Access Health CT is the Connecticut health insurance marketplace. It’s the only place where eligible individuals and families can get financial help paying for health insurance. Open enrollment for 2022 plans has ended. But in some cases, you can enroll in an individual health plan if you qualify for a Special Enrollment Period.
“Metal levels” tell you the average amount the plans pay for covered services. The chart below describes ranges of premiums and out-of-pocket costs for each plan level.
| Metal Level | Premiums | Out-of-Pocket Costs | Plan Pays* |
|---|---|---|---|
| Platinum Plans | Highest | Lowest | 90% |
| Gold Plans | Higher | Lower | 80% |
| Silver Plans | Moderate | Moderate | 70% |
| Bronze Plans | Lowest | Highest | 60% |
*Average amount plan pays for covered services.
The Passage plan puts your health care right where it belongs: between you and your doctor. You must, however, choose a PCP from those who accept Passage plans and get your PCP to refer you to some types of specialists.
This bronze plan waives the deductible for in-network primary care provider (PCP) office visits ($0 copay). Members with this plan must use PCPs who participate in the Passage plan and must get their PCP’s referral to many types of specialists.
Individual & Family In-Network Deductibles: $7,000/$14,000*
Choice plans let you manage your health your way. You may use any of the doctors, hospitals, labs, and facilities in our large network covering Connecticut, and parts of Massachusetts and Rhode Island.
This gold plan has copays for in-network services, including: $20 for primary care provider (PCP) and mental health office visits, $40 for specialist office visits, and $50 for urgent care visits.
Deductible: $1,300 Individual / $2,600 Family
Members with this gold plan have copays for most in-network services, including: $30 for primary care provider (PCP) visits, $50 for mental health and specialist office visits, and $50 for urgent care visits. This plan also includes adult dental coverage.
Deductible: $3,500 Individual / $7,000 Family*
This gold plan has copays for most in-network services, including: $40 for primary care provider (PCP) visits, $60 for mental health and specialist office visits, and 40% coinsurance for urgent care visits.
Deductible: $2,000 Individual / $4,000 Family
This silver plan has copays for most in-network services, including: $40 for primary care provider (PCP) and mental health office visits, $60 for specialist office visits, and $75 for urgent care visits.
Deductible: $4,300 Individual / $8,600 Family
This silver plan for individuals and families who qualify has no deductible. Copays for in-network services include: $10 for primary care provider (PCP) and mental health office visits, $25 for urgent care visits, and $30 for specialist office visits.
Deductible: $0 Individual / $0 Family
This silver plan for individuals and families who qualify has copays for most in-network services, including: $20 for primary care provider (PCP) and mental health office visits, $35 for urgent care visits, and $45 for specialist office visits.
Deductible: $650 Individual / $1,300 Family
This silver plan for individuals and families who qualify features copays for most in-network services, including: $40 for primary care provider (PCP) and mental health office visits, $60 for specialist office visits, and $75 for urgent care visits.
Deductible: $3,950 Individual / $7,900 Family
This bronze plan waives the deductible for in-network primary care provider (PCP) ($45 copay) and mental health office visits ($60 copay). The deductible and copayments do apply to specialist and urgent care visits. This plan also includes adult dental coverage.
Deductible: $6,000 Individual / $12,000 Family*
This bronze plan waives the deductible for in-network primary care provider (PCP) visits ($30 copay) and urgent care visits (50% coinsurance). After meeting the in-network deductible, members with this plan pay $0 copay for mental health office visits, $60 copay for specialist visits.
Deductible: $6,250 Individual / $12,500 Family*
After meeting the in-network deductible, members with this bronze plan pay 20% coinsurance for primary care provider (PCP), specialist, and mental health office visits.
Deductible: $6,500 Individual / $13,000 Family*
This bronze plan has a $50 copay for primary care provider (PCP) and mental health office visits. Specialist office visits have a $70 copay after the in-network deductible is met.
Deductible: $6,550 Individual / $13,100 Family*
This is a plan for people under 30 or who qualify because of financial hardship. It has a $30 copay for the first three (3) primary care provider (PCP) and mental health office visits plus coverage for preventive dental care.
Deductible: $8,700 Individual / $17,400 Family*
With the Compass plan, you can lower your out-of-pocket costs by visiting “preferred” primary care providers (PCPs) and hospitals in the ConnectiCare network. All others are designated as “participating”. You can visit them, too, but you may pay more.
This gold plan waives the deductible for preferred primary care provider (PCP) visits ($20 copay). Mental health and specialist office visits ($60 copay), and urgent care visits ($75 copay) are all waived from the deductible. If you chose to see a participating PCP, you will pay 40% coinsurance after deductible.
Preferred Providers Deductible: $2,000 Individual / $4,000 Family*
Participating Providers Deductible: $3,500 Individual / $7,000 Family *
This gold plan waives the deductible for preferred primary care provider (PCP) visits ($20 copay). Mental health and specialist office visits ($45 copay), and urgent care visits ($75 copay) are all waived from the deductible. If you chose to see a participating PCP, you will pay 40% coinsurance after deductible. This plan does not have out-of-network coverage other than coverage for some emergency services.**
Preferred Providers Deductible: $2,500 Individual / $5,000 Family*
Participating Providers Deductible: $4,000 Individual / $8,000 Family *
New FlexPOS plans offer coverage in Connecticut, Massachusetts, New York through EmblemHealth Prime network and nationally through the First Health® network. These plans offer in-network coverage wherever you go in the United States, plus you have emergency coverage worldwide.**
This platinum plan has copays for in-network services, including: $20 for primary care provider (PCP) and mental health office visits, $30 for specialist office visits, and $50 for urgent care visits.
Deductible: $1,200 Individual / $2,400 Family
This gold plan has copays for in-network services, including: $20 for primary care provider (PCP) and mental health office visits, $40 for specialist office visits, and $50 for urgent care visits.
Deductible: $1,300 Individual / $2,600 Family
This silver plan has copays for most in-network services, including: $40 for primary care provider (PCP) and mental health office visits, $60 for specialist office visits, and $75 for urgent care visits.
Deductible: $4,300 Individual / $8,600 Family
This silver plan for individuals and families who qualify has no deductible. Copays for in-network services include: $10 for primary care provider (PCP) and mental health office visits, $25 for urgent care visits, and $30 for specialist office visits.
Deductible: $0 Individual / $0 Family
This silver plan for individuals and families who qualify has copays for most in-network services, including: $20 for primary care provider (PCP) and mental health office visits, $35 for urgent care visits, and $45 for specialist office visits.
Deductible: $650 Individual / $1,300 Family*
This silver plan for individuals and families who qualify features copays for most in-network services, including: $40 for primary care provider (PCP) and mental health office visits, $60 for specialist office visits, and $75 for urgent care visits.
Deductible: $3,950 Individual / $7,900 Family*
After meeting the in-network deductible, members with this bronze plan pay 20% coinsurance for primary care provider (PCP), specialist, and mental health office visits.
Deductible: $6,500 Individual / $13,000 Family*
Deductible: $6,550 Individual / $13,100 Family*
*Integrated medical and prescription drug deductible.
**Subject to limitations
***Available for individuals and families up to 250% Federal of the Poverty Level. Cost Sharing Reduction (CSR) plans are only available through Access Health CT, and enrollment is limited to those individuals with qualifying income levels based on income and household size. Please visit accesshealthct.com to find out if you are eligible to enroll in a Cost Sharing Reduction Plan, which can reduce the amount you have to pay out of pocket for essential health benefits.
**** Catastrophic plans are available to those under age 30 and those who qualify for certain exemptions through Access Health CT.
Standard plans are the same for all carriers to easily compare options across carriers.
Coverage underwritten by ConnectiCare Benefits, Inc. and ConnectiCare Insurance Company, Inc., not by Access Health CT.
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Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office. Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.
