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 from Nov. 1, 2023, through Jan. 15, 2024.
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 during special enrollment.
Most people enrolled in ACA marketplace plans have seen their premiums go down because the 2021 American Rescue Plan Act (ARPA) increased tax credits for insurance premiums and expanded the number of households that qualify for them. Every household that pays more than 8.5 percent of its income qualifies for federal tax credits to help afford health insurance. These enhanced subsidies are available through 2025.
Before the 2021 law, such tax credits were only available to people earning less than a certain salary ($54,360 for one person). Most Americans with a marketplace plan can save an average of about $800 per year, according to the federal government.
Also, some Connecticut residents that meet specific eligibility requirements are receiving health insurance at no cost because of the state’s Covered Connecticut Program, which has been expanded to include eligible residents without children and now covers dental and non-emergency medical transportation benefits. To find out if you qualify, complete an application online or call 855-805-4325.
Who is eligible for an Access Health CT plan?
- State 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?
Residents are eligible for the Covered Connecticut Program if they:
- Have a household annual income that is no more than 175 percent of the federal poverty level ($23,782.50 for one person or $48,562.50 for a family of four) and don't qualify for Husky Health.
- 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?
- Access Health CT's open enrollment for 2023 health insurance coverage has closed. Open enrollment for 2024 coverage begins on Nov. 1, 2023, and runs through Jan. 15, 2024.
- 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, loss of employer-provided coverage, 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 or the Covered Connecticut Program can enroll anytime, as can American Indians and Alaska Natives.
- If your household income is no more than 150 percent of the federal poverty level ($20,385 for one person or $41,625 for a family of four) you may be eligible for a new special enrollment period allowing you to enroll at any time. Call 1-855-805-4325 to enroll. Coverage starts on the first of the month after enrollment.
How do I sign up?
You apply for coverage and choose your plan at the same time. Once you’ve enrolled, 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 create an account. You can ask general questions through a live chat between 8:15 a.m. and 3:45 p.m. Monday through Friday.
- By phone: Call the Access Health CT call center at 855-805-4325 between 8 a.m. and 5 p.m. Monday through Friday. Assistance is available in more than 100 languages. If you are deaf or hard of hearing, you can 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 open enrollment locations.
- By mail: Call the Access Health CT call center at 855-805-4325 to have the correct application mailed to you.
You can also follow the steps above to apply and enroll in the Covered Connecticut Program.
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
- 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 until 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. Six 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 consider 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. They 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 70 to 94 percent of care costs, depending on whether you qualify for cost-sharing reductions.
- Gold plans have higher monthly premiums and lower deductibles and copays. They cover roughly 80 percent of care costs.
- Platinum plans have the highest monthly premiums and the lowest deductibles and copays. They 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.
- 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 2025.
According to Megan O’Reilly, AARP vice president of government affairs for health and family, subsidy recipients ages 50 to 64 have seen average annual savings of over $950.
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?
If you qualify for this program, the state pays your share of the monthly premiums and any cost-sharing amounts (deductibles, copays, co-insurance and maximum out-of-pocket costs). Eligible participants can sign up at any time but must enroll in a Silver-level plan. Coverage starts on the first of the month following enrollment.
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 qualify for a special enrollment period or are eligible 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 9.12 percent of your household income for individual coverage 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 one. But you’ll also need to wait for open enrollment, unless you qualify for a special enrollment period or 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, may carry over. Contact your insurance company to confirm and to ask about any 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 this fall, unless you experience a qualifying life event or are eligible 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. Apply and select your Access Health CT plan before your COBRA coverage ends if you want 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 Jan. 19, 2023, with information about open enrollment.