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.
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. For the most current figures, contact Medicare at 1-800-633-4227 or CHOICES at 1-800-994-9422.
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.
| Cost | Amount |
|---|---|
| Monthly premium | $0 for most people (40+ quarters of work history) |
| Hospital deductible | $1,736 per benefit period |
| Hospital coinsurance, days 61-90 | $434 per day |
| Lifetime reserve days | $868 per day |
| SNF coinsurance, days 21-100 | $217 per day |
The hospital deductible rose $60 from 2025. A benefit period starts when you're admitted and ends 60 days after discharge. Get readmitted 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. It doesn't cover routine dental, vision, or hearing.
- Monthly premium: $202.90 (higher if your 2024 income was above $109,000 single or $218,000 married, under the income-related adjustment)
- Annual deductible: $283
- After the deductible: 20% of the Medicare-approved amount for most services
Delay Part B past your enrollment window without other creditable coverage and you'll owe a permanent late penalty of 10% for every 12 months you could have had it.
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.
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.
- Plans run on networks (HMO or PPO). Confirm your doctors and hospitals are in-network before you enroll.
- Plans typically require prior authorization for certain services, which Original Medicare generally does not.
- 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.
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. Part D now moves through three phases:
- Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
- Initial coverage: you pay copays or coinsurance while the plan and drug makers split the rest.
- Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs for the rest of the year.
The average standalone Part D premium for 2026 is about $46.50 a month, though actual plan premiums vary widely. 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. People who qualify for Extra Help pay much less, sometimes nothing.
Not sure which Part D plan fits your prescriptions? Chat with Brevy's care navigator at brevy.com.
Medigap in Connecticut
Medigap policies are sold by private insurers to fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work only with Original Medicare, not with Medicare Advantage.
Connecticut offers the federally standardized plans (letters A through 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. 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.
Your strongest opening is the federal Medigap Open Enrollment Period, the six months that start when you're 65 and enrolled in Part B. During that window an insurer must sell you any plan at the standard rate, no health screening. Outside it, Connecticut insurers may use medical underwriting.
Connecticut has no confirmed birthday rule or other state-specific guaranteed-issue protections beyond the federal baseline. If you're shopping Medigap outside your open-enrollment window, verify current CID rules before applying.
Medigap or Medicare Advantage?
You can't hold both. 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. 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.
No asset test. Connecticut does not review assets when deciding MSP eligibility. Under the federal standard, the resource limit is $9,950 for an individual and $14,910 for a couple. In Connecticut, your savings, a car, or a second account don't factor in at all.
Elevated income limits. Connecticut's income thresholds are substantially above the federal minimums. The table below compares them for 2026.
| Program | CT Individual | CT Couple | Federal Individual | What it pays |
|---|---|---|---|---|
| QMB | Up to $2,196.51 | Up to $2,972.99 | Approx. $1,350 | Part B premium + deductibles + coinsurance |
| SLMB | Up to $2,404.71 | Up to $3,254.79 | Approx. $1,616 | Part B premium |
| ALMB (= federal QI) | Up to $2,560.86 | Up to $3,466.14 | Approx. $1,816 | Part B premium |
Connecticut labels its version of the federal QI program "ALMB" (Additional Low-Income Medicare Beneficiary). The benefit is the same: it pays the Part B premium.
QMB is the most generous tier. It covers your Part B premium plus deductibles and coinsurance, and federal law prohibits providers from billing a QMB enrollee for Medicare cost-sharing. Enrolling in any of these programs automatically qualifies you for Extra Help with Part D.
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.
- Income limit (2026): up to about $1,995 a month for an individual, $2,705 for a couple
- Resource limits: $16,590 for an individual, $33,100 for a married couple
- If you qualify for Connecticut's QMB, SLMB, or ALMB, you're enrolled in Extra Help automatically
Apply through Social Security at ssa.gov or call 1-800-772-1213.
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.
| Period | Dates | What you can do |
|---|---|---|
| Initial Enrollment | 7 months around your 65th birthday | Sign up for Parts A, B, D; choose MA or Medigap |
| Annual Open Enrollment | Oct 15 - Dec 7 | Switch MA plans, move between MA and Original Medicare, change Part D |
| MA Open Enrollment | Jan 1 - Mar 31 | Switch MA plans or drop MA for Original Medicare (if already in MA) |
| General Enrollment | Jan 1 - Mar 31 | Sign up for Part B if you missed your initial window |
| Medigap Open Enrollment | 6 months from age 65 + Part B | Buy any Medigap plan at the standard rate, no health screening |
Changes made during Annual Open Enrollment take effect January 1 of the following year. If you're already receiving Social Security before 65, you're enrolled in Parts A and B automatically. If not, you sign up through Social Security.
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 after it ends. COBRA and retiree coverage don't count as current-employer coverage for this purpose.
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.
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.
Frequently Asked Questions
Most people pay $0 for Part A. The standard Part B premium is $202.90 a month with a $283 annual deductible. Part D premiums vary by plan (average about $46.50 a month), and many Medicare Advantage plans charge no extra premium. Your total depends on the plan you pick and the care you use.
No. Connecticut does not review assets when determining MSP eligibility. The federal standard imposes a resource limit of $9,950 for an individual and $14,910 for a couple. In Connecticut, those limits don't apply. Income is the only test.
Connecticut's 2026 income limits are far above the federal floor. QMB covers individuals earning up to $2,196.51 a month, versus roughly $1,350 under the federal baseline. SLMB goes up to $2,404.71 (versus about $1,616 federally), and ALMB (Connecticut's QI equivalent) reaches $2,560.86 (versus about $1,816). That means many middle-income Connecticut residents who wouldn't qualify under federal rules can still get help paying their Part B premium through SLMB or ALMB.
An individual with monthly gross income at or below $2,196.51 qualifies for QMB in 2026 (couples up to $2,972.99), with no asset test. QMB pays your Part B premium plus all Medicare deductibles and coinsurance. Federal law bars providers from billing you for that cost-sharing. Apply through CT DSS.
CHOICES (Connecticut Health Insurance Assistance, Outreach, Information and Referral, Counseling, and Eligibility Screening) is Connecticut's free Medicare counseling service, administered by the Department of Aging and Disability Services. Counselors help with plan comparisons, MSP and Extra Help applications, and billing issues. Call 1-800-994-9422.
The best time is during your federal Medigap Open Enrollment Period: the six months starting when you're both 65 and enrolled in Part B. During that window, an insurer must sell you any plan at the standard rate without reviewing your health. Outside it, Connecticut insurers may use medical underwriting. Connecticut has no confirmed birthday rule or extra guaranteed-issue window beyond the federal baseline, so timing matters.
Learn More
- Connecticut Medicare Supplement (Medigap): year-round guaranteed issue
- Medicare: The National Guide
- Original Medicare vs. Medicare Advantage
- How Medigap Works
- Medicare Part D Drug Coverage
- Medicare Enrollment Periods
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.