How to Sign Up for ACA Health Insurance in Connecticut

En español | Most residents of Connecticut are eligible to buy health insurance through Access Health CT, the state’s Affordable Care Act (ACA) marketplace, during open enrollment. The most recent open enrollment period ended January 15, 2022, and the next open enrollment period is expected to begin November 1, 2022. 

Residents who experience a qualifying life event, such as a marriage, divorce, the birth of a child, a move or lost health insurance, may be eligible to buy or change coverage outside the open enrollment period. You might be able to save money on premiums, too, thanks to expanded federal tax credits available through 2022 or the state’s Covered Connecticut Program.

Most people already enrolled in ACA marketplace plans have seen their premiums go down because the federal American Rescue Plan Act of 2021 increased tax credits for insurance premiums and expanded 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 be available only through the end of 2022. 

Also, some Connecticut residents that meet specific eligibility requirements are receiving health insurance at no cost thanks to the state’s Covered Connecticut Program. Eligible participants can enroll in this program until June 30, 2022. 

Who is eligible for an Access Health CT plan?

• Residents, including non-U.S. citizens with worker or student visas, are eligible to buy health insurance through Access Health CT, regardless of whether they are currently insured. The incarcerated are not eligible. 

• Some residents may qualify for the state’s HUSKY Health Program, which offers free or low-cost coverage to low-income singles and families, adults 65 and older, individuals 18 to 64 with a disability, children and others. 

Who is eligible for the Covered Connecticut Program?

Connecticut parents and caretakers are eligible for the Covered Connecticut Program if they:

• Have a household annual income that is greater than 160 percent, and up to an including 175 percent of the Federal Poverty Level.
• Have at least one dependent child in the household under age 19; children aged 18 must be full-time students in secondary school.
• Are eligible for financial help, including advance premium tax credits and cost-sharing reductions. 
• Use 100 percent of the financial help available. 
• Are enrolled in an eligible Silver-level Plan. 
  

When can I enroll?

• During open enrollment, which is expected to begin on Nov. 1, 2022.
• You can enroll outside of open enrollment if you experienced a qualifying life event — such as the birth or adoption of a child, a divorce or a marriage, a job loss, or a move to Connecticut. This is called a special enrollment period. You generally have only 60 days from that event to enroll. 
• Those who qualify for HUSKY Health can enroll anytime, as can American Indians and Alaska Natives. 
• Those who qualify for the Covered Connecticut Program can enroll any time before June 30, 2022.  

How do I sign up?

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. Apply and enroll during open enrollment or during a special enrollment period:   

• Online: Go to AccessHealthCT.com and click “Enroll Now.”   
• By phone: Call the Access Health CT call center at 855-805-4325 between 8 a.m. and 5 p.m. Monday to Friday. Assistance is available in more than 100 languages. If you are deaf or hearing impaired, use the TTY at 855-789-2428 or contact them with a relay operator. 
• In person: Visit one of the Access Health CT’s in-person enrollment locations. 
• By mail: Call the Access Health CT call center at 855-805-4325 to have the correct application form mailed to you. 

Apply and enroll in the Covered Connecticut Program:  

• By phone: Call the hotline at 860-241-8478 between 8 a.m. and 4 p.m. Monday to Friday. 

What is covered, and how much will it cost?

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:

• Ambulatory patient services 
• Emergency services 
• Hospitalization  
• Maternity and newborn care  
• Mental health and substance use disorder services (including treatment)  
• Rehabilitative and habilitative services and devices 
• Laboratory services 
• Preventive/wellness services and chronic disease management 
• Prescription drugs 
• Pediatric services, including oral and vision care 

Note that all Access Health CT medical plans include coverage for pediatric dental and vision services for those children, stepchildren and other dependent children through to age 26.  The dental services include preventive and diagnostic services at no cost. Basic, major and orthodontal services are also covered, however, copays or coinsurance may apply. The pediatric vision services include routine eye exams and prescription glasses, however, copays or coinsurance may apply. Adult coverage is not included but can be purchased through a separate stand-alone dental plan; four plans with varying deductibles and out-of-pocket costs are available through Access Health CT.

Also note that the HUSKY Health Program offers dental coverage for adults as well as children. 

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.

What plans are available?

 Access Health CT’s plans are organized into categories: 

• Bronze plans have the lowest monthly premiums and the highest deductibles and copays, and cover roughly 60 percent of care costs. They’re designed to help you in case of serious illness or injury.

• Silver plans have moderate monthly premiums, deductibles and copays. They cover between 70 and 94 percent of care costs, depending on which cost-sharing reductions you qualify for.

• Gold plans have higher monthly premiums and lower deductibles and copays, and cover roughly 80 percent of care costs.

• Platinum plans have the highest monthly premiums and the lowest deductibles and copays and cover roughly 90 percent of care costs. These are for people who have significant health care needs and are willing to pay the highest premiums. Currently, there are no platinum plans offered in the Access Health CT marketplace.

• Catastrophic plans are available to Connecticut residents under 30 or to those who have been granted a hardship or affordability exemption from Access Health CT. They offer low premiums and cover three primary care visits per year. You are not eligible for financial help for these plans.

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. 

How does the federal assistance for premiums work?

Every eligible household that pays insurance premiums that exceed 8.5 percent of annual income qualifies for federal tax credits for insurance premiums through 2022. For example, a single 64-year-old filer who earned $51,000 in 2021 could potentially have saved more than $8,000 with the new tax credits, according to the Kaiser Family Foundation.

Is there any other federal financial assistance available?

Yes. If you qualify for the premium federal 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. 

How does the Covered Connecticut Program work?

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 qualify. Eligible participants must enroll in a Silver-level plan by June 30, 2022. The assistance does not currently have an end date.

What if I already have health insurance?

If you already have coverage through your employer but are eligible for lower premiums, you can switch to an Access Health CT plan, but you'll need to wait until open enrollment, unless you experience a qualifying life event or qualify for the Covered Connecticut Program. Note that 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 9.61 percent of your household income for the lowest cost option for individual coverage in order for you to qualify for the tax credits.
 
If you have insurance directly through an insurance provider but are eligible for lower premiums through a marketplace plan, you can switch to a marketplace plan, but you’ll also need to wait for open enrollment, unless you experience a qualifying life event or qualify for the Covered Connecticut program. Note that if you switch to a marketplace plan but keep 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 marketplace plans.  

If you already have a marketplace plan and want to change your plan, you’ll need to wait until open enrollment, unless you experience a qualifying life event or qualify for the Covered Connecticut program. 

If you lose your COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) coverage, you may be able to sign up for a marketplace plan during a 60-day special enrollment window. Try to apply and select your Access Health CT plan before your COBRA coverage ends to make sure there’s no gap in coverage.  

Will I need to get a new doctor?

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.

Will my family members qualify for the same health plan that I do?

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 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, 2021, was updated on April 25, 2022.

Also of Interest:

• Your ACA checklist
• COVID-19 coverage under the ACA
• Test your knowledge of health care rules
• ACA Out-of-Pocket Max Costs Will Drop in 2022