Connecticut CHOICES Medicare Counseling: Who Answers 1-800-994-9422

Connecticut CHOICES Medicare counseling is free, and one call to 1-800-994-9422 is how you reach a CHOICES counselor in your area.1,2 CHOICES is Connecticut's name for its State Health Insurance Assistance Program (SHIP), the program people with Medicare, their families, and their caregivers can use for clear, unbiased help with health insurance.1 It's the call to make when a parent is about to turn 65, when a specialist's bill comes in higher than Medicare allowed, or when you're weighing drug plans before the fall deadline.

In This Guide

• How Does a CHOICES Call Reach a Counselor Near You?
• What Can a CHOICES Counselor Help You With?
• Can CHOICES Help You Buy or Switch a Medigap Policy?
• Can CHOICES Help You Pay for Medicare in Connecticut?
• Can a Connecticut Doctor Charge More Than Medicare Allows?
• How Do You Get the Most From a CHOICES Call?
• Frequently Asked Questions
• Learn More

How Does a CHOICES Call Reach a Counselor Near You?

CHOICES stands for Connecticut Health Insurance Assistance, Outreach, Information and Referral, Counseling, and Eligibility Screening.1 Because ADS runs CHOICES as a partnership with the five regional Area Agencies on Aging and the Center for Medicare Advocacy, the CHOICES counselor you end up talking with may work through your regional agency rather than a state office.1 ADS says CHOICES offers its services in person, or by phone, email, and other easy-to-use ways.2 That matters if you're helping a parent who can't easily get to an appointment, or if you live out of state and want to sit in by phone.

ADS lists Connecticut's five Area Agencies on Aging as nonprofit planning agencies funded by ADS, and says they may also directly help with information and assistance, case management, and benefits counseling.3 CHOICES' 2027 guide lists each agency with the part of the state it serves:

The two ADS documents agree on four of the five phone numbers. For the Southwestern CT agency in Bridgeport, the ADS Additional Resources page lists 203-814-3698 while the CHOICES guide lists 203-333-9288, so if one doesn't reach the agency, try the other or use the CHOICES helpline.3 When you call a regional agency, ask for CHOICES or Medicare counseling by name, since each agency runs other programs for older adults as well.

What Can a CHOICES Counselor Help You With?

ADS and the CHOICES brochure describe the help in their own words, and the two lists together cover most of what a family runs into in a Medicare year:1,2

Nationally, the Administration for Community Living (ACL), which manages SHIP, says SHIP counselors are trained to help with Original Medicare, Medicare Advantage, Part D, and Medigap, and to help people with limited income apply for Medicaid, the Medicare Savings Program, and Extra Help.1

Notice the verbs. CHOICES helps you sign up and compare, and helps you find out whether you qualify for cost help, but the eligibility decision for those programs belongs to the state agency that runs them. A CHOICES counselor is the person who sits beside you through that process, not the person who approves it.

Can CHOICES Help You Buy or Switch a Medigap Policy?

Yes. CHOICES says Connecticut Medigap plans are community-rated and guaranteed-issue, that rates are the same regardless of age, and that you can enroll in Medigap at any point in the year by contacting the plan directly.4 Connecticut law (Conn. Gen. Stat. Sec. 38a-495c) bars an insurer from issuing a policy based on your age, gender, previous claims history, or medical condition.4

Two limits are worth raising with the counselor before you buy:

• Under 65 with a disability: CHOICES' rate chart says beneficiaries under 65 with a disability may buy Plans A, B, or D (or C if eligible), not the full menu open to applicants over 65.4
• A possible waiting period: Connecticut law lets a policy exclude benefits for a preexisting condition for losses within six months of the start of coverage, and CHOICES notes that an applicant 65 or older without employer health insurance, a Medicare Advantage drug plan, or Medigap coverage within 63 days of enrolling may have that waiting period.4

CHOICES also publishes a Medigap rate and benefit chart, so the counselor can walk through what each insurer charges for the same lettered plan.1 Our Connecticut Medigap guide compares Plan G and Plan N in detail.

Can CHOICES Help You Pay for Medicare in Connecticut?

CHOICES helps you find out whether you qualify for programs that lower costs.1 The main one, the Connecticut Medicare Savings Program, runs on terms more generous than the federal standard.5 The Connecticut Department of Social Services (DSS) says the state has no asset limit for the program, so owning a home or having money in the bank doesn't by itself rule you out.5

Connecticut DSS says all three levels of the Connecticut Medicare Savings Program (QMB, SLMB and ALMB) also enroll you automatically in Extra Help, the federal program that lowers Part D drug costs.5 Connecticut DSS also says not all earned income is counted toward the Medicare Savings Program income limits, so someone whose gross wages sit above a limit should still apply to DSS.5 A CHOICES counselor can help you work out which level fits before you file. Our Connecticut Medicare Savings Programs guide walks through the application.

If someone tells you to apply for ConnPACE, the old Connecticut drug-help program, that door is closed: Public Act 13-234 eliminated ConnPACE effective January 1, 2014.6 For drug costs today, Extra Help is the program to ask CHOICES about.

Can a Connecticut Doctor Charge More Than Medicare Allows?

Sometimes, yes. CHOICES' own fact sheet, "Part B Excess Charges in Connecticut," says Part B excess charges are charges up to 15% above the Medicare-approved rate, and that Connecticut Medicare beneficiaries can be charged them unless they're enrolled in QMB.7 The same CHOICES fact sheet calls it incorrect and misleading when websites say people with Medicare in Connecticut can't be charged Part B excess charges, because that protection applies only to people in the QMB level of the Medicare Savings Program.7

Here's how the charge works. Medicare.gov says providers who don't accept assignment can charge more than the Medicare-approved amount, that in many cases the charge can't be more than 15% above it (the "limiting charge"), and that you might have to pay the full amount at the time of service.7 CHOICES adds three Connecticut-relevant details. Excess charges are most often seen with specialists, such as psychiatrists and other behavioral health providers; there's no 15% limiting charge on durable medical equipment under Part B; and some people who want to see providers who don't take assignment may choose a Medigap policy that covers Part B excess charges.7 A provider who has opted out of Medicare entirely isn't held to the limiting charge at all, and Medicare.gov suggests contacting your SHIP before signing a private contract with one.7

Connecticut law gives you a way to find out in advance. Under Conn. Gen. Stat. Sec. 20-14k, any physician licensed under Connecticut's medicine and surgery chapter must post the office's policy on Medicare assignment in a conspicuous place and inform all eligible persons of that policy before delivering care.7 If you're enrolled in QMB, federal law goes further: it bars Medicare providers from billing you for Part A and Part B cost sharing, including deductibles, coinsurance, and copayments.8 Our guide to Medicare Part B excess charges explains the federal rules.

How Do You Get the Most From a CHOICES Call?

Timing does more than anything else. Medicare Open Enrollment runs October 15 to December 7, and changes take effect January 1.9 If you're already in a Medicare Advantage plan, you get one more change between January 1 and March 31.9 Calling CHOICES in September or early October gives a counselor room to compare plans with you instead of racing the deadline. Our Medicare Open Enrollment guide explains what you can change in each window.

Before the call, gather your Medicare card, any current plan card, a list of your prescriptions with doses, and any bill or notice you have questions about. If you're calling for a parent, ask early whether your parent needs to be on the line, so you don't have to schedule a second call just to get permission.

Learn More

To reach a Connecticut CHOICES counselor, call 1-800-994-9422.1

Find personalized help getting free Medicare counseling through Connecticut CHOICES at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.