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Questions About Medicare | Medicare Basics

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Medicare Basics and
Answers to Your Questions

Ready to enroll in a Medicare Advantage plan?

What is Medicare?

Medicare is the largest health insurance program in the United States. It is run by the Centers for Medicare & Medicaid Services (CMS), a government agency. Whether you're new to Medicare or already have the basics covered and know what coverage you need, ConnectiCare is here to guide you with information to help you make the right choice.

You can join Medicare if you’re 65 or older and:

You’re a United States citizen or lawfully present in the U.S.
You or your spouse paid Medicare taxes when you worked.

You may also be able to join if you are under 65 and:

You’re a United States citizen or lawfully present in the U.S.
You have certain disabilities or conditions.

What is Medicare?

Medicare Basics

Original Medicare has two parts: Part A (Hospital Insurance) and Part B (Medical Insurance). It is a “fee-for-service” health plan. This means you pay for each service you receive. To better understand Original Medicare, let’s look at what each part covers:

Part A | Hospital Insurance

Medicare Part A covers care you receive when you stay in a hospital (this is called “inpatient” care). It also covers care you get at skilled nursing facilities, home health care, and hospice care. Read More.

Part C | Medicare Advantage Plans

Original Medicare coverage is good, but it can be hard to manage multiple plans, ID cards, bills, and networks. With a Medicare Advantage plan from a private company like ConnectiCare, you can get what you need from a single plan. Read More.

Part B | Medical Insurance

Medicare Part B helps you pay for medical services. These are services like doctor visits, tests, outpatient hospital services, and other like services. Read More.

Part D | Prescription Drug Coverage

How to Get Help Covering Costs

Medicare Savings Programs

If you have limited income and resources, you may be able to get help from your state to pay your Medicare costs. Some of the programs may help to pay your Medicare Part B premium, or some of your costs to get services like deductibles, coinsurance, or copays.

Medicaid

Medicaid is a health plan for low-income and disabled people. Each state runs its own program. The federal government and each state government share the costs of this program. “Dual eligibles” are those that have both Medicare and Medicaid and most health care expenses are covered.

"Extra Help"

Extra Help is a Medicare program to help people with limited income and resources pay Part D drug plan costs. It can help pay monthly premium fees, deductibles, and coinsurance. Are you eligible for “Extra Help”? Read More.

Moving From Individual or Group Coverage Through Access Health CT to a Medicare Plan

Once you qualify for Medicare, you may have a limited time (an initial enrollment period) to sign up. For most people, the enrollment period starts three months before their 65^th birthday and ends three months after their 65^th birthday.

In most cases, it’s to your advantage to sign up for Medicare when you’re first eligible.

Medicare Resource

Brochures

ConnectiCare Medicare Made Simple Guide

Get our Medicare Made Simple Guide — A ConnectiCare guide to help you make the right Medicare decisions.

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CMS Medicare & You Brochure

Helpful information for people eligible for Medicare and their caregivers.

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Helpful Links

Connecticut’s Program for Health Insurance Assistance, Outreach, Information and Referral, Counseling, Eligibility Screening (CHOICES) Call: 800-994-9422 TTY: 711

Official U.S. Government website for people with Medicare General information and helpful tools.

Medicare Rights Center
A national not-for-profit consumer service organization dedicated to making sure that older adults and people with disabilities get affordable health care.

Administration for Community Living
The Administration for Community Living educates people and their caregivers about the benefits and services available to help them.

Phone Numbers

Social Security Administration
800-772-1213 (TTY: 800-325-0778), Monday through Friday, 8 a.m. to 7 p.m.

We're Here for You

If not currently enrolled call 877-224-8221 (TTY: 711)

From Oct. 1 to March 31, you can call us seven days a week from 8 a.m. to 8 p.m. From April 1 to Sept. 30, you can call us Monday through Friday from 8 a.m. to 8 p.m.

Medicare members call 800-224-2273 (TTY: 711)

From Oct. 1 to March 31, you can call us seven days a week from 8 a.m. to 8 p.m. From April 1 to Sept. 30, you can call us Monday through Saturday from 8 a.m. to 8 p.m.

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Last Update: 01/22/2024

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Moving from a Marketplace or SHOP plan to a Medicare Plan

Do You Have Questions? We've Got Answers.

What if I have a Marketplace Qualified Health Plan (QHP) plan but will qualify for Medicare soon?

If you joined a plan through NY State of Health, you can keep your coverage active until your Medicare coverage starts. Then you can cancel your marketplace plan without penalty.

Once you qualify for Medicare, you’ll have a limited time (an initial enrollment period) to sign up. For most people, the enrollment period starts three months before their 65th birthday and ends three months after their 65th birthday.

In most cases, it’s to your advantage to sign up for Medicare when you’re first eligible because:

Once your Medicare Part A (hospital costs) coverage (which is free for most people) starts you won’t be able to keep any premium tax credits or lower out-of-pocket costs for a Marketplace plan based on your income. If you like, you can keep your Marketplace plan too, but you’ll have to pay full price for the Marketplace plan.
If you miss the seven-month sign-up window for Medicare Part B* (doctor costs), you'll have to wait until the next "general enrollment period" which runs from Jan. 1 to March 31 with benefits beginning the following July 1. If you don't sign up for Part B when you're first eligible, you may have to pay a late enrollment penalty.

*(or Part A if you have to pay a premium for it)

Once my coverage in Medicare starts, can my Marketplace Qualified Health Plan (QHP) disenroll me without my consent?

No, your plan may not terminate (end your coverage) you if you are enrolled in Medicare unless you request it.

If I sign up for Medicare, when do I cancel my QHP?

Once your Medicare coverage starts, you can cancel your Marketplace health plan without penalty by contacting the Marketplace call center or cancelling online. If you have Medicare coverage, you’re considered covered under the health care law. You won’t have to pay the fee that some people without insurance must pay. Be sure not to cancel your Marketplace plan before your Medicare coverage begins. Otherwise your coverage may be delayed.

Can Medicare beneficiaries with coverage under SHOP plans delay enrollment in Medicare Part B without penalty?

Yes. A Medicare beneficiary who is enrolled in employer purchased SHOP coverage is treated the same as any other person with employer group health plan coverage. You can delay enrollment if you are covered under an employer’s health plan for you or your spouse current employment.

If you’re covered under an employer’s plan, you can sign up for Part B without penalty:

Any time you are still covered by the plan.
During the eight-month period that begins the month after the employment ends or the coverage ends, whichever happens first.

If you do not sign up during this special enrollment period, late enrollment penalties may apply, and you will only be able to sign up during the General Enrollment Period, which occurs annually from January through March with coverage beginning July 1.

I want to purchase health insurance through the Marketplace. What if I have Medicare?

It’s against the law for someone who knows that you have Medicare to sell or issue you a Marketplace policy.

Medicare isn’t part of the Health Insurance Marketplace, so you don’t need to do anything. If you have Medicare, you’re considered covered. The Marketplace won’t affect your Medicare choices or benefits. No matter how you get Medicare, whether through Original Medicare or a Medicare Advantage Plan (like an HMO or PPO), you won’t have to make any changes.

Why should I join a Medicare Advantage Plan (Part C)?

Medicare Parts A and B offer the most basic Medicare coverage available. To get more complete coverage, you have a number of options, including Medicare Advantage Plans, which offer more benefits than Original Medicare, usually for the same cost. ConnectiCare offers both HMO and PPO plans and most of our plans also offer prescription drug coverage and Original Medicare does not. Plans also offer coverage for eyeglasses, annual checkups, chiropractic care, hearing and dental.

View an ConnectiCare plan in your area.

There are some exceptions and we know that each person’s situation is different. We have representatives to help you with additional information, 800-447-9169 (TTY: 711) October 1 through March 31: 8 am to 8 pm, seven days a week. April 1 through September 30: 8 am to 8 pm, Monday through Friday.

Helpful Resource

Changing from the Marketplace to Medicare - Healthcare.gov provides information for people who are changing to Medicare.

Questions About Medicare | Medicare Basics

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Visit a ConnectiCare Center

Medicare Basics and
Answers to Your Questions

What is Medicare?

What is Medicare?

Medicare Basics

Part A | Hospital Insurance

Part C | Medicare Advantage Plans

Part B | Medical Insurance

Part D | Prescription Drug Coverage

How to Get Help Covering Costs

Moving From Individual or Group Coverage Through Access Health CT to a Medicare Plan

Medicare Resource

Brochures

Helpful Links

Phone Numbers

We're Here for You

Questions About Medicare | Medicare Basics

Popular Tasks

Visit a ConnectiCare Center

Medicare Basics and Answers to Your Questions

What is Medicare?

What is Medicare?

Medicare Basics

Part A | Hospital Insurance

Part C | Medicare Advantage Plans

Part B | Medical Insurance

Part D | Prescription Drug Coverage

How to Get Help Covering Costs

Moving From Individual or Group Coverage Through Access Health CT to a Medicare Plan

Medicare Resource

Brochures

Helpful Links

Phone Numbers

We're Here for You

Medicare Basics and
Answers to Your Questions