By Trish Pearson
Insure Your Future
Trish Pearson
Open enrollment for Medicare, individual and many group insurance plans falls between October and December for a Jan. 1 effective date. They do not coincide exactly, so it is important to know the schedule for your coverage.
The important dates are Oct. 15 to Dec. 7 for the Medicare annual enrollment period and Nov. 1 to Dec. 15 for induvial insurance coverage for those under 65. Open enrollment for coverage through an employer varies, but for Jan. 1, it is generally between Oct. 15 and Dec. 15.
Medicare: The prevalent changes for this year fall in the area of extra benefits: dental, eyewear allowance and over-the-counter benefits. The impact on actual health benefits – copays, deductible and coinsurance – are minimal.
All Medicare Advantage plans are requiring an up-front deductible for name-brand medications (tier 3 and higher). The deductibles range from $225 to $616 per year. After the deductible, the cost is based on a percentage of the retail price, generally 20-25 percent. It is important to read the annual notice of change sent either through email or regular mail. These notices outline any changes in benefits to your current plan. The out-of-pocket maximum for drug costs in 2025 will be $2,100 per year. If the current plan is no longer a good fit, there may be other options available with other carriers. However, insurance companies are reducing the number of plans.
Individual plan under 65: Both Anthem and ConnectiCare will offer plans on the health exchange in 2026. Open enrollment is Nov. 1 to Dec. 15. Renewal notices will go out in October. Be sure to read the instructions for renewal and what, if any, action you should take. If you are already enrolled through Access Health CT, you may need to take action to renew your health and/or dental insurance plan and see all the financial help available to you. Do not ignore the notices, as coverage can expire Dec. 31.
HUSKY notices are also going out monthly. Some people are no longer eligible for HUSKY, but may be eligible for a plan through the exchange with an advanced premium tax credit or Covered CT. As of this writing, it is unclear if the advanced premium tax credits will be reduced and by how much. As a result, premiums may increase dramatically. If you are not sure about options, contact a broker who is certified on the exchange.
Turning 65 in 2026: It’s not too early to begin planning your Medicare enrollment. It is advisable to enroll in Medicare Part A even if you remain on an employer group plan. It is worth taking the time to compare Medicare options with current coverage to determine if Medicare and a supplemental plan will provide more comprehensive coverage at a lower cost.
Trish Pearson is a licensed independent insurance agent and certified long term care specialist. Contact her at 203-640-5969 or trishpearson281@gmail.com.