Connecticut is one of the smallest states, yet it has been a source many firsts in United States history. Of course it was a fixture in colonizing and founding the nation, but it also saw the first hamburger, Polaroid camera, color television, helicopter and submarine. Known for historical preservation, Yale, its rocky coastal destinations, as well as major corporations, there is much packed into this New England state. The residents of Connecticut have access to a number of dependable health insurance companies (some of which are headquartered locally). These include Aetna, Cigna, Blue Cross Blue Shield of Connecticut, Connecticare, and UnitedHealth. To compare the pricing of plans available from each of these insurers, enter your zip code below and get a quote. For quotes from Anthem Blue Cross Blue Shield of CT, you will need to go to our Anthem page.
Connecticut is a very healthy state to live in for various reasons, and UnitedHealth Foundation ranked it #3 for overall health in 2011. Positive contributors to the state’s ranking include a low (and decreasing) population of smokers, less obesity compared to most other states (though the number of obese individuals has increased over the years), and higher access to immunizations. Deaths caused by heart disease are slightly less frequent in Connecticut than the U.S. average, and there is a low percentage of uninsured residents.
Public health funding is average in Connecticut, providing $73 per individual, compared to the top state for public health funding, which had $244 per person. Levels of air pollution are moderate, which also lends negatively to the state’s health outlook. Despite some negatives, there are more positives and it looks as though the population of Connecticut is taking advantage of health insurance and the health care system. In terms of nutritious eating and physical activity, there can be some improvements made, which would decrease the levels of obesity, and alleviate many other health complications.
Health Insurance Plans
- Open Access Managed Choice PPO plans are available in two types: Individual PPO and Value. These plans also come with optional benefits to add on, such as unlimited primary care visits and dental coverage. With both Value and standard PPO plans, you have preventive care covered in full from the day your plan starts, as well as a copay for doctor’s office visits. Services available for a rate of coinsurance after your deductible has been met include emergency care, specialist visits, outpatient surgery, and hospital admission to name a few.
- Open Access Managed Choice High Deductible plans are as described, with a variety of high deductibles to choose from, and also are eligible for opening a health savings account (HSA). These plans have a comprehensive set of benefits, with no charge after deductible on most major medical care, such as physician’s office visits, inpatient and outpatient hospital services, lab work and surgery. Preventive care including Pap tests, mammograms, immunizations and routine physicals are covered immediately at 100%. The funds from your HSA can either be grown and saved for future use, or used to pay for your deductible or care your plan doesn’t cover.
- Open Access Managed Choice Preventive & Hospital Care plans are for individuals who do not expect to use their health insurance on a regular basis, but like to have a back-up in case of emergency. With these plans, preventive care is covered in its entirety as soon as your plan starts, and after your deductible has been met, you can receive care for 20% coinsurance. These are PPO plans, which gives you the freedom of using in-network providers for a lower rate or out-of-network if that is your preference.
Anthem Blue Cross Blue Shield of Connecticut
- Premier plans are PPOs, which connect members to Anthem’s preferred network of providers, or give you the option of using the non-network providers of your choosing. Doctor’s office visits (in-network) are available for a $30 copay with a primary care doctor, or $40 for a specialist as soon as your plan starts. Another perk of PPO plans is you do not need referrals or a primary care doctor to facilitate your care, so you have freedom with your health care. There are prescription drug coverage options, as well as preventive care covered at 100%. After you meet your deductible, many types of care will be available for either 20% or 0% coinsurance at the time of service.
- SmartSense plans are also part of the Anthem PPO network, with a more limited set of benefits for a lower monthly rate. These plans offer the first three doctor’s office visits for a $30 copay before deductible. There are several coinsurance levels to choose from: 50, 70, or 100%. After you meet your deductible, your SmartSense plan will cover the amount you select on in-network services such as outpatient surgery, hospitalization, and emergency room care. There are also discounts available on services like acupuncture, massage therapy and fitness club memberships.
- Lumenos HSA plans are high deductible plans with the ability to open a health savings account (HSA). With these plans you can save funds for future use such as retirement or emergency, or put the money towards your deductible. The funds in your HSA are tax-advantaged, so they will not be taxed when you use them for qualified medical expenses. These plans offer a comprehensive level of coverage, with many services available for no cost after you meet the deductible. You also have the option of seeking in or out-of-network care, so your health care is truly in your control.
- CelticSaver HSA plans are qualified high deductible health plans with a variety of options for deductibles, and two types of plans to choose from: PPO or Managed Indemnity. With both types of plans, there is no lifetime maximum, and preventive care is covered at 100% immediately. Many services are covered after deductible with these plans, including doctor’s office visits, prescription drugs, psychiatric care, hospitalization, rehabilitation, home health care, and more. With your HSA, you have the option of paying for medical costs or saving for the future and receiving income tax breaks.
- CelticCare Preferred plans are available in three types, including Any Doc PPO, Select PPO, and Managed Indemnity. These plans connect you with Celtic’s preferred network of providers, and have either 80 or 100% coinsurance coverage options. After you meet your deductible, Celtic will pay the amount you choose on hospital care, emergency and ambulance services, and more. Non-preventive office visits will cost $15 for the first two visits, and prescription drug benefits are optional, but will provide a $5 copay for generics. Incentive programs are also available for those who use programs to improve physical health, and those who have quit using tobacco.
- Open Access plans are PPOs with the choice of $1,000, $2,000, $3,000 or $5,000 in-network deductibles for individuals. All of these plans have 80/20 coinsurance, and once your deductible has been met, your plan will cover 80% of the total cost of qualified medical services. Some of the services covered include lab, X-ray, ultrasounds, physician services, office visits, cardiac rehabilitation, and emergency care. There is a broad range of coverage available with Open Access plans, and there are a variety of monthly premium choices to fit your budget. There is also a dental coverage option for Open Access plans from Cigna.
- Health Savings plans are high deductible plans with the capability of connecting a health savings account.These plans cover most medical expenses at 100% after you meet the deductible, including office visits to primary care doctors and specialists, inpatient services, and outpatient care. Many other services are also covered, such as retail and home delivery pharmacy services. Health Savings plans are rich in benefits and give you control over your health care spending with tax-free funds. Preventive care is always covered in full from the day your plan begins.
- High Deductible plans are available from UnitedHealthOne (UnitedHealth Care’s individual insurance) in three types: Plan 100, Plan 80 and Saver 80, which means you can either have your plan cover 80 or 100% of your health care costs after deductible. Plan 100 is the most comprehensive coverage option, with more services available for no cost after you meet your deductible in exchange for higher premiums. Both Plan 100 and Plan 80 have coverage for doctor’s office visits and prescriptions, while the Saver plan does not, due to its low premiums. High deductible plans all cover preventive care at 100% before deductible.
- Copay plans have set prices for qualified medical care, which makes them basic and easy to use. You can choose either 80 or 100% coinsurance coverage, and expect a higher premium cost. When your plan becomes effective, you have the ability to receive preventive care for no cost, and visit a primary care doctor for a flat rate. Also, prescription drugs are available for $15 for generics, and $30-40 for brand names with the Copay 100 and 80 plans. These plans have high deductibles, and a select number of covered benefits after deductible.
- Health Savings Account plans come with 100% in-network coverage on most major medical services after having met your deductible, and the ability to pair your plan with an HSA. Funds from the HSA can be used to pay for qualified health care costs, including your deductible, coinsurance, and services your plan does not cover (though there shouldn’t be many). Premiums are lower due to the high deductible, which can be either $1,900, $2,900, $3,500 or $5,000 for individuals in Connecticut. Preventive care is covered in full as soon as your plan begins.
Public Health Options
The state of Connecticut has a variety of state-funded programs for individuals who need medical assistance. This includes Connecticut residents who are disabled, have a low income, are elderly, have cancer, or are simply uninsured. Through the Department of Public Health, there are specialized educational and assistance services for individuals with diabetes, cancer, arthritis, heart disease, HIV/AIDs, and more. For a full list of services they provide, visit their site. The Department of Social Services administers Medicaid, HUSKY (children’s health insurance coverage) and other divisions of medical assistance. To read the complete set of programs offered, visit the Connecticut Department of Social Services site.
Charter Oak Health Plan: a health plan for uninsured adults of any income level in the state of Connecticut, including preventive care, emergency room, hospital care, doctor’s office visits, prescription medications, and more
Medicaid: medical coverage for pregnant women, children, families, those who are blind, disabled, or elderly, and other groups in need of health care assistance
HUSKY (Healthcare for UninSured Kids and Youth): access to health care for child residents of Connecticut without health insurance
ConnPACE: a service that provides qualifying elderly or disabled individuals with assistance in paying for many prescription medications to those who are not eligible for Medicare
Connecticut Aids Drug Assistance Program (CADAP): helps individuals with HIV/AIDS pay for medications proven to extend their lifespan once infected
ConnMAP: the Connecticut Medicare Assignment Program, which regulates the cost of services to those enrolled in Medicare
Health Insurance Laws
Regulations for health insurance in Connecticut are somewhat more helpful and protective of the consumer than other states. Pre-existing conditions are defined by insurance companies by an objective standard, which means the applicant has received care for a qualifying condition (which can be anything from acne to cancer) before they enrolled in health insurance. Insurance companies can still deny an individual a policy based on a pre-existing condition, or they can accept and issue an exclusion period of up to one year maximum. Exclusion periods are a length of time when the insurance company will not pay for any treatment related to your condition. It is also still permitted for Connecticut insurers to give individuals with pre-existing conditions an elimination rider with their plan, which permanently exempts the insurer from covering any care for the condition.
The state of Connecticut does have an alternative for individuals who have been turned down or overcharged for health insurance, called the Pre-Existing Condition Insurance Plan. These plans work similarly to a regular private insurance policy, with monthly premiums and deductibles, but specifically for adults with pre-existing conditions. Individuals who have been decided as high-risk by insurance underwriters have the ability to apply for these plans, which offer medical care such as doctor’s office visits, prescription medications, and hospital care.
Under the Affordable Care Act, insurers will be required from January 1, 2014 onward to issue health plans to adults with pre-existing conditions. This has already been implemented with children under the age of 19 with such conditions. Not only will insurance companies not be allowed to deny individuals a plan, but the use of elimination riders and exclusion periods will also be made illegal. Though many insurance companies and states fear that this will get too expensive, the overall goal of the ACA is to make health insurance available to those who need it, affordable and fair.
Guaranteed renewability (part of HIPAA) is another law that insurers abide by, which states that once an individual is insured, they must be able to renew the same plan for another year when their term is over. This also helps the insured keep their coverage. Once you have insurance, if you acquire an illness your plan cannot be canceled.