Health Insurance Today
- American Prospect - A Guide to the Nightmare of Getting Health Insurance in a Pandemic
- The Commonwealth Fund - Coverage Options for Laid-Off Workers and Others