Medicare in Connecticut: Plans and Coverage (2026)

Medicare in Connecticut follows federal rules, but the state's Medicare Savings Programs have no asset test and income limits far above the national floor.

This guide covers Medicare in Connecticut for 2026: Parts A and B, Medicare Advantage, Part D, Medigap, the programs that lower the bill, and the free CHOICES counseling service that can help you use all of it.1,2

In This Guide

• Key Takeaways
• Original Medicare: Parts A and B
• Medicare Advantage in Connecticut (Part C)
• Medicare Part D: Prescription Drugs
• Medigap in Connecticut
• Help Paying for Medicare in Connecticut
• Medicare Enrollment Periods
• Free Medicare Help: CHOICES
• Frequently Asked Questions

About these numbers: Premiums and deductibles come from CMS for calendar year 2026, effective January 1. Medicare costs change every year, and CMS publishes the new figures each fall on medicare.gov.3 To talk to a person about your own coverage, call 1-800-MEDICARE (1-800-633-4227), staffed 24 hours a day, 7 days a week except some federal holidays; TTY users call 1-877-486-2048.6 For free help in Connecticut, call CHOICES at 1-800-994-9422.1

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government. The mechanics and costs are the same in Connecticut as in every other state.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.3

The hospital deductible rose $60 from 2025.3 A benefit period starts when you're admitted and ends once you have not received inpatient hospital care or skilled care in a skilled nursing facility for 60 days in a row. That clock can run while you are still in a facility, so someone who drops from skilled to custodial care can begin a new benefit period without leaving. Get care again after that gap and the deductible applies again.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. Original Medicare doesn't cover routine dental, vision, or hearing.3,7

• Monthly premium: $202.90 (higher if your 2024 income was above $109,000 single or $218,000 married, under the income-related adjustment)3
• Annual deductible: $283
• After the deductible: 20% of the Medicare-approved amount for most services

Delay Part B past your enrollment window without qualifying for a Special Enrollment Period or a Medicare Savings Program and you'll owe a permanent late penalty of 10% for every 12 months you could have had it. Creditable drug coverage is the Part D exception, not the Part B one.8

Medicare Advantage in Connecticut (Part C)

Medicare Advantage plans are an alternative to Original Medicare, sold by private insurers. They cover everything Parts A and B cover, except hospice, which Original Medicare keeps covering. Most bundle Part D drug coverage and add extras like dental, vision, and hearing.7

Plan availability varies significantly across the state. The Hartford metro, New Haven, and the Stamford/Fairfield County corridor generally see the widest selection, reflecting those areas' larger insurer networks. Rural eastern Connecticut has fewer plans available. What's actually offered depends on your county and ZIP code, so check the Medicare Plan Finder at medicare.gov to see what's at your address.

How These Plans Work

• You still pay your Part B premium ($202.90) on top of any plan premium. The CMS estimate for the average Medicare Advantage premium in 2026 is about $14 a month, and many plans charge $0 extra. Some plans go further and may help pay part or all of your Part B premium.7
• Plans run on networks (HMO or PPO). Confirm your doctors and hospitals are in-network before you enroll; emergency care, out-of-area urgent care, and temporary out-of-area dialysis are covered in or out of network.7
• Plans may require prior authorization (plan approval) before covering certain services, which Original Medicare generally does not.7
• Every plan caps your annual in-network out-of-pocket spending (federally limited to $9,250 in 2026; many plans set it lower). Original Medicare has no such cap: CMS says there is no yearly limit on what you pay out of pocket unless you have supplemental coverage such as Medigap, Medicaid, employer, retiree, or union coverage.7

A CHOICES counselor can walk through Plan Finder results with you at no cost.

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan alongside Original Medicare, or built into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the coverage gap (the donut hole), so that higher-cost middle stage is gone.4 Part D now moves through three phases:

1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).9
2. Initial coverage: you pay copays or coinsurance while the plan and drug makers split the rest.
3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs for the rest of the year.4

The average standalone Part D premium for 2026 runs roughly $34.50 a month, though actual plan premiums vary widely.3 Every plan also has to offer the Medicare Prescription Payment Plan, which lets you spread your out-of-pocket drug costs into capped monthly payments across the year instead of paying in full at the pharmacy.4 People who qualify for Extra Help pay much less, sometimes nothing.

Medigap in Connecticut

Medigap policies are sold by private insurers to fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work with Original Medicare, and a Medigap policy can't pay a Medicare Advantage plan's copays, coinsurance, deductibles, or premiums.7

Connecticut offers the federally standardized plans (letters A-D, F, G, and K-N), regulated by the Connecticut Insurance Department (CID). Plans C and F are closed to anyone who first became Medicare-eligible on or after January 1, 2020.5 Plan G is the most common choice for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible on you.10

The federal Medigap Open Enrollment Period is the six months that start when you're both 65 and enrolled in Part B. During it, an insurer can't refuse to sell you any of the Medigap policies it offers, can't use medical underwriting to decide on your application, and can't charge you more because you have health problems.10 But Connecticut goes well beyond that federal floor.

Connecticut requires Medigap premiums to be community-rated, and Conn. Gen. Stat. Sec. 38a-495c bars an insurer from issuing a policy based on your age, gender, previous claims history, or medical condition, so a new diagnosis can't be used to deny you or raise your rate. CHOICES, the state's SHIP, describes Connecticut's plans as community-rated and guaranteed-issue, with rates the same regardless of age, and says Medigap enrollment is available at any point in the year by contacting the plan directly. The statute still lets an insurer run its usual and customary underwriting procedures; what it forbids is basing the issue decision on those four factors. One limit to know: a policy may exclude benefits for losses incurred within six months of the effective date because of a pre-existing condition, and CHOICES notes that someone 65 or older who hasn't had employer health insurance, an MA-PD plan, or a Medigap policy within 63 days of enrolling may face that waiting period. For the full picture, see our Connecticut Medigap guide.5

Medigap or Medicare Advantage?

You can't use a Medigap policy to pay a Medicare Advantage plan's copayments, coinsurance, deductibles, or premiums, and while you're in an Advantage plan it's illegal for anyone to sell you Medigap unless you're switching back to Original Medicare. Medigap keeps you on Original Medicare with the freedom to see any provider nationwide who takes Medicare, at a higher monthly premium. Medicare Advantage trades some of that freedom for a network and lower upfront cost. The choice isn't a permanent lock-out: if you join an Advantage plan for the first time, federal law gives you a trial right to buy a Medigap policy and a separate drug plan if you return to Original Medicare within 12 months of joining.7 For a side-by-side look, see Original Medicare vs. Medicare Advantage. For a deeper look at supplement options, see our guide to Medigap.

Help Paying for Medicare in Connecticut

If your income is limited, Connecticut's Medicare Savings Programs can sharply reduce what you owe. Connecticut runs one of the most accessible MSPs in the country.

Connecticut's Medicare Savings Programs: Two Big Advantages

Connecticut administers the Medicare Savings Programs through the Connecticut Department of Social Services (DSS) with two features that separate it from the federal baseline and most other states.2

No asset limit. DSS states that Connecticut does not have an asset limit for its Medicare Savings Programs, so owning a home or holding money in the bank does not by itself disqualify you. Under the federal standard, the resource limit is $9,950 for an individual and $14,910 for a couple; in Connecticut there is no such ceiling to clear.2

Elevated income limits. Connecticut's monthly income thresholds, effective March 1, 2026, are substantially above the federal minimums. Gross income determines which category you fall into, but DSS states that not all earned income, meaning income from wages, is counted toward eligibility. So the figures below are not a wage cutoff: if you are working and your gross pay is over a limit, apply anyway and let DSS do the counting. The table compares Connecticut's limits with the federal ones.2

ALMB stands for Additional Low Income Medicare Beneficiaries, and it is Connecticut's third MSP level, the one above SLMB.2

All three levels pay the Medicare Part B premium and automatically enroll you in the Part D Low-Income Subsidy, also called Extra Help.2 QMB does more than that: it also covers Medicare deductibles and co-insurance up to the Medicaid approved rate, and it pays the Medicare Part A premium for qualified adults 65 or older who are not eligible for premium-free Medicare because of their work earnings. Most people never pay a Part A premium, so that last piece matters only to the small group who owe one.2 Federal law also prohibits providers from billing a QMB enrollee for Medicare cost-sharing.2

ALMB carries two conditions the other two levels do not, and both can decide whether it is open to you. It is subject to available program funding, so it is not guaranteed the way QMB and SLMB are. And a person receiving Medicaid, which Connecticut calls HUSKY, is not eligible for ALMB. DSS also lists having Medicare Part A among ALMB's eligibility requirements.2 Even these raised limits are not a hard cutoff to screen yourself against: states can effectively lift the federal income and resource limits by disregarding certain income and resources, which is exactly what Connecticut has done, so apply rather than rule yourself out.2

To apply, contact CT DSS. CHOICES can help you complete the application.

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources. Since 2024, everyone who qualifies gets the full subsidy.11

• Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple, in the 48 contiguous states and DC (Alaska and Hawaii run higher)11
• Resource limits: $16,590 for an individual, $33,100 for a married couple, or $18,090 and $36,100 if you tell Social Security you expect to use some of your resources for burial expenses11
• If you qualify for Connecticut's QMB, SLMB, or ALMB, you're enrolled in Extra Help automatically2
• QDWI, the Medicare Savings Program for people who lost premium-free Part A after returning to work, pays the Part A premium but does not carry Extra Help with it, so a QDWI enrollee has to apply to Social Security for Extra Help separately2,11

Apply through Social Security at ssa.gov.11 Social Security's national line is 1-800-772-1213 (TTY 1-800-325-0778).12

Medicare Enrollment Periods

Miss a deadline and you face coverage gaps or permanent cost penalties. These periods are federal and identical in Connecticut and every other state.13

Changes made during Annual Open Enrollment take effect January 1 of the following year. If you start collecting Social Security at least four months before you turn 65, you're enrolled in Parts A and B automatically. If not, you sign up through Social Security.13

Working past 65 with employer coverage? You can delay Part B without penalty while that coverage is active. You get an 8-month Special Enrollment Period counted from the month that job or its coverage ends, whichever comes first. COBRA and retiree coverage don't count as current-employer coverage for this purpose, and if you're self-employed or your plan isn't available to everyone at the company, ask your insurer whether it counts as employer group health plan coverage before you delay; if it doesn't, sign up at 65. This Special Enrollment Period does not apply if you're eligible for Medicare based on End-Stage Renal Disease (ESRD).14

Free Medicare Help: CHOICES

You don't have to figure this out alone, and you don't have to pay a broker. Connecticut runs CHOICES, which stands for Connecticut Health Insurance Assistance, Outreach, Information and Referral, Counseling, and Eligibility Screening. It's the state's SHIP program, administered by the Connecticut Department of Aging and Disability Services (ADS). Counselors are trained volunteers who give free, unbiased help and don't sell insurance.1

A CHOICES counselor can help you:

• Understand Parts A, B, C, and D and what each one covers
• Compare Medicare Advantage and Part D plans side by side
• Screen you for MSP, Extra Help, and Medicaid eligibility and help you apply
• Sort out billing questions, claims, and appeals

Call the statewide CHOICES helpline at 1-800-994-9422.1

Who to Call in Connecticut

Learn More

Find personalized help comparing your Medicare plan options in Connecticut 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.