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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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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Move to the plan of a spouse, partner, or parent (if you are under 26). Their premiums may go up, but usually if you lose your own insurance, you will have the right to join their plan. If they are getting their insurance through work, the insurance will be pretty good, 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. More information 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. If your income is low or moderate (for instance up to $104,000 for a family of four), you may qualify for reduced premiums. There are no annual or lifetime limits, but you may have to switch doctors. This insurance is sold through the AccessHealthCT website, which will help you check if you are eligible for reduced premiums, or if you or anyone in your family is eligible for Medicaid/HUSKY (sometimes one or both parents may have to buy their own insurance, but the kids can get free HUSKY). More information here, and OHA can provide help with your decision]. AccessHealth 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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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 into the middle class, for instance in Connecticut you qualify if you make up to [give income limits for a single or family of four]. Your eligibility depends on your income. or the website of the state Department of Social Services. More information here, and OHA can provide help with your decision [link]. To check if you are eligible, you can go to the AccessHealthCT website.
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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. More information here, and OHA can provide help with your decision.
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Alternate forms of coverage that may be cheaper but won’t cover a lot. There are certain types of insurance coverage, sometimes called “junk insurance,” that may have cheaper premiums. But these plans, such as association health plans, short-term plans, and healthcare sharing ministries, do not operate like the normal insurance plans described above. They often do not carry the normal Affordable Care Act protections. For instance, they may be free to refuse you coverage, or charge you higher premiums, if you have a pre-existing condition. They may not cover common illnesses, conditions, procedures, or drugs. If you get sick during the year, they may be free to kick you out of the plan at the end of the year. They may have high deductibles, and may have annual or lifetime limits. If something goes wrong, state or federal government like the Connecticut Insurance Department may not have jurisdiction to assist you. All in all, despite the sometimes cheaper premiums, these plans are risky options, and you should consider them only if you 1) are very healthy, and 2) have plenty of cash saved up to pay out-of-pocket expenses if you or a family member do get sick or have an accident. More information here, and OHA can provide help with your decision.
Further information & helpful links
You can download our full health coverage selection document here.
Here are links to additional reliable resources and guides to coverage options and plan selection: