Connecticut Health & Medical Insurance Plans Rates and Quotes
When a medical or health insurance plan is purchased by an individual or family, it is sometimes referred to as a personal or private health insurance.
When a health plan is purchased as a business or as a sole proprietor, it is referred to as a Business or Group Health insurance plan.
Private or personal medical and health insurance plans usually have a lower price than business or group health insurance plans. One of the reasons for the lower premiums is the health insurance plan can reject people with any health condition and accept only those people they feel they can make a profit with.
Most people who apply for health insurance are rejected, . . . or have the price increased, . . . or are offered a health plan that wont cover your health conditions. (riders or exclusions)
Finding and purchasing the best plan for you and your family is not easy at all.
It is a good idea to find a broker that understands health plans and who will work together with you.
A good broker will contact the underwriter and discuss your situation before submitting your application.
Medical and Health Underwriting
All individual, private, and personal health insurance plans in Connecticut are medically underwritten. This means the health plan will look at your physical and mental health as well as your health history.
Here are some common examples of what some CT Health plans can do:
1. All Connecticut health plans can reject or decline you.
2. Some health plans will rider or exclude coverage on your current health problems or conditions.
3. Some health plans will charge you more for medical insurance if you smoke, have high blood pressure, are overweight, have high cholesterol, ride a motorcycle, and many other reasons.
4. Some health plans and some agents will limit which health insurance plans you will be offered.
5. Some health plans will not insure you if you have not seen a doctor recently.
6. Some health plans will not cover preexisting health conditions.
NOTE: There are many ways you can be denied health insurance in Connecticut. A denial can affect your ability to purchase health or life insurance plans. Be Careful!
Many Kinds and Types of Health Insurance Plans in Connecticut
There are many different types of health plans. There are HMO, PPO, POS network health plans.
Next, there are different kinds of health plans including co pay plans, hospital deductible plans, up front deductible plans, high deductible hospital only plans, qualified high deductible health plans, HSA compatible plans and other hybrid health insurance plans.
It is very hard to keep up with the different kinds and types of health plans.
This is why many insurance agents have stopped offering or have limited which health and medical plans they will offer to their clients.
If you can find an insurance agency that specializes in health insurance in your state, we suggest you consider using them.
They will be more knowledgeable on health plans in CT, and they will usually offer more health plans than an auto insurance agency.
Differences between Connecticut Medical Insurance Plans
When looking at a health insurance plan, look for the differences, not the similarities. There are many differences which are not clearly pointed out by the health insurance plans or brochures.
For example, “a similarity” in many CT Medical insurance plans is preventative care. The medical plan will describe in their brochures that preventive care is “covered”.
What they don’t tell you is that preventative care is covered after the deductible, or that the medical plan limits preventative care to $200 a year. These are the differences.
A major difference in “preventative care” is when it comes to a colonoscopy. A colonoscopy is considered a necessary preventative care by medical providers after age 50. A colonoscopy can easily cost $2800 or more in Conn.
Some health plans consider a colonoscopy to be a surgery. Some consider it preventative care. And some limit preventative care or colonoscopy to $200 per year.
Prescription Drug Coverage
Also if you choose a more expensive drug when a generic drug is available, you may be required to pay the difference between the generic drug and the more expensive drug.
Some health insurance plans in CT will only pay for generic drugs.
There are usually three levels of drugs and co pays.
The first level is generally for Generic drugs. Generics are also referred to as Tier 1 drugs, Preferred Drugs and Generic Drugs.
The second level of drugs are for Name brand drugs. They are also referred to as Tier 2 drugs, Non Preferred Drugs and Name brand drugs.
The third level of drugs are referred to as Tier 3 drugs, Unlisted Drugs and Designer Drugs. These drugs are usually the newest drug on the market.
Here are some differences to look for on Prescription drugs:
1. Some health plans will limit prescription drugs to $500, $1000, $2000, etc.
2. Some plans do not limit prescriptions. Look for the wording “unlimited”
3. Some plans offer a discount prescription card.
4. Some plans allow you to save money by removing the prescription coverage.
5. On some plans, the deductible does not apply to prescription drugs.
6. Some plans prescription drugs are only covered after a drug deductible.
If you do not use prescriptions and are young and healthy, you may want to put limits on drugs or remove that coverage to save money.
Doctor Visits
If your doctor is not in the network you may have to change doctors or pay for that doctor out of your own pocket.
Next, look at the amount of the Doctor’s co pay. Is the doctor co pay before or after the deductible?
Another difference to look for is whether you need a referral to see a specialist?
One other item to look for is that sometimes, those lower priced health plans will limit doctor’s visits to only 2 visits per year. When one’s health needs attention, it is not unusual to have 6 to 10 visits for a health problem.
And some plans do not cover doctor visits outside of a hospital.
Some plans will not cover doctor visits for specific health conditions.
Deductibles within health plans
Health plan deductibles are very different from one company to another company.
And . . . Health plan deductibles are different for each plan within the same health insurance company.
It is very important to review carefully and to make sure you fully understand how the health plan deductible applies to you.
Many people assume that a deductible in one health plan is exactly the same as the next plan. This is a mistake.
Many insurance agents make this mistake also.
OK . . . Here we go . .
Here are some of the differences in Deductibles to look for:
1. With some health plans the deductible applies to the hospital and surgery costs only.
2. And with some plans the deductible applies to all medical costs including prescription drugs!
3. Some medical plans the deductible does not apply to preventative care and or prescriptions.
4. With some medical plans, the deductible depends on whether you have an individual or family plan.
5. Some plans, the deductible is per admission.
6. Some plans, the deductible is per day.
7. Some plans, the deductible is per year.
8. Some plans, the deductible has a maximum per person and or per family.
Important - Please read
Some plans have a deductible that is based on calendar year which would be from January 1st through December 31st.
Some plans have a deductible that is based on a contract or policy year. This could be from June 1st through May 31st. (It is usually based on when you purchased the health plan.)
Important - Please Read
With all Connecticut health plans, the definition of what deductible applies for one person is different based on the type of plan chosen with the same company.
For example, the wording “$2,000 individual deductible / $4,000 family deductible” can mean that a deductible for one person can be $2,000 or $4,000 depending on the type of plan chosen.
The complexities and differences of what the deductible really means to you and your family can adversely affect you at the time of a claim.
Take the time to really find out what that deductible means.
Health Insurance Underwriting in CT
The purpose of underwriting is to find those persons who they feel they can offer health insurance and make a profit on.
This also means they are also looking for persons who they feel are unhealthy and unable to make a profit on.
Understand that the lower the price of a health plan, the healthier the individual and their family must be to be accepted by the health plan.
Connecticut health plans are regulated by the Department of Insurance. The CT Insurance department oversees the health plans to insure that the Connecticut health insurance plans are medically underwriting properly. This keeps the health insurance company financially solvent today and in the future.
A broker can go directly to the health plan underwriter with your health history and get an idea if you will be rejected before you send an application.
So, to avoid being denied, find a broker.
Pricing of Health Insurance
A health plan may reduce the benefits with higher deductibles and other limitations to lower the price.
A health plan can tighten their medical underwriting by only accepting the healthiest individuals in order to lower the price.
A health plan that is new to the market will generally offer lower prices to get people to join. Next year, the prices may increase significantly with hopes you will stay with them.
“The best price in a health insurance plan is to find a plan that pays for your specific medical needs.”
For example
A young man of 20 has no need for a colonoscopy or annual physical. He could find a plan that puts “preventative care” after the deductible or limit the preventative benefits to $200 a year.
A person who uses prescriptions should look for a health plan that pays for prescriptions before the deductible.
Internet Rating Programs - Health Insurance
Internet rating programs are designed to give you the lowest price available. These are teaser rates.
There is nothing in the website rating program that asks you health questions to determine if you are medically eligible to purchase the health plan.
These health insurance rating programs do not ask you what health coverage’s you currently have. This means you have to do all the coverage comparisons by yourself.
Internet rating programs are designed to give an example of the best price available. That’s it!
If you are going to use the internet to get pricing and information, we commend you for trying to understand health insurance plans on your own.
If you are going to do everything on the internet, be prepared to be denied insurance, and to have the rates increased and to have coverage removed.
Health insurance rates are fixed by state law. This means that who ever you use to purchase a health plan, all will have the same price.
The price generally includes 2 to 5% commission for a broker to help you.
It may be to your advantage to take the internet information and set up an appointment with a local broker that specializes in health insurance plans.
Who Does What in a Health Plan
Health Insurance Company
The health insurance company’s job is:
1. to collect premiums
2. pay medical claims
3. Administrative services like issue member ID cards
Health Insurance Brokers
The Insurance Brokers job is to:
1. help you find and keep a health insurance plan.
2. assess your medical needs and help you find a health plan that fits your needs and one that you can afford.
3. At your plan renewal, or when your medical or financial needs change, help you change your current plan, or switch your health plan to another health insurance company.
Who Should You Purchase Your Health Plan From
We feel everyone needs help understanding the differences between health plans.
We feel that you should search for an independent health insurance broker.
1. An independent broker represents many health insurance plans.
2. An Independent broker knows the differences between the different health plans.
3. An Independent broker represents you and your family, and will find the best coverage and pricing from all the health insurance plans in your state.
4. Health insurance pricing includes a small commission for a broker to help you. You do not get a health plan cheaper by going to the company directly.
We feel you should use someone who lives and works in your state.
Here is why:
1. Local brokers know how the health plans pay claims in your state.
2. Local brokers know the doctor networks.
3. Local brokers pay local taxes which support your schools and your children
4. Local brokers create jobs in your state. Outsourcing jobs to companies in other states does not help your local economy.
Employees of Health Insurance Companies
1. Employees of insurance companies are paid to sell you their health plans only.
2. Employees of health insurance plans will not call and review your health plan with you.
3. Employees of health insurance plans will not tell you there is a new plan with a better price for you.
4. Many employees are usually living outside of your state and do not support your school, family, or local economy.
Internet Health Insurance Websites
Some health insurance agencies and health plans market health insurance plans throughout the United States from internet websites.
Many of these websites are located outside of Connecticut.
Here are some things we have found:
1. You will never meet them.
2. They don’t pay local taxes
3. They don’t support local businesses or schools.
4. Doing business with them is outsourcing local jobs.
I hope you have found this helpful. Please do not hesitate to contact me should you have any questions – I would be happy to answer any and all of your insurance questions, without obligation. - Robin Dubord AAI, LUTCF
Connecticut Health and Medical Insurance Companies
All health insurance companiies are approved by the Department of Insurance of the State of Connecticut . The department of insurance looks at the financial papers of these health and medical insurance companies to make sure they have and maintain enough funds to pay claims, and that the company sets aside adequate moneys to pay for future claims. These requirements are done both for personal insurance plans and for business insurance plans.
Connecticut Medical and Health Insurance Plans
Aetna Health and Medical insurance plans in Connecticut
Aetna health and medical and dental insurance plans offered are: Private health insurance plans for individiuals, families and self employed. Aetna Advantage plans and Aetna medicare supplement plans. Aetna Group health plans are offered to small and large businesses in Connecticut.
View Aetna Health insurance plans, rates, and quotes here
Anthem Blue Cross and Blue Shield health and medical insurance plans Ct
Anthem Blue Cross Blue Shield medical and health insurance plans offered in Ct are: Anthem Bluecare, Century Preferred, Lumenos, and Tonik plans for individuals, families and the self employed. Anthem Blue Cross medicare supplement, medigap, and medicare advantage plans are for those who are disabled or over age 65. Anthem Blue Cross and Blue Shield group health plans, dental, for businesses.
View Anthem Blue Cross health insurance plans, rates and quotes here
Celtic Health and Medical Insurance - click here
Connecticare health and medical insurance plans in Connecticut
Connecticare is a health insurance company that serves about 240,000 members in Connecticut. This company has grown in Connecticut and has over 500 employees who reside mainly in Connecticut. Connecticare covers the entire state of Connecticut , as well as western Massachusetts, and some parts of New York. Their network has grown to over 22,000 providers and 85 hospitals. ConnectiCare has ranked #27 out of over 259 health plans by U.S. News & World Report. This was based on NCQA America’s Best Health Plans 2007. These rankings are based annually on the industry standards for clinical quality of prevention and treatment, and customer experience and satisfaction. Connecticare continues to be the highest ranked managed care plan in Connecticut. Michael Wise is the President and CEO.
ConnectiCare health Insurance has been ranked number one for having the best complaint ratio of all the health and medical plans in Ct. These complaint rankings are based on health insurance plans in Connecticut in which justified complaints have been made against Connecticare and recorded by the Connecticut Department of Insurance. In 2008, only twelve complaints against Connecticare were considered justified. This is the 4th consecutive year that ConnectiCare has earned this top honor. These annual complaint rankings are released by the State of Connecticut Department of Insurance based on information from the year 2008.
Connecticare health and medical plans offered are: Connecticare Solo plans for individuals, families, and self employed. Connecticare VIP plans which are medicare advantage plans for those persons disabled or over age 65. Connecticare Group health and dental insurance plans for small and Large businesses. These plans can be HSA, HMO, PPO, Hospital deductible, up front deductible and maternity plans.
View Connecticare health insurance plans, rates, and quotes here
Golden Rule health insurance plans in Connecticut
Golden Rule Insurance offers medical plans in Conn. and they are called: HSA, Copay Plans, UnitedHealthOne, Copay Saver Plans, Copay 100, Copay 80, Copay 100, Plan 100, Plan 80, Saver 80, HSAplans and HSA Saver plans.
View Golden Rule health insurance plans, rates and quotes here
