Covered Connecticut Program

Written by Access Health CT | Published August 6th, 2021 | Updated August 6th, 2021

As of July 1, 2021, some Connecticut residents that meet specific eligibility requirements are paying $0 for their health insurance coverage through Access Health CT, thanks to the new Covered Connecticut Program created by the State of Connecticut.

 

The State of Connecticut will pay the customer’s portion of the monthly payment (premium) directly to their insurance company (Anthem/ConnectiCare), and will also pay for the cost-sharing amounts (deductibles, co-pays, co-insurance and maximum out-of-pocket costs) that customers would normally have to pay with a health insurance plan. 

 

Parents/caretakers, and their tax dependents, must meet the following eligibility requirements to participate in the Covered Connecticut Program:

  • Have a household annual income that is greater than 160%, and up to and including 175% of the Federal Poverty Level (FPL) - see chart below
  • Have at least one dependent child in the household under age 19; Children age 18 must be a full-time student in secondary school
  • Be eligible for Advance Premium Tax Credits (APTCs) and Cost Sharing Reductions (CSRs) 
  • Use 100% of Advance Premium Tax Credits (APTCs) and Cost Sharing Reductions (CSRs) available to them, along with the expanded American Rescue Plan Act (ARPA) financial assistance 
  • Be enrolled in an eligible Silver Level Plan


   

 

Household Size

1

2

3

4

5

6

7

8

160%

$20,416

$27,584

$34,752

$41,920

$49,088

$56,256

$63,424

$70,592

175%

$22,330

$30,170

$38,010

$45,850

$53,690

$61,530

$69,370

$77,210

 


Already enrolled through Access Health CT? We will contact you in early July to make sure you know how to participate the Covered Connecticut Program. Customers must make any necessary plan changes by December 31, 2021 or the end of the Open Enrollment Period to participate and see cost savings.


How to See Savings through the Covered Connecticut Program

New customers

Starting July 1, 2021, any new Access Health CT customer who meets all the Covered Connecticut Program requirements can participate. 

 

You must: 

  • Have a household annual income that is greater than 160%, and up to and including 175% of the Federal Poverty Level (FPL)

 

  • Have at least one dependent child in the household under age 19; Children age 18 must be a full-time student in secondary school

  • Select an eligible Silver Level Plan 

 

  • Use 100% Advance Premium Tax Credits (APTCs) and Cost-Sharing Reductions (CSRs)

 

  • Use newly available financial help through the American Rescue Plan Act of 2021

 

How to get free help or to enroll:

  • Contact your Broker, or

 

  • Call us at 1-855-805-4325 Monday – Friday from 8 a.m. to 5 p.m. If you are deaf or hearing impaired, you may use TTY at 1-855-789-2428 or call with a relay operator

 

Currently enrolled customers

If you are enrolled in a Bronze, Gold or Catastrophic plan, you must:

  • Make plan changes to select an eligible Silver Level Plan by December 31, 2021

 

If you are enrolled in an eligible Silver Level Plan but DO NOT use all financial help available, you must update your application to use:

  • 100% of the APTCs and CSRs available to you and
  • The expanded American Rescue Plan Act (ARPA) financial assistance

If you meet all Covered Connecticut Program requirements: 

  • No action needed from you. We are updating your application, so you get full access to the savings from this program

 

  • New insurance cards will be re-issued by your insurance company. If you need to access your benefits before you receive your new card(s) from your insurance company, please contact them directly for a temporary or digital card

 

  • You will no longer receive monthly premium bills unless there is a balance due 

 

  • If you are charged for healthcare or services by a provider or pharmacy on or after July 1, 2021, contact your insurance company to submit a reimbursement request

 

How to review your current health plan information, premium amount, and financial help:

  • Sign in and view your Customer Summary Dashboard

 

How to get free help:

  • Contact your Broker, or
  • Call us at 1-855-805-4325 Monday – Friday from 8 a.m. to 5 p.m. If you are deaf or hearing impaired, you may use TTY at 1-855-789-2428 or call a relay operator

 

How to make plan changes:

  • Call us at 1-855-805-4325 Monday – Friday from 8 a.m. to 5 p.m. If you are deaf or hearing impaired, you may use TTY at 1-855-789-2428 or call a relay operator

 

 


 

FREQUENTLY ASKED QUESTIONS

 

How will current, eligible Access Health CT customers be notified about the new Covered Connecticut Program?

Access Health CT will be notifying eligible customers about their eligibility and actions required to benefit from the Covered Connecticut Program through email and direct mail. 

 

What types of health care or services will be covered through this program? 

All health care and services must be medically necessary and covered by the health insurance plan to be paid by the State of Connecticut. 

 

Will eligible customers really have $0 premium and $0 cost-sharing plans through the Covered Connecticut Program?

Yes! The State of Connecticut will pay the customer portion of the premium (monthly payment) and all out-of-pocket expenses (what you pay for a covered healthcare service) that customers were previously responsible for paying under their health insurance plan through Access Health CT. 

 

Is the newly available financial help offered only through Access Health CT?

Yes. This is the reason why many who buy plans “off-exchange” or are uninsured/underinsured should come and shop, compare and enroll as the newly available financial help is available only through the marketplace. 

 

When will the new program take effect?

The law is effective July 1, 2021. Depending on when you enroll, your health insurance plan may have a different effective date.

 

Should I contact a broker or my broker?  

If you want advice about whether to change plans or for selecting a plan if you are new to Access Health CT, you should speak to your broker to review your options and your needs. If you do not have a broker you can find one here.

 

What is the American Rescue Plan Act of 2021?

The American Rescue Plan Act (ARPA), signed into law on March 11, 2021, by President Biden has made health insurance coverage more affordable and accessible for many Connecticut residents during the current health crisis, by virtually eliminating or vastly reducing monthly payments (premiums) for many people with low and moderate incomes who enroll through Access Health CT; and providing new financial help for people with somewhat higher incomes who can face high premiums.

 

If eligible customers do not elect to use all APTCs available to them, will they still benefit from the Covered Connecticut Program?

No. Customers that want to participate in the Covered Connecticut Program must elect to use all APTCs available to them. Depending on the customer’s current application status and preferences, they may not have elected to use all APTCs available to them. Access Health CT will communicate with customers who have not updated their accounts but may benefit from the Covered Connecticut Program changes. 

 

If I am already paying a very low premium, should I take any action?

Probably. Many customers are already enrolled in plans that cost nearly $0 per month. But with the Covered Connecticut Program, they may be eligible for a plan with no premium (monthly payment) and no out-of-pocket expenses (what you pay for covered healthcare services).

 

How do I estimate my household income? 

Please include all estimated income for 2021, and disclose any unemployment benefits, including any supplemental payments. Any Stimulus Payments do not need to be included in annual income. 

 

Do I need to verify any of my household information after I enroll?  

Maybe. Access Health CT attempts to verify all reported information with third-party sources. If we are unable to verify some of your information, we will contact you to request your verification of certain specific information. You should always make sure you have accurately listed your annual household income and that you provide verification if requested to make sure you are receiving the correct amount of financial assistance during the year. Always remember to make updates to your income and other information right away if there are any changes during the year.

 

Are American Indians and Alaska Natives eligible for the Covered Connecticut Program?

Yes. 

 

When can eligible Covered Connecticut Program participants expect a new health insurance card?

You can expect a new insurance card from your insurance company in approximately one week. Contact your insurance company if you need a temporary card before you receive the new insurance card. If you are charged for any cost-sharing while seeking medical care or services or visiting a pharmacy, you can contact your insurance company to submit a reimbursement request. 

 

What if I already paid my July premium (monthly payment) to my insurance company?

Your insurance company will reimburse you.

 

Can I be reimbursed for premium (monthly payment) or cost-sharing amounts (deductibles, co-pays, co-insurance, and maximum out-of-pocket costs) I incurred before July 1, 2021?

No. The Covered Connecticut Program starts July 1, 2021. You are responsible for balances due for your portion of the premium and for care or services before July 1, 2021.

 

Can I still qualify if my income isn’t the same every month?

Yes. The Covered Connecticut Program income requirements are based on annual income, which must be greater than 160%, and up to and including 175%, of the FPL. If you experience a change in income, you must report it immediately. 

 

What else should I keep in mind?

Application details like household size and estimated income will impact the financial help you may be eligible for through Access Health CT. It is important to report any changes as soon as possible. Remember that updates to your application could result in changes to the type of coverage you may select.