En español | Most residents of Connecticut are eligible to buy health insurance through Access Health CT, the state’s Affordable Care Act (ACA) marketplace, now that open enrollment has begun. And you might be able to save money on premiums, thanks to expanded federal tax credits in the March coronavirus relief bill and the state’s new Covered Connecticut program.
Most people already enrolled in ACA marketplace plans will also see their premiums go down this year because the recently enacted American Rescue Plan increases tax credits for insurance premiums and expands the number of households who qualify for them. Every household that pays more than 8.5 percent of their household income now qualifies for federal tax credits to help them afford health insurance. Prior to the new law, such tax credits were only available to people making up to 400 percent of the federal poverty level (around $51,000 for one person).
The average American with a marketplace plan can save $50 per month with the new assistance, the federal government says. As of now, this additional federal financial assistance will only be available in 2021 and 2022.
You apply for coverage and choose your plan at the same time. Once you’re approved for a plan, you’ll need to pay your first monthly premium for coverage to begin. You can pay online or ask to receive a bill in the mail. To apply and enroll:
Coverage and cost depend on where you live, the type of plan you choose, your estimated household income and the age and disability status of you and your family.
If you qualify for HUSKY Health, you can get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income.
All Access Health CT plans cover 10 “essential” benefits, including:
Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family.
All Access Health CT plans cover basic dental services for those 18 and younger, including cleanings and exams. HUSKY plans offer dental coverage for adults as well. But adults who want dental coverage must add it to their Access Health CT plan. Deductibles and out-of-pocket costs vary between plans; enrolling in a family plan can cut costs.
Every eligible household that pays insurance premiums that exceed 8.5 percent of annual income now qualifies for federal tax credits for insurance premiums. For example, a single 64-year-old filer earning $51,000 per year could potentially save more than $8,000 with the new tax credits, according to the Kaiser Family Foundation.
Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction (CSR) that would help you pay for such out-of-pocket expenses as deductibles and copays. You must enroll in a Silver-level plan to get this assistance.
The state is also offering $0 health insurance plans for some families through its new Covered Connecticut program. Under this program, the state pays the monthly premiums and the cost-sharing amounts (deductibles, copays, co-insurance and maximum out-of-pocket costs) for families that have at least one dependent child in the household under age 19 (children age 18 must be a full-time student in secondary school) and a household annual income that is greater than 160 percent, and up to and including 175 percent of the Federal Poverty Level. Read the full eligibility requirements.
If you’ve collected unemployment benefits this year, even for just one week, you may qualify for an almost $0/month premium health coverage option, thanks to the American Rescue Plan. This subsidy will become available in July. If you’ve already received unemployment benefits this year while enrolled in a marketplace plan, you’ll be able to claim the additional subsidies for the months prior to July when you file your 2021 tax returns. This extra financial help will expire at the end of 2021.
Access Health CT’s plans are organized into categories:
Access Health CT’s Compare Plans tool helps you estimate costs and benefits of various plans and check whether you might qualify for financial assistance.
Access Health CT also offers the Certified Independent Broker program, which helps customers find a local broker to help with plan selection or questions. You can also call 855-805-4325 to speak with a broker.
If you already have coverage through your employer, you can switch to an Access Health CT plan through Oct. 31. But you may not qualify for tax credits if you opt out of your employer’s plan — unless those premiums exceed a certain portion of your household income. The premiums would need to be more than 9.83 percent of your household income for individual coverage or more than 8.27 percent for family coverage in order for you to qualify for the tax credits.
If you have coverage through a plan that’s outside the exchange you can also enroll in an Access Health CT during open enrollment. If you decide to swap plans but stick with the same insurance provider, any cost-sharing amounts you’ve incurred, such as deductibles and covered out-of-pocket costs, should carry over. Contact your insurance company to confirm and to ask about changes to provider networks and prescription drug benefits for Access Health CT plans.
If you get coverage through the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), you can switch to an Access Health CT plan. The federal government fully subsidized COBRA coverage through to Sep. 30, 2021, but is no longer doing so. If you’re not sure about whether making this switch makes sense for you, you can ask for free advice from a certified insurance broker.
Maybe. Not all doctors accept marketplace plans. You can talk to your primary care physician or use the Compare Plans tool to see whether a doctor or practice is in the plan’s network. You can also check the websites of Access Health CT insurers Anthem and ConnectiCare to search for covered providers.
It depends. You can enroll as a family. But in some cases, some family members may also be eligible for subsidies or other programs, depending on age, income and disability, or caregiver status.
HUSKY Health plans have their own provider networks, but there is a lot of overlap between their providers and those in the Access Health CT plans. This often allows family members on different plans to visit the same doctor or medical provider.
This guide, originally published June 16, was updated on Nov. 1, when Access Health CT's open enrollment period began.
This story is provided by AARP Connecticut. Visit the AARP Connecticut page for more news, events, and programs affecting retirement, health care, and more.
Wednesday, Feb 2, 2022 at 1:00 p.m. Eastern Time
Thursday, Feb 3, 2022 at 1:00 p.m. Eastern Time
Wednesday, Feb 9, 2022 at 7:00 p.m. Eastern Time
JOIN FOR JUST $16 A YEAR