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120-day Special Enrollment Period
Written by Yessenia Milan | Last published at: October 25, 2023
Residents affected by the Medicaid Unwinding: AHCT will offer a 120-day ‘Medicaid
Unwind’ Special Enrollment Period (SEP) for eligible individuals who lose HUSKY Health
coverage on or after April 1, 2023. Under this SEP, eligible applicants will have up to 120 days
to enroll in new health and/or dental insurance coverage after their loss of HUSKY Health
coverage. An applicant's coverage effective date will be the first day of the month following plan
selection.
More Information:
•
Medicaid Unwinding
•
Special Enrollment Periods
•
Verification Documents
|
What is the main topic of this document?
|
120-day Special Enrollment Period
Written by Yessenia Milan | Last published at: October 25, 2023
Residents affected by the Medicaid Unwinding: AHCT will offer a 120-day ‘Medicaid
Unwind’ Special E
|
120-day Special Enrollment Period
Written by Yessenia Milan | Last published at: October 25, 2023
Residents affected by the Medicaid Unwinding: AHCT will offer a 120-day ‘Medicaid
Unwind’ Special Enrollment Period (SEP) for eligible individuals who lose HUSKY Health
coverage on or after April 1, 2023. Under this SEP, eligible applicants will have up to 120 days
to enroll in new health and/or dental insurance coverage after their loss of HUSKY Health
coverage. An applicant's coverage effective date will be the first day of the month following plan
selection.
More Information:
•
Medicaid Unwinding
•
Special Enrollment Periods
•
Verification Documents
|
Who is mentioned in the document?
|
120-day Special Enrollment Period
Written by Yessenia Milan | Last published at: October 25, 2023
Residents affected by the Medicaid Unwinding: AHCT will offer a 120-day ‘Medicaid
Unwind’ Special E
|
120-day Special Enrollment Period
Written by Yessenia Milan | Last published at: October 25, 2023
Residents affected by the Medicaid Unwinding: AHCT will offer a 120-day ‘Medicaid
Unwind’ Special Enrollment Period (SEP) for eligible individuals who lose HUSKY Health
coverage on or after April 1, 2023. Under this SEP, eligible applicants will have up to 120 days
to enroll in new health and/or dental insurance coverage after their loss of HUSKY Health
coverage. An applicant's coverage effective date will be the first day of the month following plan
selection.
More Information:
•
Medicaid Unwinding
•
Special Enrollment Periods
•
Verification Documents
|
What are the key takeaways from this text?
|
120-day Special Enrollment Period
Written by Yessenia Milan | Last published at: October 25, 2023
Residents affected by the Medicaid Unwinding: AHCT will offer a 120-day ‘Medicaid
Unwind’ Special E
|
About the IRS Tax Penalty
Written by Yessenia Milan | Last published at: November 25, 2024
For Tax Year 2020, the penalty or fee for not having health insurance coverage is $0.
For Tax Years 2018 and earlier, individuals without coverage during those years may be subject
to a penalty. This penalty is also known as the “Individual Responsibility Payment.”
If you did not have healthcare coverage in 2018, the Internal Revenue Service (IRS) may charge a
penalty when you file your federal tax return. The State of Connecticut does not charge a penalty for
not having healthcare coverage.
The IRS reviews the number of months out of the tax year that you didn’t have coverage, and
charges a penalty based on those months if they exceeded three months total.
The penalty amount can vary. The IRS calculates the total amount for the year that you owe for
months you were not covered. You will pay 1/12th of the total amount for the year for each month you
and/or members of your tax household were not covered.
The easiest way to avoid a penalty is to get coverage. Many types of coverage count to help you
avoid a penalty from the IRS. These include plans offered through your employer, plans available
through Access Health CT and other individual market plans, HUSKY (Medicaid), Medicare, the
Children’s Health Insurance Plan (CHIP or HUSKY B), VA Care or Tricare.
|
What is the main topic of this document?
|
About the IRS Tax Penalty
Written by Yessenia Milan | Last published at: November 25, 2024
For Tax Year 2020, the penalty or fee for not having health insurance coverage is $0.
For Tax Years 2018 and
|
About the IRS Tax Penalty
Written by Yessenia Milan | Last published at: November 25, 2024
For Tax Year 2020, the penalty or fee for not having health insurance coverage is $0.
For Tax Years 2018 and earlier, individuals without coverage during those years may be subject
to a penalty. This penalty is also known as the “Individual Responsibility Payment.”
If you did not have healthcare coverage in 2018, the Internal Revenue Service (IRS) may charge a
penalty when you file your federal tax return. The State of Connecticut does not charge a penalty for
not having healthcare coverage.
The IRS reviews the number of months out of the tax year that you didn’t have coverage, and
charges a penalty based on those months if they exceeded three months total.
The penalty amount can vary. The IRS calculates the total amount for the year that you owe for
months you were not covered. You will pay 1/12th of the total amount for the year for each month you
and/or members of your tax household were not covered.
The easiest way to avoid a penalty is to get coverage. Many types of coverage count to help you
avoid a penalty from the IRS. These include plans offered through your employer, plans available
through Access Health CT and other individual market plans, HUSKY (Medicaid), Medicare, the
Children’s Health Insurance Plan (CHIP or HUSKY B), VA Care or Tricare.
|
Who is mentioned in the document?
|
About the IRS Tax Penalty
Written by Yessenia Milan | Last published at: November 25, 2024
For Tax Year 2020, the penalty or fee for not having health insurance coverage is $0.
For Tax Years 2018 and
|
About the IRS Tax Penalty
Written by Yessenia Milan | Last published at: November 25, 2024
For Tax Year 2020, the penalty or fee for not having health insurance coverage is $0.
For Tax Years 2018 and earlier, individuals without coverage during those years may be subject
to a penalty. This penalty is also known as the “Individual Responsibility Payment.”
If you did not have healthcare coverage in 2018, the Internal Revenue Service (IRS) may charge a
penalty when you file your federal tax return. The State of Connecticut does not charge a penalty for
not having healthcare coverage.
The IRS reviews the number of months out of the tax year that you didn’t have coverage, and
charges a penalty based on those months if they exceeded three months total.
The penalty amount can vary. The IRS calculates the total amount for the year that you owe for
months you were not covered. You will pay 1/12th of the total amount for the year for each month you
and/or members of your tax household were not covered.
The easiest way to avoid a penalty is to get coverage. Many types of coverage count to help you
avoid a penalty from the IRS. These include plans offered through your employer, plans available
through Access Health CT and other individual market plans, HUSKY (Medicaid), Medicare, the
Children’s Health Insurance Plan (CHIP or HUSKY B), VA Care or Tricare.
|
What are the key takeaways from this text?
|
About the IRS Tax Penalty
Written by Yessenia Milan | Last published at: November 25, 2024
For Tax Year 2020, the penalty or fee for not having health insurance coverage is $0.
For Tax Years 2018 and
|
¿Access Health CT ofrece un plan catastrófico?
Written by Yessenia Milan | Last published at: April 26, 2023
Los planes catastróficos solo están disponibles para personas menores de 30 años o para
aquellos a quienes se les otorgó una exención por dificultades o asequibilidad de Access
Health CT. No puede obtener ayuda financiera para pagar los planes Catastróficos.
Estos planes tienen primas mensuales bajas y brindan el nivel más bajo de cobertura, pero
tienen gastos de bolsillo más altos que otros tipos de planes.
Cuando complete una solicitud de cobertura, verá los planes catastróficos enumerados como
una opción solo si califica para ellos. Si no califica, no los verá como una opción para
seleccionar. Solo Access Health CT puede otorgar una exención por dificultades o
asequibilidad para comprar un plan catastrófico. Haga clic aquí para descargar la solicitud y las
instrucciones sobre cómo completar el formulario.
¿Este plan es para ti?
Puede ser una buena opción para las personas que desean protegerse de los peores
escenarios, como enfermarse o lesionarse gravemente, pero usted pagará la mayoría de los
gastos médicos de rutina. Estos planes tienen primas mensuales bajas, pero también tienen
deducibles altos (su deducible es el monto que paga por los servicios de atención médica
cubiertos antes que su plan de seguro comience a pagar). Su deducible no se aplicará a sus
primeras 3 visitas de atención primaria, pero debe alcanzar el deducible del plan para todos los
demás servicios cubiertos antes que el plan brinde cobertura. Después de gastar el monto
del deducible, su compañía de seguros paga todos los servicios cubiertos,
sin copago ni coseguro. Si califica para créditos fiscales para la prima en función de los
ingresos de su hogar, no se pueden aplicar a un plan Catastrófico. Es posible que desee
considerar un plan Bronce o Plata, que puede ser mejor valor. Asegúrese de comparar.
Para obtener más información sobre los tipos de planes que puede obtener a través de Access
Health CT, haga clic aquí.
|
What is the main topic of this document?
|
¿Access Health CT ofrece un plan catastrófico?
Written by Yessenia Milan | Last published at: April 26, 2023
Los planes catastróficos solo están disponibles para personas menores de 30 años o para
|
¿Access Health CT ofrece un plan catastrófico?
Written by Yessenia Milan | Last published at: April 26, 2023
Los planes catastróficos solo están disponibles para personas menores de 30 años o para
aquellos a quienes se les otorgó una exención por dificultades o asequibilidad de Access
Health CT. No puede obtener ayuda financiera para pagar los planes Catastróficos.
Estos planes tienen primas mensuales bajas y brindan el nivel más bajo de cobertura, pero
tienen gastos de bolsillo más altos que otros tipos de planes.
Cuando complete una solicitud de cobertura, verá los planes catastróficos enumerados como
una opción solo si califica para ellos. Si no califica, no los verá como una opción para
seleccionar. Solo Access Health CT puede otorgar una exención por dificultades o
asequibilidad para comprar un plan catastrófico. Haga clic aquí para descargar la solicitud y las
instrucciones sobre cómo completar el formulario.
¿Este plan es para ti?
Puede ser una buena opción para las personas que desean protegerse de los peores
escenarios, como enfermarse o lesionarse gravemente, pero usted pagará la mayoría de los
gastos médicos de rutina. Estos planes tienen primas mensuales bajas, pero también tienen
deducibles altos (su deducible es el monto que paga por los servicios de atención médica
cubiertos antes que su plan de seguro comience a pagar). Su deducible no se aplicará a sus
primeras 3 visitas de atención primaria, pero debe alcanzar el deducible del plan para todos los
demás servicios cubiertos antes que el plan brinde cobertura. Después de gastar el monto
del deducible, su compañía de seguros paga todos los servicios cubiertos,
sin copago ni coseguro. Si califica para créditos fiscales para la prima en función de los
ingresos de su hogar, no se pueden aplicar a un plan Catastrófico. Es posible que desee
considerar un plan Bronce o Plata, que puede ser mejor valor. Asegúrese de comparar.
Para obtener más información sobre los tipos de planes que puede obtener a través de Access
Health CT, haga clic aquí.
|
Who is mentioned in the document?
|
¿Access Health CT ofrece un plan catastrófico?
Written by Yessenia Milan | Last published at: April 26, 2023
Los planes catastróficos solo están disponibles para personas menores de 30 años o para
|
¿Access Health CT ofrece un plan catastrófico?
Written by Yessenia Milan | Last published at: April 26, 2023
Los planes catastróficos solo están disponibles para personas menores de 30 años o para
aquellos a quienes se les otorgó una exención por dificultades o asequibilidad de Access
Health CT. No puede obtener ayuda financiera para pagar los planes Catastróficos.
Estos planes tienen primas mensuales bajas y brindan el nivel más bajo de cobertura, pero
tienen gastos de bolsillo más altos que otros tipos de planes.
Cuando complete una solicitud de cobertura, verá los planes catastróficos enumerados como
una opción solo si califica para ellos. Si no califica, no los verá como una opción para
seleccionar. Solo Access Health CT puede otorgar una exención por dificultades o
asequibilidad para comprar un plan catastrófico. Haga clic aquí para descargar la solicitud y las
instrucciones sobre cómo completar el formulario.
¿Este plan es para ti?
Puede ser una buena opción para las personas que desean protegerse de los peores
escenarios, como enfermarse o lesionarse gravemente, pero usted pagará la mayoría de los
gastos médicos de rutina. Estos planes tienen primas mensuales bajas, pero también tienen
deducibles altos (su deducible es el monto que paga por los servicios de atención médica
cubiertos antes que su plan de seguro comience a pagar). Su deducible no se aplicará a sus
primeras 3 visitas de atención primaria, pero debe alcanzar el deducible del plan para todos los
demás servicios cubiertos antes que el plan brinde cobertura. Después de gastar el monto
del deducible, su compañía de seguros paga todos los servicios cubiertos,
sin copago ni coseguro. Si califica para créditos fiscales para la prima en función de los
ingresos de su hogar, no se pueden aplicar a un plan Catastrófico. Es posible que desee
considerar un plan Bronce o Plata, que puede ser mejor valor. Asegúrese de comparar.
Para obtener más información sobre los tipos de planes que puede obtener a través de Access
Health CT, haga clic aquí.
|
What are the key takeaways from this text?
|
¿Access Health CT ofrece un plan catastrófico?
Written by Yessenia Milan | Last published at: April 26, 2023
Los planes catastróficos solo están disponibles para personas menores de 30 años o para
|
Advance Premium Tax Credit Disclaimer
If you enroll in a Qualified Health Plan (QHP) and you are eligible for advance payments of the Premium
Tax Credit (APTC) you can choose to use the full amount to reduce your monthly premium OR take less
by using the scale in the disclaimer below. The sliding scale appears in the disclaimer below.
You Should Know:
Those who take less APTC may be eligible to receive the remaining tax credit as a refund based on
the actual Modified Adjusted Gross Income (MAGI) reported on their federal Income tax return.
If you actual annual income could be higher than what you listed in your application, you can select
to receive a smaller APTC amount. To select a smaller APTC amount, move the slider to the left (see
example below).
The IRS ultimately decides who receives repayment of tax credits and how much they receive.
Access Health CT cannot guarantee payment of any remaining APTC when you file your federal tax
return.
For additional information about the tax provisions of the Affordable Care Act (ACA), click here.
|
What is the main topic of this document?
|
Advance Premium Tax Credit Disclaimer
If you enroll in a Qualified Health Plan (QHP) and you are eligible for advance payments of the Premium
Tax Credit (APTC) you can choose to use the full amoun
|
Advance Premium Tax Credit Disclaimer
If you enroll in a Qualified Health Plan (QHP) and you are eligible for advance payments of the Premium
Tax Credit (APTC) you can choose to use the full amount to reduce your monthly premium OR take less
by using the scale in the disclaimer below. The sliding scale appears in the disclaimer below.
You Should Know:
Those who take less APTC may be eligible to receive the remaining tax credit as a refund based on
the actual Modified Adjusted Gross Income (MAGI) reported on their federal Income tax return.
If you actual annual income could be higher than what you listed in your application, you can select
to receive a smaller APTC amount. To select a smaller APTC amount, move the slider to the left (see
example below).
The IRS ultimately decides who receives repayment of tax credits and how much they receive.
Access Health CT cannot guarantee payment of any remaining APTC when you file your federal tax
return.
For additional information about the tax provisions of the Affordable Care Act (ACA), click here.
|
Who is mentioned in the document?
|
Advance Premium Tax Credit Disclaimer
If you enroll in a Qualified Health Plan (QHP) and you are eligible for advance payments of the Premium
Tax Credit (APTC) you can choose to use the full amoun
|
Advance Premium Tax Credit Disclaimer
If you enroll in a Qualified Health Plan (QHP) and you are eligible for advance payments of the Premium
Tax Credit (APTC) you can choose to use the full amount to reduce your monthly premium OR take less
by using the scale in the disclaimer below. The sliding scale appears in the disclaimer below.
You Should Know:
Those who take less APTC may be eligible to receive the remaining tax credit as a refund based on
the actual Modified Adjusted Gross Income (MAGI) reported on their federal Income tax return.
If you actual annual income could be higher than what you listed in your application, you can select
to receive a smaller APTC amount. To select a smaller APTC amount, move the slider to the left (see
example below).
The IRS ultimately decides who receives repayment of tax credits and how much they receive.
Access Health CT cannot guarantee payment of any remaining APTC when you file your federal tax
return.
For additional information about the tax provisions of the Affordable Care Act (ACA), click here.
|
What are the key takeaways from this text?
|
Advance Premium Tax Credit Disclaimer
If you enroll in a Qualified Health Plan (QHP) and you are eligible for advance payments of the Premium
Tax Credit (APTC) you can choose to use the full amoun
|
• Take advantage of key in-network preventive care visits, which
are covered 100% and can help you stay healthy
• Use in-netw
• Save money with generic drugs and mail-order programs
• Call your insurance company directly with questions or to learn
more about resources available to you
• Always pay your premiums on time to avoid coverage delays
or lapses
After You Enroll
After you enroll in healthcare coverage through Access Health CT, you’ll receive additional materials from us
and from your insurance company (materials may vary depending on the plan you choose). To stay organized,
check off each item below as you receive it from us.
Questions about your coverage?
Access Health CT does not have access to that information.
Anthem:
1-855-738-6644
Anthem.com
Get the most from your healthcare coverage
Start by choosing a primary care doctor from your insurance company’s provider directory, and
schedule your annual checkup. Make sure you:
When
From
What
about 3 days after enrolling
Access Health CT and your insurance
company will each mail you a separate letter.
Your insurance company will send you a bill
is due and how to pay it.
about 5–10 days after enrolling
about 1–2 weeks after you
available any day, 24/7
Your insurance company’s website:
Anthem.com
ConnectiCare.com
HuskyHealthCT.org
First Bill
Pharmacy and
Doctor Directories
ID Card
You may be asked to provide proof of your income (such as a recent pay stub), identity
(such as a driver’s license or passport), and immigration status (such as visa documents)
Important note:
Learn more about managing your account after enrollment at AccessHealthCT.com/manage-your-account
AccessHealthCT.com | Follow us on:
Your insurance company; they can help you
find in-network pharmacies, primary care
physicians, specialists, and hospitals to
help save money.
ConnectiCare Benefits, Inc. &
ConnectiCare Insurance Company, Inc.:
1-800-251-7722
ConnectiCare.com
Department of Social Services,
Husky Health Member Services:
1-800-859-9889
HuskyHealthCT.org
Confirmation Letter
|
What is the main topic of this document?
|
• Take advantage of key in-network preventive care visits, which
are covered 100% and can help you stay healthy
• Use in-netw
• Save money with generic drugs and mail-order programs
• Call your insu
|
• Take advantage of key in-network preventive care visits, which
are covered 100% and can help you stay healthy
• Use in-netw
• Save money with generic drugs and mail-order programs
• Call your insurance company directly with questions or to learn
more about resources available to you
• Always pay your premiums on time to avoid coverage delays
or lapses
After You Enroll
After you enroll in healthcare coverage through Access Health CT, you’ll receive additional materials from us
and from your insurance company (materials may vary depending on the plan you choose). To stay organized,
check off each item below as you receive it from us.
Questions about your coverage?
Access Health CT does not have access to that information.
Anthem:
1-855-738-6644
Anthem.com
Get the most from your healthcare coverage
Start by choosing a primary care doctor from your insurance company’s provider directory, and
schedule your annual checkup. Make sure you:
When
From
What
about 3 days after enrolling
Access Health CT and your insurance
company will each mail you a separate letter.
Your insurance company will send you a bill
is due and how to pay it.
about 5–10 days after enrolling
about 1–2 weeks after you
available any day, 24/7
Your insurance company’s website:
Anthem.com
ConnectiCare.com
HuskyHealthCT.org
First Bill
Pharmacy and
Doctor Directories
ID Card
You may be asked to provide proof of your income (such as a recent pay stub), identity
(such as a driver’s license or passport), and immigration status (such as visa documents)
Important note:
Learn more about managing your account after enrollment at AccessHealthCT.com/manage-your-account
AccessHealthCT.com | Follow us on:
Your insurance company; they can help you
find in-network pharmacies, primary care
physicians, specialists, and hospitals to
help save money.
ConnectiCare Benefits, Inc. &
ConnectiCare Insurance Company, Inc.:
1-800-251-7722
ConnectiCare.com
Department of Social Services,
Husky Health Member Services:
1-800-859-9889
HuskyHealthCT.org
Confirmation Letter
|
Who is mentioned in the document?
|
• Take advantage of key in-network preventive care visits, which
are covered 100% and can help you stay healthy
• Use in-netw
• Save money with generic drugs and mail-order programs
• Call your insu
|
• Take advantage of key in-network preventive care visits, which
are covered 100% and can help you stay healthy
• Use in-netw
• Save money with generic drugs and mail-order programs
• Call your insurance company directly with questions or to learn
more about resources available to you
• Always pay your premiums on time to avoid coverage delays
or lapses
After You Enroll
After you enroll in healthcare coverage through Access Health CT, you’ll receive additional materials from us
and from your insurance company (materials may vary depending on the plan you choose). To stay organized,
check off each item below as you receive it from us.
Questions about your coverage?
Access Health CT does not have access to that information.
Anthem:
1-855-738-6644
Anthem.com
Get the most from your healthcare coverage
Start by choosing a primary care doctor from your insurance company’s provider directory, and
schedule your annual checkup. Make sure you:
When
From
What
about 3 days after enrolling
Access Health CT and your insurance
company will each mail you a separate letter.
Your insurance company will send you a bill
is due and how to pay it.
about 5–10 days after enrolling
about 1–2 weeks after you
available any day, 24/7
Your insurance company’s website:
Anthem.com
ConnectiCare.com
HuskyHealthCT.org
First Bill
Pharmacy and
Doctor Directories
ID Card
You may be asked to provide proof of your income (such as a recent pay stub), identity
(such as a driver’s license or passport), and immigration status (such as visa documents)
Important note:
Learn more about managing your account after enrollment at AccessHealthCT.com/manage-your-account
AccessHealthCT.com | Follow us on:
Your insurance company; they can help you
find in-network pharmacies, primary care
physicians, specialists, and hospitals to
help save money.
ConnectiCare Benefits, Inc. &
ConnectiCare Insurance Company, Inc.:
1-800-251-7722
ConnectiCare.com
Department of Social Services,
Husky Health Member Services:
1-800-859-9889
HuskyHealthCT.org
Confirmation Letter
|
What are the key takeaways from this text?
|
• Take advantage of key in-network preventive care visits, which
are covered 100% and can help you stay healthy
• Use in-netw
• Save money with generic drugs and mail-order programs
• Call your insu
|
Access Health CT Glossary
Written by Roberto Blundo | Last published at: May 08, 2024
Glossary
acuerdo de reembolso de salud
Las cuentas de reembolso de salud son planes de salud grupales financiados por el empleador,
de los cuales los empleados son reembolsados libres de impuestos para los gastos médicos
calificados hasta un monto fijo en dólares por año. Los montos no utilizadas pueden ser
renovados para ser utilizadose en años posteriores. El empleador financia y es propietario de la
cuenta.
Affordable Care Act (ACA)
(also known as the Patient Protection and Affordable Care Act or Obamacare) and is the
landmark health reform legislation signed into law in March 2010. Key provisions are intended to
extend coverage to millions of uninsured Americans, implement measures that will lower health
care costs and improve system efficiency, and eliminate industry practices that include rescission
and denial of coverage due to pre-existing conditions.
Agent
An agent is a state-licensed individual or entity representing one or more insurance companies.
An agent solicits and facilitates the sale of insurance contracts or policies and provides services
to the policyholder on behalf of the insurer.
Agente
Un agente es una persona o entidad con licencia estatal que representa a una o más compañías
de seguros. Un agente solicita y facilita la venta de contratos o pólizas de seguro y brinda
servicios al titular de la póliza en nombre del asegurador.
Agente de seguros
Un agente de seguros es un representante legal autorizado del titular de la póliza, que negocia
con una compañía de seguros en nombre de un cliente. La compañía de seguros le paga una
comisión.
Annual Limit
A limit on the benefits your health plan will pay in a year. Limits are sometimes placed on
particular services, such as prescriptions or physical therapy treatments. They can also be placed
on the dollar amount or on the number of visits. After an annual limit is reached, you must pay all
related health care costs for the rest of the year.
año calendario
1 de enero - 31 de diciembre
APTC
also known as Advanced Premium Tax Credits. The credit amount will be paid directly to the
insurance company from the federal government. The individual pays the difference between the
credit and the plan's premium.
Authorized Representative
An authorized representative is a person who has been designated in the Exchange to act on
someone else’s behalf.
Beneficios esenciales de salud
Todos los planes de salud calificados (QHP en inglés) que se ofrecen a través de Access Health
CT brindan el mismo conjunto de 10 beneficios esenciales de salud. Los beneficios pueden
costar más o menos en diferentes planes en diferentes niveles, puede estar seguro de que todos
los planes brindarán: 1. Servicios preventivos y de bienestar y manejo de enfermedades crónicas
2. Servicios pediátricos 3. Servicios ambulatorios para pacientes (atención ambulatoria que
recibe sin hospitalización) 4. Cobertura de la sala de emergencias 5. Hospitalización (como
cirugía) 6. Atención de maternidad y del recién nacido (atención antes y después del nacimiento
de su bebé) 7. Servicios de salud mental y abuso de sustancias, incluido el tratamiento de salud
conductual (incluye asesoramiento y psicoterapia) 8. Cobertura de medicamentos prescritos 9.
Servicios y dispositivos de rehabilitación y habilitación (servicios y dispositivos para ayudar a las
personas con lesiones, discapacidades o afecciones crónicas a obtener o recuperar habilidades
mentales y físicas) 10. Cobertura de servicios de laboratorio
Broker
A broker is a licensed legal representative of the policyholder, who negotiates with an insurance
company on behalf of a customer but is paid a commission by the insurance company.
Calendar Year
January 1 - December 31
Catastrophic Plans
Catastrophic plans are available to people younger than 30 years old or to those who have been
granted a hardship or affordability exemption. You are not eligible to get financial help to pay for
catastrophic plans. These plans have low monthly premiums and provide the lowest level of
coverage. Catastrophic plans offer protection when healthcare costs near or reach annual-of-
pocket cost maximums.
Centers for Medicare and Medicaid Services (CMS)
Centers for Medicare and Medicaid Services (CMS) is the federal agency responsible for
administering Medicare, Medicaid, State Children's Health Insurance, Health Insurance Portability
and Accountability Act, Clinical Laboratory Improvement Amendments, and several other health-
related programs. CMS also establishes standards for healthcare providers that must be complied
with in order for providers to meet certain certification requirements.
Centro de Servicios de Medicare y Medicaid (CMS en inglés)
El Centro de Servicios de Medicare y Medicaid (CMS) es la agencia federal responsable de
administrar Medicare, Medicaid, el seguro médico para niños (CHIP en inglés), la Ley de
Responsabilidad y Portabilidad del Seguro de Salud, las Enmiendas para mejorar los
Laboratorios Clínicos y varios otros programas relacionados con la salud. El Centro de Servicios
de Medicare y Medicaid también establece estándares para los proveedores de atención médica,
los cuales deben cumplirse para que los proveedores cumplan con ciertos requisitos de
certificación.
Children’s Health Insurance Program (CHIP)
CHIP is an insurance program funded by state and Federal government that provides health
insurance to children in low-income households. In Connecticut, this program is referred to as
HUSKY B.
Claim
A claim is a request for payment that you or your health care provider submits to your health
insurer when you get items or services.
Cobertura acreditable
La cobertura acreditable es cualquiera de los siguientes planes: plan de salud grupal, plan de
salud individual, plan de salud para estudiantes, Medicare, Medicaid, CHAMPUS y TRICARE,
Programa de Beneficios de Salud para Empleados Federales, Servicio de Salud para Indígenas,
Cuerpo de Paz, plan de salud pública (como los de el gobierno de los EE. UU., un gobierno
estatal, o un país extranjero) o el Programa de seguro médico para niños (CHIP en inglés).
Cobertura de dependientes
La cobertura de dependientes se refiere a la cobertura de seguro para los miembros de la familia
del titular de la póliza, como un cónyuge, hijo o pareja.
Cobertura dento de la red
su compañía de seguros ha contratado a hospitales, proveedores y proveedores para brindar
servicios a un costo menor. Puede averiguar si un proveedor está dentro de la red utilizando el
directorio de proveedores en línea o comunicándose con su compañía de seguros.
Cobertura esencial minima
La Cobertura Esencial Mínima (MEC en inglés) es el tipo de cobertura que una persona debe
tener para cumplir con el requisito de responsabilidad individual, según la Ley de Cuidado de
Salud a Bajo Costo. Esto incluye pólizas de mercado individuales, cobertura a través de su
trabajo, Medicare, Medicaid, Programa de seguro médico para niños, TRICARE y algunas otras
coberturas.
Co-Insurance
The percentage of costs you pay for a covered healthcare services after you have paid your
deductible.
Copago
Un copago es una cantidad fija (por ejemplo, $15) que paga por un servicio de atención médica
cubierto, generalmente cuando recibe el servicio. El monto en dólares puede variar según el tipo
de servicio.
Co-Payment
A co-payment is a fixed amount (for example $15) that you pay for a covered healthcare service,
usually when you receive the service. The dollar amount can vary by the type of service.
Coseguro
El porcentaje de los costos que paga por los servicios de atención médica cubiertos después de
haber pagado su deducible.
Cost-Sharing Reduction
Cost-Sharing Reduction (CSR) lowers the amount you pay out-of-pocket for deductibles, co-
insurance and co-payments when you get medical services. If you qualify for CSR, you must
enroll in a Silver level plan to get these lower costs.
Creditable Coverage
Creditable coverage is any of the following plans: group health plan, individual health plan,
student health plan, Medicare, Medicaid, CHAMPUS and TRICARE, Federal Employees Health
Benefits Program, Indian Health Service, Peace Corps, public health plan (such as those from the
US Government, or a state government, or a foreign country), or Children’s Health Insurance
Program (CHIP)
Creditos fiscales anticipados para la prima
también conocido como créditos fiscales anticipados para la prima. El monto del crédito se
pagará directamente del gobierno federal a la compañía de seguros. El individuo paga la
diferencia entre el crédito y la prima del plan.
Cuenta de ahorro para la salud
Las cuentas de ahorro para la salud (HSA en inglés) le permiten apartar dinero antes de
impuestos para pagar los gastos médicos calificados si tiene un plan de seguro de salud con
deducible alto.
deducible
El deducible es el monto que paga por los servicios de atención médica cubiertos antes que su
plan de seguro comience a pagar. Puede que no se aplique a todos los servicios.
Deductible
The deductible is the amount you pay for covered healthcare services before your insurance plan
starts to pay. It may not apply to all services.
Dependent Coverage
Dependent coverage refers to insurance coverage for family members of the policyholder, such
as a spouse, child, or partner.
Dependent(s)
A dependent is a spouse, child or family member of the household obtaining health coverage
under the primary applicant's insurance plan
Dependiente(s)
Un dependiente es un cónyuge, hijo o miembro de la familia del hogar que obtiene cobertura
médica bajo el plan de seguro del solicitante principal.
Especialista
médico que se enfoca en un área específica de la medicina o en un grupo de pacientes para
diagnosticar, manejar, prevenir o tratar ciertos tipos de síntomas y afecciones.
essential health benefits
All qualified health plans (QHP) offered through Access Health CT provide the same set
of 10 Essential Health Benefits. While the benefits may cost more or less in different plans at
different levels, you can be assured that all plans will provide: 1. Preventive and wellness
services and chronic disease management 2. Pediatric services 3. Ambulatory patient services
(outpatient care you get without being admitted to a hospital) 4. Emergency room coverage 5.
Hospitalization (such as surgery) 6. Maternity and newborn care (care before and after your baby
is born) 7. Mental health and substance abuse services, including behavioral health treatment
(includes counseling and psychotherapy) 8. Prescription drug coverage 9. Rehabilitation and
Habilitation services and devices (services and devices to help people with injuries, disabilities, or
chronic conditions gain or recover mental and physical skills) 10. Laboratory service coverage
evento de vida calificado
Un evento de vida calificado (QLE en inglés) es un cambio en su vida, como perder la cobertura
de salud, casarse, tener un bebé, o mudarse a Connecticut, que puede hacerlo elegible para un
período de inscripción especial, lo que le permite inscribirse en un seguro de salud fuera del
período abierto anual de inscripción.
Federal Poverty Level
The Federal Poverty Level (FPL) is a measure of income issued every year by the Department of
Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility
for certain programs and benefits, including savings on Marketplace health insurance, and
Medicaid and CHIP coverage.
Fuera de la red
Proveedores o servicios con los que su plan de seguro médico no tiene contrato. Es posible que
termine pagando una mayor parte del costo de esta atención. Asegúrese de verificar si sus
proveedores están dentro de la red. Puede averiguar si un proveedor está dentro de la red
utilizando el directorio de proveedores en línea o comunicándose con su compañía de seguros.
Gastos de bolsillo
Los gastos de bolsillo son gastos de atención médica que no son reembolsados por su compañía
de seguros. Estos costos incluyen deducibles, coseguros y copagos por servicios cubiertos, más
todos los costos por servicios que no están cubiertos.
Health Reimbursement Account (HRA)
Health Reimbursement Accounts are employer-funded group health plans from which employees
are reimbursed tax-free for qualified medical expenses up to a fixed dollar amount per year.
Unused amounts may be rolled over to be used in subsequent years. The employer funds and
owns the account.
Health Savings Account (HSA)
Health Savings Accounts (HSA) allow you to set aside money on a pre-tax basis to pay for
qualified medical expenses if you have a high deductible health insurance plan.
High Deductible Health Plans (HDHP)
A High Deductible Health Plan (HDHP) is plan that requires higher deductibles than other plans.
These can be combined with a health savings account or a health reimbursement arrangement to
allow you to pay for qualified out-of-pocket medical expenses on a pre-tax basis.
Hogar (hogar fiscal)
Para la mayoría de las personas, un hogar está formado por el declarante de impuestos, su
cónyuge, si tiene uno, y sus dependientes fiscales, incluidos aquellos que no necesitan
cobertura. El Mercado cuenta los ingresos estimados de todos los miembros del hogar, incluso
aquellos que no solicitan cobertura. Cuando calcule sus ingresos para recibir ayuda financiera,
debe contar los ingresos de todas las personas de su hogar fiscal.
Household (Tax Household)
For most people, a household consists of the tax filer, their spouse if they have one, and their tax
dependents, including those who don’t need coverage. The Marketplace counts estimated income
of all household members, even those who are not applying for coverage. When you estimate
your income to receive financial help you should count income for everyone in your tax
household.
In-Network Coverage
Your insurance company has contracted with hospitals, providers and suppliers to provide
services at a lower cost. You can find out if a provider is in-network using the online provider
directory or by contacting your insurance company.
Ley de Cuidado de Salud a Bajo Precio
(también conocida como la Ley de Protección al Paciente y Cuidado de Salud a bajo precio u
Obamacare) es una legislación histórica de reforma de salud promulgada en marzo de 2010. Las
disposiciones clave están destinadas a extender la cobertura a millones de estadounidenses sin
seguro, implementar medidas que reduzcan los costos de atención médica, mejorar la eficiencia
del sistema, y eliminar las prácticas de la industria que incluyen la rescisión y denegación de
cobertura debido a condiciones preexistentes.
Limite Annual
Un límite en los beneficios que pagará su plan de salud en un año. A veces, se imponen límites a
servicios particulares, como prescripciones o tratamientos de fisioterapia. También se pueden
colocar en el monto en dólares o en el número de visitas. Una vez que se alcanza un límite
anual, debe pagar todos los costos de atención médica relacionados durante el resto del año.
Máximo de gastos de bolsillo
El máximo de gastos de bolsillo (MOOP en inglés), también conocido como límites de gastos de
bolsillo, es lo máximo que pagará durante un período de póliza (generalmente un año) antes de
que su plan de salud comience a pagar el 100% de la cantidad permitida. Este límite nunca
incluye su prima, los cargos facturados por el saldo o los servicios que su plan no cubre. Algunos
planes de salud no cuentan todos sus copagos, deducibles, pagos de coseguro, pagos fuera de
la red u otros gastos para este límite. Para el Programa de salud HUSKY (Medicaid / Programa
de seguro médico para niños), el límite sí incluye las primas.
Maximum-Out-of-Pocket (MOOP)
The Maximum-Out-Of-Pocket (MOOP) also known as out-of-pocket limits, is the most you will pay
during a policy period (usually a year) before your health plan begins to pay 100% of the allowed
amount. This limit never includes your premium, balance-billed charges or services your plan
does not cover. Some health plans do not count all of your co-payments, deductibles, co-
insurance payments, out-of-network payments or other expenses toward this limit. For HUSKY
Health Program (Medicaid/Children’s Health Insurance Program), the limit does include
premiums.
Medicaid
Medicaid is state-administered health insurance program for low-income families and children,
pregnant women, the elderly, people with disabilities, and in some states, other adults. The
federal government provides a portion of the funding for Medicaid and sets guidelines for the
program. States also have choices in how they design their program, so Medicaid varies state by
state.
Medicaid (español)
Medicaid es un programa de seguro médico administrado por el estado para familias y niños de
hogares de bajos ingresos, mujeres embarazadas, ancianos, personas con discapacidades y, en
algunos estados, otros adultos. El gobierno federal proporciona una parte de los fondos
para Medicaid y establece las pautas para el programa. Los estados también tienen opciones
sobre cómo diseñar su programa, por lo que Medicaid varía de un estado a otro.
Medicare
Medicare is a federal health insurance program for people who are age 65 or older and for certain
younger people with disabilities. Medicare offers broad coverage – Part A covers hospital
insurance; Part B is medical insurance and Part D covers prescription drugs. Part C can
supplement Part A, B and sometimes D.
Medicare (español)
Medicare es un programa de seguro médico federal para personas de 65 años o más y para
ciertas personas más jóvenes con discapacidades. Medicare ofrece una amplia cobertura: la
Parte A cubre el seguro hospitalario; La Parte B es un seguro médico y la Parte D cubre los
medicamentos recetados. La Parte C puede complementar la Parte A, B y, a veces, la D.
Médico de atención primaria (PCP en inglés)
Un médico que brinda, coordina o ayuda a un paciente a acceder a una variedad de servicios de
atención médica.
Minimum Essential Coverage (MEC)
Minimum Essential Coverage (MEC) is the type of coverage an individual needs to have to meet
the individual responsibility requirement under the Affordable Care Act. This includes individual
market policies, job-based coverage, Medicare, Medicaid, Children’s Health Insurance Program,
TRICARE, and certain other coverage.
Modified Adjusted Gross Income (MAGI)
Modified Adjusted Gross Income (MAGI) is defined by the Internal Revenue Service (IRS).
Calculations include determination of MAGI with respect to federal poverty level and other
considerations such as pregnancy, children, children’s age, and whether the applicant is a
caretaker for other dependents.
nivel federal de pobreza
El Nivel Federal de Pobreza (FPL en inglés) es una medida de ingresos emitida cada año por el
Departamento de Salud y Servicios Humanos (HHS en inglés). Los niveles federales de pobreza
se utilizan para determinar su elegibilidad para ciertos programas y beneficios, incluyendo los
ahorros en el seguro médico del Mercado y la cobertura de Medicaid y CHIP.
Open Enrollment Period
The period of time, from November 1 – January 15, when you can enroll or renew in qualified
health plans (QHP) through Access Health CT. Open Enrollment Periods can differ between
states and coverage types.
Out-of-Network
Providers or services with which your health insurance plan has not contracted. You may end up
paying more of the cost for this care. Be sure to check if your providers are in-network. You can
find out if a provider is in-network using the online provider directory or by contacting your
insurance company.
Out-of-Pocket Costs
Out-of-pocket costs are expenses for medical care that are not reimbursed
by your insurance company. These costs include deductibles, co-insurance, and co-payments for
covered services plus all costs for services that are not covered.
periodo abierto de inscripción
Es un período de tiempo, del 1 de noviembre al 15 de enero, en el que puede inscribirse o
renovar en planes de salud calificados (QHP en inglés) a través de Access Health CT. Los
períodos abierto de inscripción pueden diferir entre los estados y los tipos de cobertura.
Periodo de Inscripción Especial
Un Período de Inscripción Especial (SEP en inglés) es un período de tiempo especial durante el
año en el que puede inscribirse en cobertura de salud a través de Access Health CT. Para
obtener un Período de Inscripción Especial, debe demostrar que tiene un Evento de Vida
Calificado y tendrá 60 días, a partir de la fecha de ese evento, para comenzar su proceso de
solicitud.
plan catastrófico
Los planes catastróficos están disponibles para personas menores de 30 años o para aquellos a
quienes se les haya otorgado una exención por dificultades económicas. Los planes catastróficos
no son elegibles para ayuda financiera. Estos planes tienen primas mensuales bajas y brindan el
nivel más bajo de cobertura. Los planes catastróficos ofrecen protección cuando los costos de
atención médica se acercan o alcanzan los costos máximos anuales de bolsillo.
Plan de Organización de Proveedores Preferidos
Un plan de Organización de Proveedores Preferidos (PPO en inglés) contrata a proveedores de
salud, como hospitales y médicos, para crear una red de proveedores participantes. Paga menos
si utiliza proveedores que pertenecen a la red del plan. Por lo general, puede utilizar médicos,
hospitales y proveedores fuera de la red por un costo adicional.
Plan de punto de servicio
Un plan de punto de servicio (POS en inglés) ofrece servicios con descuento si utiliza médicos,
hospitales y otros proveedores de atención médica que pertenecen a la red del plan. Los planes
de punto de servicio pueden requerir que obtenga una remisión de su médico de atención
primaria para ver a un especialista.
Plan de Salud Calificado
Un plan de salud calificado (QHP en inglés) por Access Health CT, proporciona beneficios
esenciales de salud, sigue los límites establecidos sobre costos compartidos (como deducibles,
copagos y montos máximos de gastos de bolsillo) y cumple con otros requisitos.
Plan de salud con un deducible alto
Un plan de salud con deducible alto (HDHP en inglés) es un plan que requiere deducibles más
altos que otros planes. Estos pueden combinarse con una cuenta de ahorros para la salud (HSA
en inglés) o un acuerdo de reembolso de la salud (HRA en inglés) para permitirle pagar los
gastos médicos calificados de su bolsillo antes de impuestos.
Plan Network
A plan network includes specific doctors, hospitals, pharmacies, and other health care providers
who have contracted with the health insurance company.
Point-of-Service (POS) Plan
A Point-of-Service Plan (POS) type offers discounted services if you use doctors, hospitals, and
other healthcare providers that belong to the plan’s network. POS plans may require you to get a
referral from your primary care doctor in order to see a specialist.
Preferred Provider Organization (PPO) Plan
A Preferred Provider Organization plan (PPO) contracts with medical providers, such as hospitals
and doctors, to create a network of participating providers. You pay less if you use providers that
belong to the plan’s network. You can usually use doctors, hospitals, and providers outside of the
network for an additional cost.
Premium
The amount you pay for your health insurance plan to the insurance company every month.
Preventive Services
These services include annual check-ups, immunizations, patient counseling, and screenings.
Preventive services are an Essential Health Benefit and covered under plans offered through
Access Health CT.
Prima
La cantidad que paga por su plan de seguro médico a la compañía de seguros cada mes.
Primary Care Physician (PCP)
A doctor who provides, coordinates or helps a patient access a range of health care services.
Programa de seguro médico para niños (CHIP en inglés)
CHIP es un programa de seguro financiado por el gobierno estatal y federal, que brinda seguro
de salud a niños en hogares de bajos ingresos. En Connecticut, este programa se conoce como
HUSKY B.
Qualified Health Plan (QHP)
An insurance plan that is certified by Access Health CT, provides Essential Health Benefits,
follows established limits on cost -sharing (like deductibles, co-payments, and out-of-pocket
maximum amounts), and meets other requirements.
Qualifying Life Event (QLE)
A Qualifying Life Event (QLE) is a change in your life — like losing health coverage, getting
married, having a baby or moving to Connecticut— that can make you eligible for a Special
Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment
Period.
Reclamo
Un reclamo es una solicitud de pago que usted o su proveedor de atención médica presentan a
su aseguradora de salud cuando recibe artículos o servicios.
Red de un plan
La red de un plan incluye médicos, hospitales, farmacias y otros proveedores de atención médica
específicos que tienen contrato con la compañía de seguro médico.
Red escalonada
Una red escalonada divide a los hospitales y médicos en grupos, según la información sobre la
calidad de su atención y los costos de sus servicios. Lo que paga se basa en el nivel del
proveedor.
Reducción de Costos Compartidos (CSR en inglés)
Reducción de Costos Compartidos (CSR) reduce la cantidad que paga de su bolsillo por
deducibles, coseguros y copagos cuando recibe servicios médicos. Si califica para Reducción de
Costos Compartidos, debe inscribirse en un plan de nivel Plata para obtener estos bajos costos.
Representante Autorizado
Un representante autorizado es una persona que ha sido designada en la solicitud para actuar
en nombre de otra persona.
Servicios Preventivos
Estos servicios incluyen chequeos anuales, vacunas, asesoramiento para pacientes y exámenes
de detección. Los servicios preventivos son un beneficio esencial salud y están cubiertos por los
planes que se ofrecen a través de Access Health CT.
Special Enrollment Period (SEP)
A Special Enrollment Period (SEP) is a special window of time during the year when you can
enroll in health insurance through Access Health CT. To get a Special Enrollment Period, you
must prove that you have a Qualifying Life Event – and you will have 60 days from the date of
that event begin your application process.
Specialist
A doctor who focuses on a specific area of medicine or a group of patients to diagnose, manage,
prevent or treat certain types of symptoms and conditions.
Tiered Network
A tiered network divides hospitals and doctors into groups, based on information about the quality
of their care and the costs of their services. What you pay is based on the tier of the provider.
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What is the main topic of this document?
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Access Health CT Glossary
Written by Roberto Blundo | Last published at: May 08, 2024
Glossary
acuerdo de reembolso de salud
Las cuentas de reembolso de salud son planes de salud grupales financiados
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Access Health CT Glossary
Written by Roberto Blundo | Last published at: May 08, 2024
Glossary
acuerdo de reembolso de salud
Las cuentas de reembolso de salud son planes de salud grupales financiados por el empleador,
de los cuales los empleados son reembolsados libres de impuestos para los gastos médicos
calificados hasta un monto fijo en dólares por año. Los montos no utilizadas pueden ser
renovados para ser utilizadose en años posteriores. El empleador financia y es propietario de la
cuenta.
Affordable Care Act (ACA)
(also known as the Patient Protection and Affordable Care Act or Obamacare) and is the
landmark health reform legislation signed into law in March 2010. Key provisions are intended to
extend coverage to millions of uninsured Americans, implement measures that will lower health
care costs and improve system efficiency, and eliminate industry practices that include rescission
and denial of coverage due to pre-existing conditions.
Agent
An agent is a state-licensed individual or entity representing one or more insurance companies.
An agent solicits and facilitates the sale of insurance contracts or policies and provides services
to the policyholder on behalf of the insurer.
Agente
Un agente es una persona o entidad con licencia estatal que representa a una o más compañías
de seguros. Un agente solicita y facilita la venta de contratos o pólizas de seguro y brinda
servicios al titular de la póliza en nombre del asegurador.
Agente de seguros
Un agente de seguros es un representante legal autorizado del titular de la póliza, que negocia
con una compañía de seguros en nombre de un cliente. La compañía de seguros le paga una
comisión.
Annual Limit
A limit on the benefits your health plan will pay in a year. Limits are sometimes placed on
particular services, such as prescriptions or physical therapy treatments. They can also be placed
on the dollar amount or on the number of visits. After an annual limit is reached, you must pay all
related health care costs for the rest of the year.
año calendario
1 de enero - 31 de diciembre
APTC
also known as Advanced Premium Tax Credits. The credit amount will be paid directly to the
insurance company from the federal government. The individual pays the difference between the
credit and the plan's premium.
Authorized Representative
An authorized representative is a person who has been designated in the Exchange to act on
someone else’s behalf.
Beneficios esenciales de salud
Todos los planes de salud calificados (QHP en inglés) que se ofrecen a través de Access Health
CT brindan el mismo conjunto de 10 beneficios esenciales de salud. Los beneficios pueden
costar más o menos en diferentes planes en diferentes niveles, puede estar seguro de que todos
los planes brindarán: 1. Servicios preventivos y de bienestar y manejo de enfermedades crónicas
2. Servicios pediátricos 3. Servicios ambulatorios para pacientes (atención ambulatoria que
recibe sin hospitalización) 4. Cobertura de la sala de emergencias 5. Hospitalización (como
cirugía) 6. Atención de maternidad y del recién nacido (atención antes y después del nacimiento
de su bebé) 7. Servicios de salud mental y abuso de sustancias, incluido el tratamiento de salud
conductual (incluye asesoramiento y psicoterapia) 8. Cobertura de medicamentos prescritos 9.
Servicios y dispositivos de rehabilitación y habilitación (servicios y dispositivos para ayudar a las
personas con lesiones, discapacidades o afecciones crónicas a obtener o recuperar habilidades
mentales y físicas) 10. Cobertura de servicios de laboratorio
Broker
A broker is a licensed legal representative of the policyholder, who negotiates with an insurance
company on behalf of a customer but is paid a commission by the insurance company.
Calendar Year
January 1 - December 31
Catastrophic Plans
Catastrophic plans are available to people younger than 30 years old or to those who have been
granted a hardship or affordability exemption. You are not eligible to get financial help to pay for
catastrophic plans. These plans have low monthly premiums and provide the lowest level of
coverage. Catastrophic plans offer protection when healthcare costs near or reach annual-of-
pocket cost maximums.
Centers for Medicare and Medicaid Services (CMS)
Centers for Medicare and Medicaid Services (CMS) is the federal agency responsible for
administering Medicare, Medicaid, State Children's Health Insurance, Health Insurance Portability
and Accountability Act, Clinical Laboratory Improvement Amendments, and several other health-
related programs. CMS also establishes standards for healthcare providers that must be complied
with in order for providers to meet certain certification requirements.
Centro de Servicios de Medicare y Medicaid (CMS en inglés)
El Centro de Servicios de Medicare y Medicaid (CMS) es la agencia federal responsable de
administrar Medicare, Medicaid, el seguro médico para niños (CHIP en inglés), la Ley de
Responsabilidad y Portabilidad del Seguro de Salud, las Enmiendas para mejorar los
Laboratorios Clínicos y varios otros programas relacionados con la salud. El Centro de Servicios
de Medicare y Medicaid también establece estándares para los proveedores de atención médica,
los cuales deben cumplirse para que los proveedores cumplan con ciertos requisitos de
certificación.
Children’s Health Insurance Program (CHIP)
CHIP is an insurance program funded by state and Federal government that provides health
insurance to children in low-income households. In Connecticut, this program is referred to as
HUSKY B.
Claim
A claim is a request for payment that you or your health care provider submits to your health
insurer when you get items or services.
Cobertura acreditable
La cobertura acreditable es cualquiera de los siguientes planes: plan de salud grupal, plan de
salud individual, plan de salud para estudiantes, Medicare, Medicaid, CHAMPUS y TRICARE,
Programa de Beneficios de Salud para Empleados Federales, Servicio de Salud para Indígenas,
Cuerpo de Paz, plan de salud pública (como los de el gobierno de los EE. UU., un gobierno
estatal, o un país extranjero) o el Programa de seguro médico para niños (CHIP en inglés).
Cobertura de dependientes
La cobertura de dependientes se refiere a la cobertura de seguro para los miembros de la familia
del titular de la póliza, como un cónyuge, hijo o pareja.
Cobertura dento de la red
su compañía de seguros ha contratado a hospitales, proveedores y proveedores para brindar
servicios a un costo menor. Puede averiguar si un proveedor está dentro de la red utilizando el
directorio de proveedores en línea o comunicándose con su compañía de seguros.
Cobertura esencial minima
La Cobertura Esencial Mínima (MEC en inglés) es el tipo de cobertura que una persona debe
tener para cumplir con el requisito de responsabilidad individual, según la Ley de Cuidado de
Salud a Bajo Costo. Esto incluye pólizas de mercado individuales, cobertura a través de su
trabajo, Medicare, Medicaid, Programa de seguro médico para niños, TRICARE y algunas otras
coberturas.
Co-Insurance
The percentage of costs you pay for a covered healthcare services after you have paid your
deductible.
Copago
Un copago es una cantidad fija (por ejemplo, $15) que paga por un servicio de atención médica
cubierto, generalmente cuando recibe el servicio. El monto en dólares puede variar según el tipo
de servicio.
Co-Payment
A co-payment is a fixed amount (for example $15) that you pay for a covered healthcare service,
usually when you receive the service. The dollar amount can vary by the type of service.
Coseguro
El porcentaje de los costos que paga por los servicios de atención médica cubiertos después de
haber pagado su deducible.
Cost-Sharing Reduction
Cost-Sharing Reduction (CSR) lowers the amount you pay out-of-pocket for deductibles, co-
insurance and co-payments when you get medical services. If you qualify for CSR, you must
enroll in a Silver level plan to get these lower costs.
Creditable Coverage
Creditable coverage is any of the following plans: group health plan, individual health plan,
student health plan, Medicare, Medicaid, CHAMPUS and TRICARE, Federal Employees Health
Benefits Program, Indian Health Service, Peace Corps, public health plan (such as those from the
US Government, or a state government, or a foreign country), or Children’s Health Insurance
Program (CHIP)
Creditos fiscales anticipados para la prima
también conocido como créditos fiscales anticipados para la prima. El monto del crédito se
pagará directamente del gobierno federal a la compañía de seguros. El individuo paga la
diferencia entre el crédito y la prima del plan.
Cuenta de ahorro para la salud
Las cuentas de ahorro para la salud (HSA en inglés) le permiten apartar dinero antes de
impuestos para pagar los gastos médicos calificados si tiene un plan de seguro de salud con
deducible alto.
deducible
El deducible es el monto que paga por los servicios de atención médica cubiertos antes que su
plan de seguro comience a pagar. Puede que no se aplique a todos los servicios.
Deductible
The deductible is the amount you pay for covered healthcare services before your insurance plan
starts to pay. It may not apply to all services.
Dependent Coverage
Dependent coverage refers to insurance coverage for family members of the policyholder, such
as a spouse, child, or partner.
Dependent(s)
A dependent is a spouse, child or family member of the household obtaining health coverage
under the primary applicant's insurance plan
Dependiente(s)
Un dependiente es un cónyuge, hijo o miembro de la familia del hogar que obtiene cobertura
médica bajo el plan de seguro del solicitante principal.
Especialista
médico que se enfoca en un área específica de la medicina o en un grupo de pacientes para
diagnosticar, manejar, prevenir o tratar ciertos tipos de síntomas y afecciones.
essential health benefits
All qualified health plans (QHP) offered through Access Health CT provide the same set
of 10 Essential Health Benefits. While the benefits may cost more or less in different plans at
different levels, you can be assured that all plans will provide: 1. Preventive and wellness
services and chronic disease management 2. Pediatric services 3. Ambulatory patient services
(outpatient care you get without being admitted to a hospital) 4. Emergency room coverage 5.
Hospitalization (such as surgery) 6. Maternity and newborn care (care before and after your baby
is born) 7. Mental health and substance abuse services, including behavioral health treatment
(includes counseling and psychotherapy) 8. Prescription drug coverage 9. Rehabilitation and
Habilitation services and devices (services and devices to help people with injuries, disabilities, or
chronic conditions gain or recover mental and physical skills) 10. Laboratory service coverage
evento de vida calificado
Un evento de vida calificado (QLE en inglés) es un cambio en su vida, como perder la cobertura
de salud, casarse, tener un bebé, o mudarse a Connecticut, que puede hacerlo elegible para un
período de inscripción especial, lo que le permite inscribirse en un seguro de salud fuera del
período abierto anual de inscripción.
Federal Poverty Level
The Federal Poverty Level (FPL) is a measure of income issued every year by the Department of
Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility
for certain programs and benefits, including savings on Marketplace health insurance, and
Medicaid and CHIP coverage.
Fuera de la red
Proveedores o servicios con los que su plan de seguro médico no tiene contrato. Es posible que
termine pagando una mayor parte del costo de esta atención. Asegúrese de verificar si sus
proveedores están dentro de la red. Puede averiguar si un proveedor está dentro de la red
utilizando el directorio de proveedores en línea o comunicándose con su compañía de seguros.
Gastos de bolsillo
Los gastos de bolsillo son gastos de atención médica que no son reembolsados por su compañía
de seguros. Estos costos incluyen deducibles, coseguros y copagos por servicios cubiertos, más
todos los costos por servicios que no están cubiertos.
Health Reimbursement Account (HRA)
Health Reimbursement Accounts are employer-funded group health plans from which employees
are reimbursed tax-free for qualified medical expenses up to a fixed dollar amount per year.
Unused amounts may be rolled over to be used in subsequent years. The employer funds and
owns the account.
Health Savings Account (HSA)
Health Savings Accounts (HSA) allow you to set aside money on a pre-tax basis to pay for
qualified medical expenses if you have a high deductible health insurance plan.
High Deductible Health Plans (HDHP)
A High Deductible Health Plan (HDHP) is plan that requires higher deductibles than other plans.
These can be combined with a health savings account or a health reimbursement arrangement to
allow you to pay for qualified out-of-pocket medical expenses on a pre-tax basis.
Hogar (hogar fiscal)
Para la mayoría de las personas, un hogar está formado por el declarante de impuestos, su
cónyuge, si tiene uno, y sus dependientes fiscales, incluidos aquellos que no necesitan
cobertura. El Mercado cuenta los ingresos estimados de todos los miembros del hogar, incluso
aquellos que no solicitan cobertura. Cuando calcule sus ingresos para recibir ayuda financiera,
debe contar los ingresos de todas las personas de su hogar fiscal.
Household (Tax Household)
For most people, a household consists of the tax filer, their spouse if they have one, and their tax
dependents, including those who don’t need coverage. The Marketplace counts estimated income
of all household members, even those who are not applying for coverage. When you estimate
your income to receive financial help you should count income for everyone in your tax
household.
In-Network Coverage
Your insurance company has contracted with hospitals, providers and suppliers to provide
services at a lower cost. You can find out if a provider is in-network using the online provider
directory or by contacting your insurance company.
Ley de Cuidado de Salud a Bajo Precio
(también conocida como la Ley de Protección al Paciente y Cuidado de Salud a bajo precio u
Obamacare) es una legislación histórica de reforma de salud promulgada en marzo de 2010. Las
disposiciones clave están destinadas a extender la cobertura a millones de estadounidenses sin
seguro, implementar medidas que reduzcan los costos de atención médica, mejorar la eficiencia
del sistema, y eliminar las prácticas de la industria que incluyen la rescisión y denegación de
cobertura debido a condiciones preexistentes.
Limite Annual
Un límite en los beneficios que pagará su plan de salud en un año. A veces, se imponen límites a
servicios particulares, como prescripciones o tratamientos de fisioterapia. También se pueden
colocar en el monto en dólares o en el número de visitas. Una vez que se alcanza un límite
anual, debe pagar todos los costos de atención médica relacionados durante el resto del año.
Máximo de gastos de bolsillo
El máximo de gastos de bolsillo (MOOP en inglés), también conocido como límites de gastos de
bolsillo, es lo máximo que pagará durante un período de póliza (generalmente un año) antes de
que su plan de salud comience a pagar el 100% de la cantidad permitida. Este límite nunca
incluye su prima, los cargos facturados por el saldo o los servicios que su plan no cubre. Algunos
planes de salud no cuentan todos sus copagos, deducibles, pagos de coseguro, pagos fuera de
la red u otros gastos para este límite. Para el Programa de salud HUSKY (Medicaid / Programa
de seguro médico para niños), el límite sí incluye las primas.
Maximum-Out-of-Pocket (MOOP)
The Maximum-Out-Of-Pocket (MOOP) also known as out-of-pocket limits, is the most you will pay
during a policy period (usually a year) before your health plan begins to pay 100% of the allowed
amount. This limit never includes your premium, balance-billed charges or services your plan
does not cover. Some health plans do not count all of your co-payments, deductibles, co-
insurance payments, out-of-network payments or other expenses toward this limit. For HUSKY
Health Program (Medicaid/Children’s Health Insurance Program), the limit does include
premiums.
Medicaid
Medicaid is state-administered health insurance program for low-income families and children,
pregnant women, the elderly, people with disabilities, and in some states, other adults. The
federal government provides a portion of the funding for Medicaid and sets guidelines for the
program. States also have choices in how they design their program, so Medicaid varies state by
state.
Medicaid (español)
Medicaid es un programa de seguro médico administrado por el estado para familias y niños de
hogares de bajos ingresos, mujeres embarazadas, ancianos, personas con discapacidades y, en
algunos estados, otros adultos. El gobierno federal proporciona una parte de los fondos
para Medicaid y establece las pautas para el programa. Los estados también tienen opciones
sobre cómo diseñar su programa, por lo que Medicaid varía de un estado a otro.
Medicare
Medicare is a federal health insurance program for people who are age 65 or older and for certain
younger people with disabilities. Medicare offers broad coverage – Part A covers hospital
insurance; Part B is medical insurance and Part D covers prescription drugs. Part C can
supplement Part A, B and sometimes D.
Medicare (español)
Medicare es un programa de seguro médico federal para personas de 65 años o más y para
ciertas personas más jóvenes con discapacidades. Medicare ofrece una amplia cobertura: la
Parte A cubre el seguro hospitalario; La Parte B es un seguro médico y la Parte D cubre los
medicamentos recetados. La Parte C puede complementar la Parte A, B y, a veces, la D.
Médico de atención primaria (PCP en inglés)
Un médico que brinda, coordina o ayuda a un paciente a acceder a una variedad de servicios de
atención médica.
Minimum Essential Coverage (MEC)
Minimum Essential Coverage (MEC) is the type of coverage an individual needs to have to meet
the individual responsibility requirement under the Affordable Care Act. This includes individual
market policies, job-based coverage, Medicare, Medicaid, Children’s Health Insurance Program,
TRICARE, and certain other coverage.
Modified Adjusted Gross Income (MAGI)
Modified Adjusted Gross Income (MAGI) is defined by the Internal Revenue Service (IRS).
Calculations include determination of MAGI with respect to federal poverty level and other
considerations such as pregnancy, children, children’s age, and whether the applicant is a
caretaker for other dependents.
nivel federal de pobreza
El Nivel Federal de Pobreza (FPL en inglés) es una medida de ingresos emitida cada año por el
Departamento de Salud y Servicios Humanos (HHS en inglés). Los niveles federales de pobreza
se utilizan para determinar su elegibilidad para ciertos programas y beneficios, incluyendo los
ahorros en el seguro médico del Mercado y la cobertura de Medicaid y CHIP.
Open Enrollment Period
The period of time, from November 1 – January 15, when you can enroll or renew in qualified
health plans (QHP) through Access Health CT. Open Enrollment Periods can differ between
states and coverage types.
Out-of-Network
Providers or services with which your health insurance plan has not contracted. You may end up
paying more of the cost for this care. Be sure to check if your providers are in-network. You can
find out if a provider is in-network using the online provider directory or by contacting your
insurance company.
Out-of-Pocket Costs
Out-of-pocket costs are expenses for medical care that are not reimbursed
by your insurance company. These costs include deductibles, co-insurance, and co-payments for
covered services plus all costs for services that are not covered.
periodo abierto de inscripción
Es un período de tiempo, del 1 de noviembre al 15 de enero, en el que puede inscribirse o
renovar en planes de salud calificados (QHP en inglés) a través de Access Health CT. Los
períodos abierto de inscripción pueden diferir entre los estados y los tipos de cobertura.
Periodo de Inscripción Especial
Un Período de Inscripción Especial (SEP en inglés) es un período de tiempo especial durante el
año en el que puede inscribirse en cobertura de salud a través de Access Health CT. Para
obtener un Período de Inscripción Especial, debe demostrar que tiene un Evento de Vida
Calificado y tendrá 60 días, a partir de la fecha de ese evento, para comenzar su proceso de
solicitud.
plan catastrófico
Los planes catastróficos están disponibles para personas menores de 30 años o para aquellos a
quienes se les haya otorgado una exención por dificultades económicas. Los planes catastróficos
no son elegibles para ayuda financiera. Estos planes tienen primas mensuales bajas y brindan el
nivel más bajo de cobertura. Los planes catastróficos ofrecen protección cuando los costos de
atención médica se acercan o alcanzan los costos máximos anuales de bolsillo.
Plan de Organización de Proveedores Preferidos
Un plan de Organización de Proveedores Preferidos (PPO en inglés) contrata a proveedores de
salud, como hospitales y médicos, para crear una red de proveedores participantes. Paga menos
si utiliza proveedores que pertenecen a la red del plan. Por lo general, puede utilizar médicos,
hospitales y proveedores fuera de la red por un costo adicional.
Plan de punto de servicio
Un plan de punto de servicio (POS en inglés) ofrece servicios con descuento si utiliza médicos,
hospitales y otros proveedores de atención médica que pertenecen a la red del plan. Los planes
de punto de servicio pueden requerir que obtenga una remisión de su médico de atención
primaria para ver a un especialista.
Plan de Salud Calificado
Un plan de salud calificado (QHP en inglés) por Access Health CT, proporciona beneficios
esenciales de salud, sigue los límites establecidos sobre costos compartidos (como deducibles,
copagos y montos máximos de gastos de bolsillo) y cumple con otros requisitos.
Plan de salud con un deducible alto
Un plan de salud con deducible alto (HDHP en inglés) es un plan que requiere deducibles más
altos que otros planes. Estos pueden combinarse con una cuenta de ahorros para la salud (HSA
en inglés) o un acuerdo de reembolso de la salud (HRA en inglés) para permitirle pagar los
gastos médicos calificados de su bolsillo antes de impuestos.
Plan Network
A plan network includes specific doctors, hospitals, pharmacies, and other health care providers
who have contracted with the health insurance company.
Point-of-Service (POS) Plan
A Point-of-Service Plan (POS) type offers discounted services if you use doctors, hospitals, and
other healthcare providers that belong to the plan’s network. POS plans may require you to get a
referral from your primary care doctor in order to see a specialist.
Preferred Provider Organization (PPO) Plan
A Preferred Provider Organization plan (PPO) contracts with medical providers, such as hospitals
and doctors, to create a network of participating providers. You pay less if you use providers that
belong to the plan’s network. You can usually use doctors, hospitals, and providers outside of the
network for an additional cost.
Premium
The amount you pay for your health insurance plan to the insurance company every month.
Preventive Services
These services include annual check-ups, immunizations, patient counseling, and screenings.
Preventive services are an Essential Health Benefit and covered under plans offered through
Access Health CT.
Prima
La cantidad que paga por su plan de seguro médico a la compañía de seguros cada mes.
Primary Care Physician (PCP)
A doctor who provides, coordinates or helps a patient access a range of health care services.
Programa de seguro médico para niños (CHIP en inglés)
CHIP es un programa de seguro financiado por el gobierno estatal y federal, que brinda seguro
de salud a niños en hogares de bajos ingresos. En Connecticut, este programa se conoce como
HUSKY B.
Qualified Health Plan (QHP)
An insurance plan that is certified by Access Health CT, provides Essential Health Benefits,
follows established limits on cost -sharing (like deductibles, co-payments, and out-of-pocket
maximum amounts), and meets other requirements.
Qualifying Life Event (QLE)
A Qualifying Life Event (QLE) is a change in your life — like losing health coverage, getting
married, having a baby or moving to Connecticut— that can make you eligible for a Special
Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment
Period.
Reclamo
Un reclamo es una solicitud de pago que usted o su proveedor de atención médica presentan a
su aseguradora de salud cuando recibe artículos o servicios.
Red de un plan
La red de un plan incluye médicos, hospitales, farmacias y otros proveedores de atención médica
específicos que tienen contrato con la compañía de seguro médico.
Red escalonada
Una red escalonada divide a los hospitales y médicos en grupos, según la información sobre la
calidad de su atención y los costos de sus servicios. Lo que paga se basa en el nivel del
proveedor.
Reducción de Costos Compartidos (CSR en inglés)
Reducción de Costos Compartidos (CSR) reduce la cantidad que paga de su bolsillo por
deducibles, coseguros y copagos cuando recibe servicios médicos. Si califica para Reducción de
Costos Compartidos, debe inscribirse en un plan de nivel Plata para obtener estos bajos costos.
Representante Autorizado
Un representante autorizado es una persona que ha sido designada en la solicitud para actuar
en nombre de otra persona.
Servicios Preventivos
Estos servicios incluyen chequeos anuales, vacunas, asesoramiento para pacientes y exámenes
de detección. Los servicios preventivos son un beneficio esencial salud y están cubiertos por los
planes que se ofrecen a través de Access Health CT.
Special Enrollment Period (SEP)
A Special Enrollment Period (SEP) is a special window of time during the year when you can
enroll in health insurance through Access Health CT. To get a Special Enrollment Period, you
must prove that you have a Qualifying Life Event – and you will have 60 days from the date of
that event begin your application process.
Specialist
A doctor who focuses on a specific area of medicine or a group of patients to diagnose, manage,
prevent or treat certain types of symptoms and conditions.
Tiered Network
A tiered network divides hospitals and doctors into groups, based on information about the quality
of their care and the costs of their services. What you pay is based on the tier of the provider.
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Who is mentioned in the document?
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Access Health CT Glossary
Written by Roberto Blundo | Last published at: May 08, 2024
Glossary
acuerdo de reembolso de salud
Las cuentas de reembolso de salud son planes de salud grupales financiados
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Access Health CT Glossary
Written by Roberto Blundo | Last published at: May 08, 2024
Glossary
acuerdo de reembolso de salud
Las cuentas de reembolso de salud son planes de salud grupales financiados por el empleador,
de los cuales los empleados son reembolsados libres de impuestos para los gastos médicos
calificados hasta un monto fijo en dólares por año. Los montos no utilizadas pueden ser
renovados para ser utilizadose en años posteriores. El empleador financia y es propietario de la
cuenta.
Affordable Care Act (ACA)
(also known as the Patient Protection and Affordable Care Act or Obamacare) and is the
landmark health reform legislation signed into law in March 2010. Key provisions are intended to
extend coverage to millions of uninsured Americans, implement measures that will lower health
care costs and improve system efficiency, and eliminate industry practices that include rescission
and denial of coverage due to pre-existing conditions.
Agent
An agent is a state-licensed individual or entity representing one or more insurance companies.
An agent solicits and facilitates the sale of insurance contracts or policies and provides services
to the policyholder on behalf of the insurer.
Agente
Un agente es una persona o entidad con licencia estatal que representa a una o más compañías
de seguros. Un agente solicita y facilita la venta de contratos o pólizas de seguro y brinda
servicios al titular de la póliza en nombre del asegurador.
Agente de seguros
Un agente de seguros es un representante legal autorizado del titular de la póliza, que negocia
con una compañía de seguros en nombre de un cliente. La compañía de seguros le paga una
comisión.
Annual Limit
A limit on the benefits your health plan will pay in a year. Limits are sometimes placed on
particular services, such as prescriptions or physical therapy treatments. They can also be placed
on the dollar amount or on the number of visits. After an annual limit is reached, you must pay all
related health care costs for the rest of the year.
año calendario
1 de enero - 31 de diciembre
APTC
also known as Advanced Premium Tax Credits. The credit amount will be paid directly to the
insurance company from the federal government. The individual pays the difference between the
credit and the plan's premium.
Authorized Representative
An authorized representative is a person who has been designated in the Exchange to act on
someone else’s behalf.
Beneficios esenciales de salud
Todos los planes de salud calificados (QHP en inglés) que se ofrecen a través de Access Health
CT brindan el mismo conjunto de 10 beneficios esenciales de salud. Los beneficios pueden
costar más o menos en diferentes planes en diferentes niveles, puede estar seguro de que todos
los planes brindarán: 1. Servicios preventivos y de bienestar y manejo de enfermedades crónicas
2. Servicios pediátricos 3. Servicios ambulatorios para pacientes (atención ambulatoria que
recibe sin hospitalización) 4. Cobertura de la sala de emergencias 5. Hospitalización (como
cirugía) 6. Atención de maternidad y del recién nacido (atención antes y después del nacimiento
de su bebé) 7. Servicios de salud mental y abuso de sustancias, incluido el tratamiento de salud
conductual (incluye asesoramiento y psicoterapia) 8. Cobertura de medicamentos prescritos 9.
Servicios y dispositivos de rehabilitación y habilitación (servicios y dispositivos para ayudar a las
personas con lesiones, discapacidades o afecciones crónicas a obtener o recuperar habilidades
mentales y físicas) 10. Cobertura de servicios de laboratorio
Broker
A broker is a licensed legal representative of the policyholder, who negotiates with an insurance
company on behalf of a customer but is paid a commission by the insurance company.
Calendar Year
January 1 - December 31
Catastrophic Plans
Catastrophic plans are available to people younger than 30 years old or to those who have been
granted a hardship or affordability exemption. You are not eligible to get financial help to pay for
catastrophic plans. These plans have low monthly premiums and provide the lowest level of
coverage. Catastrophic plans offer protection when healthcare costs near or reach annual-of-
pocket cost maximums.
Centers for Medicare and Medicaid Services (CMS)
Centers for Medicare and Medicaid Services (CMS) is the federal agency responsible for
administering Medicare, Medicaid, State Children's Health Insurance, Health Insurance Portability
and Accountability Act, Clinical Laboratory Improvement Amendments, and several other health-
related programs. CMS also establishes standards for healthcare providers that must be complied
with in order for providers to meet certain certification requirements.
Centro de Servicios de Medicare y Medicaid (CMS en inglés)
El Centro de Servicios de Medicare y Medicaid (CMS) es la agencia federal responsable de
administrar Medicare, Medicaid, el seguro médico para niños (CHIP en inglés), la Ley de
Responsabilidad y Portabilidad del Seguro de Salud, las Enmiendas para mejorar los
Laboratorios Clínicos y varios otros programas relacionados con la salud. El Centro de Servicios
de Medicare y Medicaid también establece estándares para los proveedores de atención médica,
los cuales deben cumplirse para que los proveedores cumplan con ciertos requisitos de
certificación.
Children’s Health Insurance Program (CHIP)
CHIP is an insurance program funded by state and Federal government that provides health
insurance to children in low-income households. In Connecticut, this program is referred to as
HUSKY B.
Claim
A claim is a request for payment that you or your health care provider submits to your health
insurer when you get items or services.
Cobertura acreditable
La cobertura acreditable es cualquiera de los siguientes planes: plan de salud grupal, plan de
salud individual, plan de salud para estudiantes, Medicare, Medicaid, CHAMPUS y TRICARE,
Programa de Beneficios de Salud para Empleados Federales, Servicio de Salud para Indígenas,
Cuerpo de Paz, plan de salud pública (como los de el gobierno de los EE. UU., un gobierno
estatal, o un país extranjero) o el Programa de seguro médico para niños (CHIP en inglés).
Cobertura de dependientes
La cobertura de dependientes se refiere a la cobertura de seguro para los miembros de la familia
del titular de la póliza, como un cónyuge, hijo o pareja.
Cobertura dento de la red
su compañía de seguros ha contratado a hospitales, proveedores y proveedores para brindar
servicios a un costo menor. Puede averiguar si un proveedor está dentro de la red utilizando el
directorio de proveedores en línea o comunicándose con su compañía de seguros.
Cobertura esencial minima
La Cobertura Esencial Mínima (MEC en inglés) es el tipo de cobertura que una persona debe
tener para cumplir con el requisito de responsabilidad individual, según la Ley de Cuidado de
Salud a Bajo Costo. Esto incluye pólizas de mercado individuales, cobertura a través de su
trabajo, Medicare, Medicaid, Programa de seguro médico para niños, TRICARE y algunas otras
coberturas.
Co-Insurance
The percentage of costs you pay for a covered healthcare services after you have paid your
deductible.
Copago
Un copago es una cantidad fija (por ejemplo, $15) que paga por un servicio de atención médica
cubierto, generalmente cuando recibe el servicio. El monto en dólares puede variar según el tipo
de servicio.
Co-Payment
A co-payment is a fixed amount (for example $15) that you pay for a covered healthcare service,
usually when you receive the service. The dollar amount can vary by the type of service.
Coseguro
El porcentaje de los costos que paga por los servicios de atención médica cubiertos después de
haber pagado su deducible.
Cost-Sharing Reduction
Cost-Sharing Reduction (CSR) lowers the amount you pay out-of-pocket for deductibles, co-
insurance and co-payments when you get medical services. If you qualify for CSR, you must
enroll in a Silver level plan to get these lower costs.
Creditable Coverage
Creditable coverage is any of the following plans: group health plan, individual health plan,
student health plan, Medicare, Medicaid, CHAMPUS and TRICARE, Federal Employees Health
Benefits Program, Indian Health Service, Peace Corps, public health plan (such as those from the
US Government, or a state government, or a foreign country), or Children’s Health Insurance
Program (CHIP)
Creditos fiscales anticipados para la prima
también conocido como créditos fiscales anticipados para la prima. El monto del crédito se
pagará directamente del gobierno federal a la compañía de seguros. El individuo paga la
diferencia entre el crédito y la prima del plan.
Cuenta de ahorro para la salud
Las cuentas de ahorro para la salud (HSA en inglés) le permiten apartar dinero antes de
impuestos para pagar los gastos médicos calificados si tiene un plan de seguro de salud con
deducible alto.
deducible
El deducible es el monto que paga por los servicios de atención médica cubiertos antes que su
plan de seguro comience a pagar. Puede que no se aplique a todos los servicios.
Deductible
The deductible is the amount you pay for covered healthcare services before your insurance plan
starts to pay. It may not apply to all services.
Dependent Coverage
Dependent coverage refers to insurance coverage for family members of the policyholder, such
as a spouse, child, or partner.
Dependent(s)
A dependent is a spouse, child or family member of the household obtaining health coverage
under the primary applicant's insurance plan
Dependiente(s)
Un dependiente es un cónyuge, hijo o miembro de la familia del hogar que obtiene cobertura
médica bajo el plan de seguro del solicitante principal.
Especialista
médico que se enfoca en un área específica de la medicina o en un grupo de pacientes para
diagnosticar, manejar, prevenir o tratar ciertos tipos de síntomas y afecciones.
essential health benefits
All qualified health plans (QHP) offered through Access Health CT provide the same set
of 10 Essential Health Benefits. While the benefits may cost more or less in different plans at
different levels, you can be assured that all plans will provide: 1. Preventive and wellness
services and chronic disease management 2. Pediatric services 3. Ambulatory patient services
(outpatient care you get without being admitted to a hospital) 4. Emergency room coverage 5.
Hospitalization (such as surgery) 6. Maternity and newborn care (care before and after your baby
is born) 7. Mental health and substance abuse services, including behavioral health treatment
(includes counseling and psychotherapy) 8. Prescription drug coverage 9. Rehabilitation and
Habilitation services and devices (services and devices to help people with injuries, disabilities, or
chronic conditions gain or recover mental and physical skills) 10. Laboratory service coverage
evento de vida calificado
Un evento de vida calificado (QLE en inglés) es un cambio en su vida, como perder la cobertura
de salud, casarse, tener un bebé, o mudarse a Connecticut, que puede hacerlo elegible para un
período de inscripción especial, lo que le permite inscribirse en un seguro de salud fuera del
período abierto anual de inscripción.
Federal Poverty Level
The Federal Poverty Level (FPL) is a measure of income issued every year by the Department of
Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility
for certain programs and benefits, including savings on Marketplace health insurance, and
Medicaid and CHIP coverage.
Fuera de la red
Proveedores o servicios con los que su plan de seguro médico no tiene contrato. Es posible que
termine pagando una mayor parte del costo de esta atención. Asegúrese de verificar si sus
proveedores están dentro de la red. Puede averiguar si un proveedor está dentro de la red
utilizando el directorio de proveedores en línea o comunicándose con su compañía de seguros.
Gastos de bolsillo
Los gastos de bolsillo son gastos de atención médica que no son reembolsados por su compañía
de seguros. Estos costos incluyen deducibles, coseguros y copagos por servicios cubiertos, más
todos los costos por servicios que no están cubiertos.
Health Reimbursement Account (HRA)
Health Reimbursement Accounts are employer-funded group health plans from which employees
are reimbursed tax-free for qualified medical expenses up to a fixed dollar amount per year.
Unused amounts may be rolled over to be used in subsequent years. The employer funds and
owns the account.
Health Savings Account (HSA)
Health Savings Accounts (HSA) allow you to set aside money on a pre-tax basis to pay for
qualified medical expenses if you have a high deductible health insurance plan.
High Deductible Health Plans (HDHP)
A High Deductible Health Plan (HDHP) is plan that requires higher deductibles than other plans.
These can be combined with a health savings account or a health reimbursement arrangement to
allow you to pay for qualified out-of-pocket medical expenses on a pre-tax basis.
Hogar (hogar fiscal)
Para la mayoría de las personas, un hogar está formado por el declarante de impuestos, su
cónyuge, si tiene uno, y sus dependientes fiscales, incluidos aquellos que no necesitan
cobertura. El Mercado cuenta los ingresos estimados de todos los miembros del hogar, incluso
aquellos que no solicitan cobertura. Cuando calcule sus ingresos para recibir ayuda financiera,
debe contar los ingresos de todas las personas de su hogar fiscal.
Household (Tax Household)
For most people, a household consists of the tax filer, their spouse if they have one, and their tax
dependents, including those who don’t need coverage. The Marketplace counts estimated income
of all household members, even those who are not applying for coverage. When you estimate
your income to receive financial help you should count income for everyone in your tax
household.
In-Network Coverage
Your insurance company has contracted with hospitals, providers and suppliers to provide
services at a lower cost. You can find out if a provider is in-network using the online provider
directory or by contacting your insurance company.
Ley de Cuidado de Salud a Bajo Precio
(también conocida como la Ley de Protección al Paciente y Cuidado de Salud a bajo precio u
Obamacare) es una legislación histórica de reforma de salud promulgada en marzo de 2010. Las
disposiciones clave están destinadas a extender la cobertura a millones de estadounidenses sin
seguro, implementar medidas que reduzcan los costos de atención médica, mejorar la eficiencia
del sistema, y eliminar las prácticas de la industria que incluyen la rescisión y denegación de
cobertura debido a condiciones preexistentes.
Limite Annual
Un límite en los beneficios que pagará su plan de salud en un año. A veces, se imponen límites a
servicios particulares, como prescripciones o tratamientos de fisioterapia. También se pueden
colocar en el monto en dólares o en el número de visitas. Una vez que se alcanza un límite
anual, debe pagar todos los costos de atención médica relacionados durante el resto del año.
Máximo de gastos de bolsillo
El máximo de gastos de bolsillo (MOOP en inglés), también conocido como límites de gastos de
bolsillo, es lo máximo que pagará durante un período de póliza (generalmente un año) antes de
que su plan de salud comience a pagar el 100% de la cantidad permitida. Este límite nunca
incluye su prima, los cargos facturados por el saldo o los servicios que su plan no cubre. Algunos
planes de salud no cuentan todos sus copagos, deducibles, pagos de coseguro, pagos fuera de
la red u otros gastos para este límite. Para el Programa de salud HUSKY (Medicaid / Programa
de seguro médico para niños), el límite sí incluye las primas.
Maximum-Out-of-Pocket (MOOP)
The Maximum-Out-Of-Pocket (MOOP) also known as out-of-pocket limits, is the most you will pay
during a policy period (usually a year) before your health plan begins to pay 100% of the allowed
amount. This limit never includes your premium, balance-billed charges or services your plan
does not cover. Some health plans do not count all of your co-payments, deductibles, co-
insurance payments, out-of-network payments or other expenses toward this limit. For HUSKY
Health Program (Medicaid/Children’s Health Insurance Program), the limit does include
premiums.
Medicaid
Medicaid is state-administered health insurance program for low-income families and children,
pregnant women, the elderly, people with disabilities, and in some states, other adults. The
federal government provides a portion of the funding for Medicaid and sets guidelines for the
program. States also have choices in how they design their program, so Medicaid varies state by
state.
Medicaid (español)
Medicaid es un programa de seguro médico administrado por el estado para familias y niños de
hogares de bajos ingresos, mujeres embarazadas, ancianos, personas con discapacidades y, en
algunos estados, otros adultos. El gobierno federal proporciona una parte de los fondos
para Medicaid y establece las pautas para el programa. Los estados también tienen opciones
sobre cómo diseñar su programa, por lo que Medicaid varía de un estado a otro.
Medicare
Medicare is a federal health insurance program for people who are age 65 or older and for certain
younger people with disabilities. Medicare offers broad coverage – Part A covers hospital
insurance; Part B is medical insurance and Part D covers prescription drugs. Part C can
supplement Part A, B and sometimes D.
Medicare (español)
Medicare es un programa de seguro médico federal para personas de 65 años o más y para
ciertas personas más jóvenes con discapacidades. Medicare ofrece una amplia cobertura: la
Parte A cubre el seguro hospitalario; La Parte B es un seguro médico y la Parte D cubre los
medicamentos recetados. La Parte C puede complementar la Parte A, B y, a veces, la D.
Médico de atención primaria (PCP en inglés)
Un médico que brinda, coordina o ayuda a un paciente a acceder a una variedad de servicios de
atención médica.
Minimum Essential Coverage (MEC)
Minimum Essential Coverage (MEC) is the type of coverage an individual needs to have to meet
the individual responsibility requirement under the Affordable Care Act. This includes individual
market policies, job-based coverage, Medicare, Medicaid, Children’s Health Insurance Program,
TRICARE, and certain other coverage.
Modified Adjusted Gross Income (MAGI)
Modified Adjusted Gross Income (MAGI) is defined by the Internal Revenue Service (IRS).
Calculations include determination of MAGI with respect to federal poverty level and other
considerations such as pregnancy, children, children’s age, and whether the applicant is a
caretaker for other dependents.
nivel federal de pobreza
El Nivel Federal de Pobreza (FPL en inglés) es una medida de ingresos emitida cada año por el
Departamento de Salud y Servicios Humanos (HHS en inglés). Los niveles federales de pobreza
se utilizan para determinar su elegibilidad para ciertos programas y beneficios, incluyendo los
ahorros en el seguro médico del Mercado y la cobertura de Medicaid y CHIP.
Open Enrollment Period
The period of time, from November 1 – January 15, when you can enroll or renew in qualified
health plans (QHP) through Access Health CT. Open Enrollment Periods can differ between
states and coverage types.
Out-of-Network
Providers or services with which your health insurance plan has not contracted. You may end up
paying more of the cost for this care. Be sure to check if your providers are in-network. You can
find out if a provider is in-network using the online provider directory or by contacting your
insurance company.
Out-of-Pocket Costs
Out-of-pocket costs are expenses for medical care that are not reimbursed
by your insurance company. These costs include deductibles, co-insurance, and co-payments for
covered services plus all costs for services that are not covered.
periodo abierto de inscripción
Es un período de tiempo, del 1 de noviembre al 15 de enero, en el que puede inscribirse o
renovar en planes de salud calificados (QHP en inglés) a través de Access Health CT. Los
períodos abierto de inscripción pueden diferir entre los estados y los tipos de cobertura.
Periodo de Inscripción Especial
Un Período de Inscripción Especial (SEP en inglés) es un período de tiempo especial durante el
año en el que puede inscribirse en cobertura de salud a través de Access Health CT. Para
obtener un Período de Inscripción Especial, debe demostrar que tiene un Evento de Vida
Calificado y tendrá 60 días, a partir de la fecha de ese evento, para comenzar su proceso de
solicitud.
plan catastrófico
Los planes catastróficos están disponibles para personas menores de 30 años o para aquellos a
quienes se les haya otorgado una exención por dificultades económicas. Los planes catastróficos
no son elegibles para ayuda financiera. Estos planes tienen primas mensuales bajas y brindan el
nivel más bajo de cobertura. Los planes catastróficos ofrecen protección cuando los costos de
atención médica se acercan o alcanzan los costos máximos anuales de bolsillo.
Plan de Organización de Proveedores Preferidos
Un plan de Organización de Proveedores Preferidos (PPO en inglés) contrata a proveedores de
salud, como hospitales y médicos, para crear una red de proveedores participantes. Paga menos
si utiliza proveedores que pertenecen a la red del plan. Por lo general, puede utilizar médicos,
hospitales y proveedores fuera de la red por un costo adicional.
Plan de punto de servicio
Un plan de punto de servicio (POS en inglés) ofrece servicios con descuento si utiliza médicos,
hospitales y otros proveedores de atención médica que pertenecen a la red del plan. Los planes
de punto de servicio pueden requerir que obtenga una remisión de su médico de atención
primaria para ver a un especialista.
Plan de Salud Calificado
Un plan de salud calificado (QHP en inglés) por Access Health CT, proporciona beneficios
esenciales de salud, sigue los límites establecidos sobre costos compartidos (como deducibles,
copagos y montos máximos de gastos de bolsillo) y cumple con otros requisitos.
Plan de salud con un deducible alto
Un plan de salud con deducible alto (HDHP en inglés) es un plan que requiere deducibles más
altos que otros planes. Estos pueden combinarse con una cuenta de ahorros para la salud (HSA
en inglés) o un acuerdo de reembolso de la salud (HRA en inglés) para permitirle pagar los
gastos médicos calificados de su bolsillo antes de impuestos.
Plan Network
A plan network includes specific doctors, hospitals, pharmacies, and other health care providers
who have contracted with the health insurance company.
Point-of-Service (POS) Plan
A Point-of-Service Plan (POS) type offers discounted services if you use doctors, hospitals, and
other healthcare providers that belong to the plan’s network. POS plans may require you to get a
referral from your primary care doctor in order to see a specialist.
Preferred Provider Organization (PPO) Plan
A Preferred Provider Organization plan (PPO) contracts with medical providers, such as hospitals
and doctors, to create a network of participating providers. You pay less if you use providers that
belong to the plan’s network. You can usually use doctors, hospitals, and providers outside of the
network for an additional cost.
Premium
The amount you pay for your health insurance plan to the insurance company every month.
Preventive Services
These services include annual check-ups, immunizations, patient counseling, and screenings.
Preventive services are an Essential Health Benefit and covered under plans offered through
Access Health CT.
Prima
La cantidad que paga por su plan de seguro médico a la compañía de seguros cada mes.
Primary Care Physician (PCP)
A doctor who provides, coordinates or helps a patient access a range of health care services.
Programa de seguro médico para niños (CHIP en inglés)
CHIP es un programa de seguro financiado por el gobierno estatal y federal, que brinda seguro
de salud a niños en hogares de bajos ingresos. En Connecticut, este programa se conoce como
HUSKY B.
Qualified Health Plan (QHP)
An insurance plan that is certified by Access Health CT, provides Essential Health Benefits,
follows established limits on cost -sharing (like deductibles, co-payments, and out-of-pocket
maximum amounts), and meets other requirements.
Qualifying Life Event (QLE)
A Qualifying Life Event (QLE) is a change in your life — like losing health coverage, getting
married, having a baby or moving to Connecticut— that can make you eligible for a Special
Enrollment Period, allowing you to enroll in health insurance outside the yearly Open Enrollment
Period.
Reclamo
Un reclamo es una solicitud de pago que usted o su proveedor de atención médica presentan a
su aseguradora de salud cuando recibe artículos o servicios.
Red de un plan
La red de un plan incluye médicos, hospitales, farmacias y otros proveedores de atención médica
específicos que tienen contrato con la compañía de seguro médico.
Red escalonada
Una red escalonada divide a los hospitales y médicos en grupos, según la información sobre la
calidad de su atención y los costos de sus servicios. Lo que paga se basa en el nivel del
proveedor.
Reducción de Costos Compartidos (CSR en inglés)
Reducción de Costos Compartidos (CSR) reduce la cantidad que paga de su bolsillo por
deducibles, coseguros y copagos cuando recibe servicios médicos. Si califica para Reducción de
Costos Compartidos, debe inscribirse en un plan de nivel Plata para obtener estos bajos costos.
Representante Autorizado
Un representante autorizado es una persona que ha sido designada en la solicitud para actuar
en nombre de otra persona.
Servicios Preventivos
Estos servicios incluyen chequeos anuales, vacunas, asesoramiento para pacientes y exámenes
de detección. Los servicios preventivos son un beneficio esencial salud y están cubiertos por los
planes que se ofrecen a través de Access Health CT.
Special Enrollment Period (SEP)
A Special Enrollment Period (SEP) is a special window of time during the year when you can
enroll in health insurance through Access Health CT. To get a Special Enrollment Period, you
must prove that you have a Qualifying Life Event – and you will have 60 days from the date of
that event begin your application process.
Specialist
A doctor who focuses on a specific area of medicine or a group of patients to diagnose, manage,
prevent or treat certain types of symptoms and conditions.
Tiered Network
A tiered network divides hospitals and doctors into groups, based on information about the quality
of their care and the costs of their services. What you pay is based on the tier of the provider.
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What are the key takeaways from this text?
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Access Health CT Glossary
Written by Roberto Blundo | Last published at: May 08, 2024
Glossary
acuerdo de reembolso de salud
Las cuentas de reembolso de salud son planes de salud grupales financiados
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American Indians and Alaska Natives
Written by Yessenia Milan | Last published at: October 25, 2024
If you are an American Indian or Alaska Native, you can enroll in a Qualified Health Plan (QHP) or
Stand-Alone Dental Plan at any time during the year and may change your health and/or dental plan
selection once a month. The coverage effective date(s) for your health and/or dental plan depend(s)
on the day you enroll. If you enroll by the 15th of the month, your coverage will start on the 1st day
of the following month (for example, if you enroll by February 15, your coverage will start on March
1). When you complete your application for health and/or dental coverage, you will not be asked to
provide documents to verify your American Indian or Alaska Native status, but you must provide the
name of your federally recognized tribe and your tribal status.
Financial Help
Based on your household's Modified Adjusted Gross Income (MAGI), you and your household
members may qualify for financial help to lower your health insurance costs.
You may qualify for a zero-cost sharing health plan if your household's income is between 100-
300% of the Federal Poverty Level (FPL). You do not owe any out-of-pocket costs for services
when you use a zero-cost sharing health plan, regardless of whether you receive care from an in-
or out-of-network provider.
You may qualify for a low-cost sharing health plan if your household's income is above 300% of
the FPL.
Your out-of-pocket costs may be waived if you receive services from an Indian Health Service
provider.
Calculating your Modified Adjusted Gross Income (MAGI)
Certain distributions and payments made to the American Indians and Alaska Natives are excluded
from MAGI for purposes of determining your household's eligibility for HUSKY Health coverage
(Medicaid and the Children's Health Insurance Program (CHIP)), the Covered CT Program, and
financial help.
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What is the main topic of this document?
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American Indians and Alaska Natives
Written by Yessenia Milan | Last published at: October 25, 2024
If you are an American Indian or Alaska Native, you can enroll in a Qualified Health Plan (QHP) or
S
|
American Indians and Alaska Natives
Written by Yessenia Milan | Last published at: October 25, 2024
If you are an American Indian or Alaska Native, you can enroll in a Qualified Health Plan (QHP) or
Stand-Alone Dental Plan at any time during the year and may change your health and/or dental plan
selection once a month. The coverage effective date(s) for your health and/or dental plan depend(s)
on the day you enroll. If you enroll by the 15th of the month, your coverage will start on the 1st day
of the following month (for example, if you enroll by February 15, your coverage will start on March
1). When you complete your application for health and/or dental coverage, you will not be asked to
provide documents to verify your American Indian or Alaska Native status, but you must provide the
name of your federally recognized tribe and your tribal status.
Financial Help
Based on your household's Modified Adjusted Gross Income (MAGI), you and your household
members may qualify for financial help to lower your health insurance costs.
You may qualify for a zero-cost sharing health plan if your household's income is between 100-
300% of the Federal Poverty Level (FPL). You do not owe any out-of-pocket costs for services
when you use a zero-cost sharing health plan, regardless of whether you receive care from an in-
or out-of-network provider.
You may qualify for a low-cost sharing health plan if your household's income is above 300% of
the FPL.
Your out-of-pocket costs may be waived if you receive services from an Indian Health Service
provider.
Calculating your Modified Adjusted Gross Income (MAGI)
Certain distributions and payments made to the American Indians and Alaska Natives are excluded
from MAGI for purposes of determining your household's eligibility for HUSKY Health coverage
(Medicaid and the Children's Health Insurance Program (CHIP)), the Covered CT Program, and
financial help.
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Who is mentioned in the document?
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American Indians and Alaska Natives
Written by Yessenia Milan | Last published at: October 25, 2024
If you are an American Indian or Alaska Native, you can enroll in a Qualified Health Plan (QHP) or
S
|
American Indians and Alaska Natives
Written by Yessenia Milan | Last published at: October 25, 2024
If you are an American Indian or Alaska Native, you can enroll in a Qualified Health Plan (QHP) or
Stand-Alone Dental Plan at any time during the year and may change your health and/or dental plan
selection once a month. The coverage effective date(s) for your health and/or dental plan depend(s)
on the day you enroll. If you enroll by the 15th of the month, your coverage will start on the 1st day
of the following month (for example, if you enroll by February 15, your coverage will start on March
1). When you complete your application for health and/or dental coverage, you will not be asked to
provide documents to verify your American Indian or Alaska Native status, but you must provide the
name of your federally recognized tribe and your tribal status.
Financial Help
Based on your household's Modified Adjusted Gross Income (MAGI), you and your household
members may qualify for financial help to lower your health insurance costs.
You may qualify for a zero-cost sharing health plan if your household's income is between 100-
300% of the Federal Poverty Level (FPL). You do not owe any out-of-pocket costs for services
when you use a zero-cost sharing health plan, regardless of whether you receive care from an in-
or out-of-network provider.
You may qualify for a low-cost sharing health plan if your household's income is above 300% of
the FPL.
Your out-of-pocket costs may be waived if you receive services from an Indian Health Service
provider.
Calculating your Modified Adjusted Gross Income (MAGI)
Certain distributions and payments made to the American Indians and Alaska Natives are excluded
from MAGI for purposes of determining your household's eligibility for HUSKY Health coverage
(Medicaid and the Children's Health Insurance Program (CHIP)), the Covered CT Program, and
financial help.
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What are the key takeaways from this text?
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American Indians and Alaska Natives
Written by Yessenia Milan | Last published at: October 25, 2024
If you are an American Indian or Alaska Native, you can enroll in a Qualified Health Plan (QHP) or
S
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American Rescue Plan Act & Inflation Reduction
Act
Written by Yessenia Milan | Last published at: February 20, 2025
The American Rescue Plan (ARPA) and the Inflation Reduction Act (IRA) make health
insurance coverage more affordable and accessible for many Connecticut residents. These
laws changed the way we calculate financial help for customers. As a result, many more
customers now qualify for financial help to make plans more affordable. Whether you’re a first-
time shopper or an existing customer, we want to make sure you know how to take advantage
of all the financial help available. Enhanced plan subsidies are in place through Plan Year 2025,
unless they are extended beyond 2025 through federal legislation.
Real-Life example* of savings for Connecticut residents and their families due to the
ARPA and IRA:
Household
Size
Metal
Level
Coverage
Year
Income
Premium Before
Financial Help
Premium After
Financial Help
1
Silver
2022
$19,800
$ 1,289.08
$ 706.08
2023
$19,800
$ 1,340.37
$ 5.75
As a result of the ARPA and IRA:
•
More people than ever before qualify for help paying for health coverage, even those
who weren’t eligible in the past.
•
Most people currently enrolled in a plan through Access Health CT qualify for more tax
credits.
•
Your portion of health insurance premiums may be lower.
•
While the ARPA and IRA are effective, eligible individuals and households will have at
least one health plan option that costs no more than 8.5% of the annual income of their
tax household.
•
There are no changes to how someone qualifies for HUSKY Health. The ARPA added
COVID-19 vaccine and treatment coverage to more HUSKY Health Medicaid programs,
including the new COVID-19 uninsured coverage group.
To find out now if you qualify for savings on Qualified Health Plans, you can Compare
Plans or submit an application online, by phone, or with the help of an Enrollment
Specialist or Broker
We will post updates to this article as new information is available. Access Health CT customers
will hear from us directly about next steps and the impact on their household.
Complete an application at AccessHealthCT.com and we will let you know if you qualify for the
Covered Connecticut Program, a state-funded program that provides free health and dental
coverage and non-emergency medical transportation benefits to eligible Connecticut residents.
You can also call our call center for free enrollment and eligibility help at 1-855-805-4325. If you
are deaf or hearing impaired, you may use the TTY at 1-855-789-2428 or contact us at 1-855-
805-4325 with a relay operator.
We will post updates to this article as new information is available. Access Health CT
customers will hear from us directly about next steps and the impact on their household.
*All information provided in this example is for general informational purposes only, and Access
Health CT makes no representation or warranty of any kind, express or implied, regarding the
accuracy, availability, or completeness of the information provided in this example. To find out if
you qualify for financial help, you can Compare Plans or submit an application online, by phone,
or with the help of an Enrollment Specialist or Broker.
|
What is the main topic of this document?
|
American Rescue Plan Act & Inflation Reduction
Act
Written by Yessenia Milan | Last published at: February 20, 2025
The American Rescue Plan (ARPA) and the Inflation Reduction Act (IRA) make health
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American Rescue Plan Act & Inflation Reduction
Act
Written by Yessenia Milan | Last published at: February 20, 2025
The American Rescue Plan (ARPA) and the Inflation Reduction Act (IRA) make health
insurance coverage more affordable and accessible for many Connecticut residents. These
laws changed the way we calculate financial help for customers. As a result, many more
customers now qualify for financial help to make plans more affordable. Whether you’re a first-
time shopper or an existing customer, we want to make sure you know how to take advantage
of all the financial help available. Enhanced plan subsidies are in place through Plan Year 2025,
unless they are extended beyond 2025 through federal legislation.
Real-Life example* of savings for Connecticut residents and their families due to the
ARPA and IRA:
Household
Size
Metal
Level
Coverage
Year
Income
Premium Before
Financial Help
Premium After
Financial Help
1
Silver
2022
$19,800
$ 1,289.08
$ 706.08
2023
$19,800
$ 1,340.37
$ 5.75
As a result of the ARPA and IRA:
•
More people than ever before qualify for help paying for health coverage, even those
who weren’t eligible in the past.
•
Most people currently enrolled in a plan through Access Health CT qualify for more tax
credits.
•
Your portion of health insurance premiums may be lower.
•
While the ARPA and IRA are effective, eligible individuals and households will have at
least one health plan option that costs no more than 8.5% of the annual income of their
tax household.
•
There are no changes to how someone qualifies for HUSKY Health. The ARPA added
COVID-19 vaccine and treatment coverage to more HUSKY Health Medicaid programs,
including the new COVID-19 uninsured coverage group.
To find out now if you qualify for savings on Qualified Health Plans, you can Compare
Plans or submit an application online, by phone, or with the help of an Enrollment
Specialist or Broker
We will post updates to this article as new information is available. Access Health CT customers
will hear from us directly about next steps and the impact on their household.
Complete an application at AccessHealthCT.com and we will let you know if you qualify for the
Covered Connecticut Program, a state-funded program that provides free health and dental
coverage and non-emergency medical transportation benefits to eligible Connecticut residents.
You can also call our call center for free enrollment and eligibility help at 1-855-805-4325. If you
are deaf or hearing impaired, you may use the TTY at 1-855-789-2428 or contact us at 1-855-
805-4325 with a relay operator.
We will post updates to this article as new information is available. Access Health CT
customers will hear from us directly about next steps and the impact on their household.
*All information provided in this example is for general informational purposes only, and Access
Health CT makes no representation or warranty of any kind, express or implied, regarding the
accuracy, availability, or completeness of the information provided in this example. To find out if
you qualify for financial help, you can Compare Plans or submit an application online, by phone,
or with the help of an Enrollment Specialist or Broker.
|
Who is mentioned in the document?
|
American Rescue Plan Act & Inflation Reduction
Act
Written by Yessenia Milan | Last published at: February 20, 2025
The American Rescue Plan (ARPA) and the Inflation Reduction Act (IRA) make health
|
American Rescue Plan Act & Inflation Reduction
Act
Written by Yessenia Milan | Last published at: February 20, 2025
The American Rescue Plan (ARPA) and the Inflation Reduction Act (IRA) make health
insurance coverage more affordable and accessible for many Connecticut residents. These
laws changed the way we calculate financial help for customers. As a result, many more
customers now qualify for financial help to make plans more affordable. Whether you’re a first-
time shopper or an existing customer, we want to make sure you know how to take advantage
of all the financial help available. Enhanced plan subsidies are in place through Plan Year 2025,
unless they are extended beyond 2025 through federal legislation.
Real-Life example* of savings for Connecticut residents and their families due to the
ARPA and IRA:
Household
Size
Metal
Level
Coverage
Year
Income
Premium Before
Financial Help
Premium After
Financial Help
1
Silver
2022
$19,800
$ 1,289.08
$ 706.08
2023
$19,800
$ 1,340.37
$ 5.75
As a result of the ARPA and IRA:
•
More people than ever before qualify for help paying for health coverage, even those
who weren’t eligible in the past.
•
Most people currently enrolled in a plan through Access Health CT qualify for more tax
credits.
•
Your portion of health insurance premiums may be lower.
•
While the ARPA and IRA are effective, eligible individuals and households will have at
least one health plan option that costs no more than 8.5% of the annual income of their
tax household.
•
There are no changes to how someone qualifies for HUSKY Health. The ARPA added
COVID-19 vaccine and treatment coverage to more HUSKY Health Medicaid programs,
including the new COVID-19 uninsured coverage group.
To find out now if you qualify for savings on Qualified Health Plans, you can Compare
Plans or submit an application online, by phone, or with the help of an Enrollment
Specialist or Broker
We will post updates to this article as new information is available. Access Health CT customers
will hear from us directly about next steps and the impact on their household.
Complete an application at AccessHealthCT.com and we will let you know if you qualify for the
Covered Connecticut Program, a state-funded program that provides free health and dental
coverage and non-emergency medical transportation benefits to eligible Connecticut residents.
You can also call our call center for free enrollment and eligibility help at 1-855-805-4325. If you
are deaf or hearing impaired, you may use the TTY at 1-855-789-2428 or contact us at 1-855-
805-4325 with a relay operator.
We will post updates to this article as new information is available. Access Health CT
customers will hear from us directly about next steps and the impact on their household.
*All information provided in this example is for general informational purposes only, and Access
Health CT makes no representation or warranty of any kind, express or implied, regarding the
accuracy, availability, or completeness of the information provided in this example. To find out if
you qualify for financial help, you can Compare Plans or submit an application online, by phone,
or with the help of an Enrollment Specialist or Broker.
|
What are the key takeaways from this text?
|
American Rescue Plan Act & Inflation Reduction
Act
Written by Yessenia Milan | Last published at: February 20, 2025
The American Rescue Plan (ARPA) and the Inflation Reduction Act (IRA) make health
|
Application Disclaimers
You must agree to the following disclaimers to complete your application. If you do not agree to the
disclaimers, you will not be eligible to enroll in a Qualified Health Plan or Medicaid.
Medicaid Only Disclaimers: You may be eligible for programs offered through the Department of Social
Services such as Medicaid (known as HUSKY A and Husky D) and the Children’s Health Insurance
Program (known as CHIP or HUSKY B). The information listed on your application will be used to decide if
you are eligible for these programs.
_____________________________________________________________________________________
I know that I must tell the program I’m enrolled in if information I listed on this application changes.
MEDICAID ONLY: I know that if Medicaid pays for a medical expense any money I get from other health
insurance or legal settlements will go to Medicaid in an amount equal to what Medicaid pays for the
expense.
MEDICAID ONLY: I know that if Medicaid pays for any of my medical expenses, any money I receive from
a lawsuit will be assigned to the State to pay for any medical expenses paid by the State related to injuries
that led to the lawsuit. If I have other insurance or a third party is liable to pay for my medical expenses,
the State may recover the cost of my medical bills directly from the insurer or third party. The State may
bill a legally liable relative to repay the State for the costs of my medical care. The State may recover
money from the estates of those people who were 55 years old or older at the time that community
medical benefits were paid and who do not have a living spouse or surviving child under age 21 or blind or
disabled. The State may recover from an inheritance or other lump sum of money I receive to repay the
State for the costs of my medical care. The State may place a lien, under certain conditions, on my home if
I permanently enter a nursing facility.
I know I’ll be asked to cooperate with the agency that collects medical support from the absent parent. If I
think that cooperating to collect medical support will harm me or my children, I can tell the agency and I
won’t have to cooperate.
I understand that AccessHealthCT.com will use data from my tax return during the renewal process to
determine yearly eligibility for help paying for health insurance for the next 5 years. I understand that if I
check this box I can change my answer later, and if I don’t check the box I can select less than 5 years.
I know that any change that I report may alter mine or my household’s eligibility status. If the change
results in me and my household becoming ineligible for help paying for health coverage, I and my
household may no longer receive help paying for coverage.
I’m signing this application under penalty of perjury. This means I’ve provided true answers to all the
questions on this form to the best of my knowledge. I know that if I’m not truthful, there may be a
penalty.
|
What is the main topic of this document?
|
Application Disclaimers
You must agree to the following disclaimers to complete your application. If you do not agree to the
disclaimers, you will not be eligible to enroll in a Qualified Health Pla
|
Application Disclaimers
You must agree to the following disclaimers to complete your application. If you do not agree to the
disclaimers, you will not be eligible to enroll in a Qualified Health Plan or Medicaid.
Medicaid Only Disclaimers: You may be eligible for programs offered through the Department of Social
Services such as Medicaid (known as HUSKY A and Husky D) and the Children’s Health Insurance
Program (known as CHIP or HUSKY B). The information listed on your application will be used to decide if
you are eligible for these programs.
_____________________________________________________________________________________
I know that I must tell the program I’m enrolled in if information I listed on this application changes.
MEDICAID ONLY: I know that if Medicaid pays for a medical expense any money I get from other health
insurance or legal settlements will go to Medicaid in an amount equal to what Medicaid pays for the
expense.
MEDICAID ONLY: I know that if Medicaid pays for any of my medical expenses, any money I receive from
a lawsuit will be assigned to the State to pay for any medical expenses paid by the State related to injuries
that led to the lawsuit. If I have other insurance or a third party is liable to pay for my medical expenses,
the State may recover the cost of my medical bills directly from the insurer or third party. The State may
bill a legally liable relative to repay the State for the costs of my medical care. The State may recover
money from the estates of those people who were 55 years old or older at the time that community
medical benefits were paid and who do not have a living spouse or surviving child under age 21 or blind or
disabled. The State may recover from an inheritance or other lump sum of money I receive to repay the
State for the costs of my medical care. The State may place a lien, under certain conditions, on my home if
I permanently enter a nursing facility.
I know I’ll be asked to cooperate with the agency that collects medical support from the absent parent. If I
think that cooperating to collect medical support will harm me or my children, I can tell the agency and I
won’t have to cooperate.
I understand that AccessHealthCT.com will use data from my tax return during the renewal process to
determine yearly eligibility for help paying for health insurance for the next 5 years. I understand that if I
check this box I can change my answer later, and if I don’t check the box I can select less than 5 years.
I know that any change that I report may alter mine or my household’s eligibility status. If the change
results in me and my household becoming ineligible for help paying for health coverage, I and my
household may no longer receive help paying for coverage.
I’m signing this application under penalty of perjury. This means I’ve provided true answers to all the
questions on this form to the best of my knowledge. I know that if I’m not truthful, there may be a
penalty.
|
Who is mentioned in the document?
|
Application Disclaimers
You must agree to the following disclaimers to complete your application. If you do not agree to the
disclaimers, you will not be eligible to enroll in a Qualified Health Pla
|
Application Disclaimers
You must agree to the following disclaimers to complete your application. If you do not agree to the
disclaimers, you will not be eligible to enroll in a Qualified Health Plan or Medicaid.
Medicaid Only Disclaimers: You may be eligible for programs offered through the Department of Social
Services such as Medicaid (known as HUSKY A and Husky D) and the Children’s Health Insurance
Program (known as CHIP or HUSKY B). The information listed on your application will be used to decide if
you are eligible for these programs.
_____________________________________________________________________________________
I know that I must tell the program I’m enrolled in if information I listed on this application changes.
MEDICAID ONLY: I know that if Medicaid pays for a medical expense any money I get from other health
insurance or legal settlements will go to Medicaid in an amount equal to what Medicaid pays for the
expense.
MEDICAID ONLY: I know that if Medicaid pays for any of my medical expenses, any money I receive from
a lawsuit will be assigned to the State to pay for any medical expenses paid by the State related to injuries
that led to the lawsuit. If I have other insurance or a third party is liable to pay for my medical expenses,
the State may recover the cost of my medical bills directly from the insurer or third party. The State may
bill a legally liable relative to repay the State for the costs of my medical care. The State may recover
money from the estates of those people who were 55 years old or older at the time that community
medical benefits were paid and who do not have a living spouse or surviving child under age 21 or blind or
disabled. The State may recover from an inheritance or other lump sum of money I receive to repay the
State for the costs of my medical care. The State may place a lien, under certain conditions, on my home if
I permanently enter a nursing facility.
I know I’ll be asked to cooperate with the agency that collects medical support from the absent parent. If I
think that cooperating to collect medical support will harm me or my children, I can tell the agency and I
won’t have to cooperate.
I understand that AccessHealthCT.com will use data from my tax return during the renewal process to
determine yearly eligibility for help paying for health insurance for the next 5 years. I understand that if I
check this box I can change my answer later, and if I don’t check the box I can select less than 5 years.
I know that any change that I report may alter mine or my household’s eligibility status. If the change
results in me and my household becoming ineligible for help paying for health coverage, I and my
household may no longer receive help paying for coverage.
I’m signing this application under penalty of perjury. This means I’ve provided true answers to all the
questions on this form to the best of my knowledge. I know that if I’m not truthful, there may be a
penalty.
|
What are the key takeaways from this text?
|
Application Disclaimers
You must agree to the following disclaimers to complete your application. If you do not agree to the
disclaimers, you will not be eligible to enroll in a Qualified Health Pla
|
Asistencia de traducción de idiomas y TTY
Written by Yessenia Milan | Last published at: January 08, 2025
¿Cómo puedo obtener ayuda con la traducción de idiomas o TTY?
Si necesita asistencia en otro idioma, contamos con traductores capacitados en más de 200
idiomas que están aquí para ayudarle. Comuníquese con el centro de llamadas de Access
Health CT al 1-855-805-4325.
Si es sordo o tiene problemas de audición, puede usar el TTY al 1-855-789-2428 o
comunicarse al 1-855-805-4325 con nosotros a través de un operador de retransmisión.
Descargue una copia de nuestra lista de verificación de inscripción aquí, disponible en varios
idiomas:
Español
Inglés
Criollo haitiano
Polaco
|
What is the main topic of this document?
|
Asistencia de traducción de idiomas y TTY
Written by Yessenia Milan | Last published at: January 08, 2025
¿Cómo puedo obtener ayuda con la traducción de idiomas o TTY?
Si necesita asistencia e
|
Asistencia de traducción de idiomas y TTY
Written by Yessenia Milan | Last published at: January 08, 2025
¿Cómo puedo obtener ayuda con la traducción de idiomas o TTY?
Si necesita asistencia en otro idioma, contamos con traductores capacitados en más de 200
idiomas que están aquí para ayudarle. Comuníquese con el centro de llamadas de Access
Health CT al 1-855-805-4325.
Si es sordo o tiene problemas de audición, puede usar el TTY al 1-855-789-2428 o
comunicarse al 1-855-805-4325 con nosotros a través de un operador de retransmisión.
Descargue una copia de nuestra lista de verificación de inscripción aquí, disponible en varios
idiomas:
Español
Inglés
Criollo haitiano
Polaco
|
Who is mentioned in the document?
|
Asistencia de traducción de idiomas y TTY
Written by Yessenia Milan | Last published at: January 08, 2025
¿Cómo puedo obtener ayuda con la traducción de idiomas o TTY?
Si necesita asistencia e
|
Asistencia de traducción de idiomas y TTY
Written by Yessenia Milan | Last published at: January 08, 2025
¿Cómo puedo obtener ayuda con la traducción de idiomas o TTY?
Si necesita asistencia en otro idioma, contamos con traductores capacitados en más de 200
idiomas que están aquí para ayudarle. Comuníquese con el centro de llamadas de Access
Health CT al 1-855-805-4325.
Si es sordo o tiene problemas de audición, puede usar el TTY al 1-855-789-2428 o
comunicarse al 1-855-805-4325 con nosotros a través de un operador de retransmisión.
Descargue una copia de nuestra lista de verificación de inscripción aquí, disponible en varios
idiomas:
Español
Inglés
Criollo haitiano
Polaco
|
What are the key takeaways from this text?
|
Asistencia de traducción de idiomas y TTY
Written by Yessenia Milan | Last published at: January 08, 2025
¿Cómo puedo obtener ayuda con la traducción de idiomas o TTY?
Si necesita asistencia e
|
Birth Control Coverage
Written by Yessenia Milan | Last published at: October 17, 2023
Yes and at no cost!
All Access Health CT health plans must cover all approved forms of birth control under the Affordable
Care Act at no cost to the consumer. This means any plan bought through Access Health CT must
offer these contraceptive benefits as part of your health insurance coverage. You should still review
your plan benefits and costs with the insurance company you chose or are looking to choose.
|
What is the main topic of this document?
|
Birth Control Coverage
Written by Yessenia Milan | Last published at: October 17, 2023
Yes and at no cost!
All Access Health CT health plans must cover all approved forms of birth control under the Af
|
Birth Control Coverage
Written by Yessenia Milan | Last published at: October 17, 2023
Yes and at no cost!
All Access Health CT health plans must cover all approved forms of birth control under the Affordable
Care Act at no cost to the consumer. This means any plan bought through Access Health CT must
offer these contraceptive benefits as part of your health insurance coverage. You should still review
your plan benefits and costs with the insurance company you chose or are looking to choose.
|
Who is mentioned in the document?
|
Birth Control Coverage
Written by Yessenia Milan | Last published at: October 17, 2023
Yes and at no cost!
All Access Health CT health plans must cover all approved forms of birth control under the Af
|
Birth Control Coverage
Written by Yessenia Milan | Last published at: October 17, 2023
Yes and at no cost!
All Access Health CT health plans must cover all approved forms of birth control under the Affordable
Care Act at no cost to the consumer. This means any plan bought through Access Health CT must
offer these contraceptive benefits as part of your health insurance coverage. You should still review
your plan benefits and costs with the insurance company you chose or are looking to choose.
|
What are the key takeaways from this text?
|
Birth Control Coverage
Written by Yessenia Milan | Last published at: October 17, 2023
Yes and at no cost!
All Access Health CT health plans must cover all approved forms of birth control under the Af
|
Can I apply for a qualified health plan
through Access Health CT if I have COBRA?
Written by Yessenia Milan | Last published at: October 24, 2024
1. What is COBRA?
COBRA is a federal law that may allow you to temporarily keep your health coverage after a
qualifying event, such as job loss. If you choose COBRA continuation coverage, you may have to
pay 100% of the monthly payments (premium), including the share the employer used to pay, and a
small administrative fee.
If you are being offered COBRA continuation coverage, there are some things you should know
before you make a final decision. Access Health CT may offer a better, less expensive choice for you
and your family.
2. COBRA Coverage vs. Coverage through Access Health CT
We recommend that you check your options with Access Health before choosing COBRA for these
reasons:
Access Health CT is the only place you can qualify for financial help to pay for health insurance.
With COBRA coverage, you may have to pay 100% of the monthly payment (premium), including
the share the employer used to pay, plus a small administrative fee.
If you decide you want to end your COBRA coverage early, you are only eligible to enroll during
the Annual – unless you have a Qualifying Life Event.
You may qualify for Medicaid or the Children’s Health Insurance Program (CHIP), and you can
apply for and enroll in those programs any time of year.
Also consider what other options you have, like being added to a spouse or household member’s
health plan.
3. Can I apply for private health insurance through Access Health CT if I already have
COBRA?
You may be eligible to enroll in a Qualified Health Plan (QHP) during a Special Enrollment Period if
your COBRA coverage ends or your former employer stops contributing and you must pay the full
cost. If the cost does not change and you voluntarily terminate your COBRA coverage early, you will
not be eligible to enroll in a QHP until the Open Enrollment Period begins.
More Information:
Learn More About Special Enrollment Periods
|
What is the main topic of this document?
|
Can I apply for a qualified health plan
through Access Health CT if I have COBRA?
Written by Yessenia Milan | Last published at: October 24, 2024
1. What is COBRA?
COBRA is a federal law that may allo
|
Can I apply for a qualified health plan
through Access Health CT if I have COBRA?
Written by Yessenia Milan | Last published at: October 24, 2024
1. What is COBRA?
COBRA is a federal law that may allow you to temporarily keep your health coverage after a
qualifying event, such as job loss. If you choose COBRA continuation coverage, you may have to
pay 100% of the monthly payments (premium), including the share the employer used to pay, and a
small administrative fee.
If you are being offered COBRA continuation coverage, there are some things you should know
before you make a final decision. Access Health CT may offer a better, less expensive choice for you
and your family.
2. COBRA Coverage vs. Coverage through Access Health CT
We recommend that you check your options with Access Health before choosing COBRA for these
reasons:
Access Health CT is the only place you can qualify for financial help to pay for health insurance.
With COBRA coverage, you may have to pay 100% of the monthly payment (premium), including
the share the employer used to pay, plus a small administrative fee.
If you decide you want to end your COBRA coverage early, you are only eligible to enroll during
the Annual – unless you have a Qualifying Life Event.
You may qualify for Medicaid or the Children’s Health Insurance Program (CHIP), and you can
apply for and enroll in those programs any time of year.
Also consider what other options you have, like being added to a spouse or household member’s
health plan.
3. Can I apply for private health insurance through Access Health CT if I already have
COBRA?
You may be eligible to enroll in a Qualified Health Plan (QHP) during a Special Enrollment Period if
your COBRA coverage ends or your former employer stops contributing and you must pay the full
cost. If the cost does not change and you voluntarily terminate your COBRA coverage early, you will
not be eligible to enroll in a QHP until the Open Enrollment Period begins.
More Information:
Learn More About Special Enrollment Periods
|
Who is mentioned in the document?
|
Can I apply for a qualified health plan
through Access Health CT if I have COBRA?
Written by Yessenia Milan | Last published at: October 24, 2024
1. What is COBRA?
COBRA is a federal law that may allo
|
Can I apply for a qualified health plan
through Access Health CT if I have COBRA?
Written by Yessenia Milan | Last published at: October 24, 2024
1. What is COBRA?
COBRA is a federal law that may allow you to temporarily keep your health coverage after a
qualifying event, such as job loss. If you choose COBRA continuation coverage, you may have to
pay 100% of the monthly payments (premium), including the share the employer used to pay, and a
small administrative fee.
If you are being offered COBRA continuation coverage, there are some things you should know
before you make a final decision. Access Health CT may offer a better, less expensive choice for you
and your family.
2. COBRA Coverage vs. Coverage through Access Health CT
We recommend that you check your options with Access Health before choosing COBRA for these
reasons:
Access Health CT is the only place you can qualify for financial help to pay for health insurance.
With COBRA coverage, you may have to pay 100% of the monthly payment (premium), including
the share the employer used to pay, plus a small administrative fee.
If you decide you want to end your COBRA coverage early, you are only eligible to enroll during
the Annual – unless you have a Qualifying Life Event.
You may qualify for Medicaid or the Children’s Health Insurance Program (CHIP), and you can
apply for and enroll in those programs any time of year.
Also consider what other options you have, like being added to a spouse or household member’s
health plan.
3. Can I apply for private health insurance through Access Health CT if I already have
COBRA?
You may be eligible to enroll in a Qualified Health Plan (QHP) during a Special Enrollment Period if
your COBRA coverage ends or your former employer stops contributing and you must pay the full
cost. If the cost does not change and you voluntarily terminate your COBRA coverage early, you will
not be eligible to enroll in a QHP until the Open Enrollment Period begins.
More Information:
Learn More About Special Enrollment Periods
|
What are the key takeaways from this text?
|
Can I apply for a qualified health plan
through Access Health CT if I have COBRA?
Written by Yessenia Milan | Last published at: October 24, 2024
1. What is COBRA?
COBRA is a federal law that may allo
|
Can I get a plan with a Health Savings
Account (HSA) through Access Health CT?
Written by Yessenia Milan | Last published at: February 19, 2025
Health Savings Accounts (HSAs) are medical savings accounts available to taxpayers who are
enrolled in a High Deductible Health Plan (HDHP). The funds contributed to the account aren’t
subject to federal income tax at the time of deposit. Funds must be used to pay for qualified medical
expenses and leftover funds roll over year to year if you don’t spend them, which means you don’t
lose them if they are not spent.
Some insurance companies offer High Deductible Health Plans that are compatible with a Health
Savings Account (HSA). These accounts are managed by the insurance companies and not by
Access Health CT. However, HSA compatible plans are available through the Access Health CT
Marketplace and are identified as such in the plan name. Just look for "HSA" in the plan name when
you are comparing health plans.
For more information on types of plans available through Access Health CT, click here.
|
What is the main topic of this document?
|
Can I get a plan with a Health Savings
Account (HSA) through Access Health CT?
Written by Yessenia Milan | Last published at: February 19, 2025
Health Savings Accounts (HSAs) are medical savings accou
|
Can I get a plan with a Health Savings
Account (HSA) through Access Health CT?
Written by Yessenia Milan | Last published at: February 19, 2025
Health Savings Accounts (HSAs) are medical savings accounts available to taxpayers who are
enrolled in a High Deductible Health Plan (HDHP). The funds contributed to the account aren’t
subject to federal income tax at the time of deposit. Funds must be used to pay for qualified medical
expenses and leftover funds roll over year to year if you don’t spend them, which means you don’t
lose them if they are not spent.
Some insurance companies offer High Deductible Health Plans that are compatible with a Health
Savings Account (HSA). These accounts are managed by the insurance companies and not by
Access Health CT. However, HSA compatible plans are available through the Access Health CT
Marketplace and are identified as such in the plan name. Just look for "HSA" in the plan name when
you are comparing health plans.
For more information on types of plans available through Access Health CT, click here.
|
Who is mentioned in the document?
|
Can I get a plan with a Health Savings
Account (HSA) through Access Health CT?
Written by Yessenia Milan | Last published at: February 19, 2025
Health Savings Accounts (HSAs) are medical savings accou
|
Can I get a plan with a Health Savings
Account (HSA) through Access Health CT?
Written by Yessenia Milan | Last published at: February 19, 2025
Health Savings Accounts (HSAs) are medical savings accounts available to taxpayers who are
enrolled in a High Deductible Health Plan (HDHP). The funds contributed to the account aren’t
subject to federal income tax at the time of deposit. Funds must be used to pay for qualified medical
expenses and leftover funds roll over year to year if you don’t spend them, which means you don’t
lose them if they are not spent.
Some insurance companies offer High Deductible Health Plans that are compatible with a Health
Savings Account (HSA). These accounts are managed by the insurance companies and not by
Access Health CT. However, HSA compatible plans are available through the Access Health CT
Marketplace and are identified as such in the plan name. Just look for "HSA" in the plan name when
you are comparing health plans.
For more information on types of plans available through Access Health CT, click here.
|
What are the key takeaways from this text?
|
Can I get a plan with a Health Savings
Account (HSA) through Access Health CT?
Written by Yessenia Milan | Last published at: February 19, 2025
Health Savings Accounts (HSAs) are medical savings accou
|
Continuous Enrollment Unwinding and HUSKY
Health Coverage
Written by Kecia Stauffer | Last published at: January 08, 2025
What is the Continuous Enrollment Unwinding?
During the pandemic, Connecticut extended health coverage for most Medicaid members
enrolled on or after March 18, 2020, even if they no longer qualified, a process the federal
government calls Continuous Enrollment. The federal rules have changed; Continuous
Enrollment ends March 31, 2023 and the process of reviewing households for eligibility, referred
to as Continuous Enrollment Unwinding, will resume. You can click here for the latest updates
on this process.
What steps can I take to get ready?
1.
Update us so we can update you! Make sure your address and phone number are up to
date with Access Health CT and/or the Department of Social Services (DSS). Consider
providing your email address, opting to receive text messages or selecting paperless
delivery for important notifications.
–
HUSKY A, B and D members: Update your information online through Access
Health CT or by calling Access Health CT at 1-855-805-4325 (TTY 1-855-789-
2428 or call 1-855-805-4325 with a relay operator)
–
HUSKY C members: Update your information online at Connecticut Department of
Social Services or by calling DSS at 1-855-626-6632
2.
Look for mail or email messages from DSS, Access Health CT and HUSKY Health
3.
Follow the Department of Social Services on social media for updates CT Department of
Social Services | Facebook and https://twitter.com/ctdss
What happens to my coverage when Continuous Enrollment ends?
The Department of Social Services will contact you to complete a renewal form to see if you
qualify for coverage for the next year. Each month for the next 12 months after March 31, 2023,
a portion of HUSKY Health members will be sent a renewal notification. You should wait until
you receive your renewal notification to take action but you can update your contact information
at any time.
You will receive a renewal form 45 days before your coverage is due to end. It is important to
complete your renewal quickly and provide any documentation that may be requested. This may
help you to avoid any gaps in medical coverage.
How do I complete my renewal once I get the notice?
When you receive your renewal notification, the fastest way to complete it is to go online.
•
HUSKY A, B, and D members, visit accesshealthct.com
•
HUSKY C members, visit mydss.ct.gov
When you update or confirm your application details through Access Health CT, you will get a
final determination on whether your HUSKY Health coverage will be renewed or if you qualify for
another program. You will see that result on the final screen of the application, and you will also
receive a confirmation by mail (1-3 business days) or through your online account inbox.
What if I no longer qualify for HUSKY Health?
If you no longer qualify for HUSKY Health, you can shop for health and dental coverage through
Access Health CT. There are full coverage options available at little or no cost. Contact Access
Health CT to find out what you may qualify for:
•
Online at Access Health CT
•
Over the phone at 1-855-805-4325 (If you are deaf or hearing impaired, you may use the
TTY at 1-855-789-2428 or contact us at 1-855-805-4325 with a relay operator)
What do I need to do now?
Update your household and contact information! You can call us or follow the steps below to
make your updates online. Make sure we have the most up to date information about your
household, including your annual income and your contact information
•
If you don’t have any updates to report, wait for a notice telling you when it’s time to take
further action
•
There is no need to contact us until you receive your notice
|
What is the main topic of this document?
|
Continuous Enrollment Unwinding and HUSKY
Health Coverage
Written by Kecia Stauffer | Last published at: January 08, 2025
What is the Continuous Enrollment Unwinding?
During the pandemic, Connecti
|
Continuous Enrollment Unwinding and HUSKY
Health Coverage
Written by Kecia Stauffer | Last published at: January 08, 2025
What is the Continuous Enrollment Unwinding?
During the pandemic, Connecticut extended health coverage for most Medicaid members
enrolled on or after March 18, 2020, even if they no longer qualified, a process the federal
government calls Continuous Enrollment. The federal rules have changed; Continuous
Enrollment ends March 31, 2023 and the process of reviewing households for eligibility, referred
to as Continuous Enrollment Unwinding, will resume. You can click here for the latest updates
on this process.
What steps can I take to get ready?
1.
Update us so we can update you! Make sure your address and phone number are up to
date with Access Health CT and/or the Department of Social Services (DSS). Consider
providing your email address, opting to receive text messages or selecting paperless
delivery for important notifications.
–
HUSKY A, B and D members: Update your information online through Access
Health CT or by calling Access Health CT at 1-855-805-4325 (TTY 1-855-789-
2428 or call 1-855-805-4325 with a relay operator)
–
HUSKY C members: Update your information online at Connecticut Department of
Social Services or by calling DSS at 1-855-626-6632
2.
Look for mail or email messages from DSS, Access Health CT and HUSKY Health
3.
Follow the Department of Social Services on social media for updates CT Department of
Social Services | Facebook and https://twitter.com/ctdss
What happens to my coverage when Continuous Enrollment ends?
The Department of Social Services will contact you to complete a renewal form to see if you
qualify for coverage for the next year. Each month for the next 12 months after March 31, 2023,
a portion of HUSKY Health members will be sent a renewal notification. You should wait until
you receive your renewal notification to take action but you can update your contact information
at any time.
You will receive a renewal form 45 days before your coverage is due to end. It is important to
complete your renewal quickly and provide any documentation that may be requested. This may
help you to avoid any gaps in medical coverage.
How do I complete my renewal once I get the notice?
When you receive your renewal notification, the fastest way to complete it is to go online.
•
HUSKY A, B, and D members, visit accesshealthct.com
•
HUSKY C members, visit mydss.ct.gov
When you update or confirm your application details through Access Health CT, you will get a
final determination on whether your HUSKY Health coverage will be renewed or if you qualify for
another program. You will see that result on the final screen of the application, and you will also
receive a confirmation by mail (1-3 business days) or through your online account inbox.
What if I no longer qualify for HUSKY Health?
If you no longer qualify for HUSKY Health, you can shop for health and dental coverage through
Access Health CT. There are full coverage options available at little or no cost. Contact Access
Health CT to find out what you may qualify for:
•
Online at Access Health CT
•
Over the phone at 1-855-805-4325 (If you are deaf or hearing impaired, you may use the
TTY at 1-855-789-2428 or contact us at 1-855-805-4325 with a relay operator)
What do I need to do now?
Update your household and contact information! You can call us or follow the steps below to
make your updates online. Make sure we have the most up to date information about your
household, including your annual income and your contact information
•
If you don’t have any updates to report, wait for a notice telling you when it’s time to take
further action
•
There is no need to contact us until you receive your notice
|
Who is mentioned in the document?
|
Continuous Enrollment Unwinding and HUSKY
Health Coverage
Written by Kecia Stauffer | Last published at: January 08, 2025
What is the Continuous Enrollment Unwinding?
During the pandemic, Connecti
|
Continuous Enrollment Unwinding and HUSKY
Health Coverage
Written by Kecia Stauffer | Last published at: January 08, 2025
What is the Continuous Enrollment Unwinding?
During the pandemic, Connecticut extended health coverage for most Medicaid members
enrolled on or after March 18, 2020, even if they no longer qualified, a process the federal
government calls Continuous Enrollment. The federal rules have changed; Continuous
Enrollment ends March 31, 2023 and the process of reviewing households for eligibility, referred
to as Continuous Enrollment Unwinding, will resume. You can click here for the latest updates
on this process.
What steps can I take to get ready?
1.
Update us so we can update you! Make sure your address and phone number are up to
date with Access Health CT and/or the Department of Social Services (DSS). Consider
providing your email address, opting to receive text messages or selecting paperless
delivery for important notifications.
–
HUSKY A, B and D members: Update your information online through Access
Health CT or by calling Access Health CT at 1-855-805-4325 (TTY 1-855-789-
2428 or call 1-855-805-4325 with a relay operator)
–
HUSKY C members: Update your information online at Connecticut Department of
Social Services or by calling DSS at 1-855-626-6632
2.
Look for mail or email messages from DSS, Access Health CT and HUSKY Health
3.
Follow the Department of Social Services on social media for updates CT Department of
Social Services | Facebook and https://twitter.com/ctdss
What happens to my coverage when Continuous Enrollment ends?
The Department of Social Services will contact you to complete a renewal form to see if you
qualify for coverage for the next year. Each month for the next 12 months after March 31, 2023,
a portion of HUSKY Health members will be sent a renewal notification. You should wait until
you receive your renewal notification to take action but you can update your contact information
at any time.
You will receive a renewal form 45 days before your coverage is due to end. It is important to
complete your renewal quickly and provide any documentation that may be requested. This may
help you to avoid any gaps in medical coverage.
How do I complete my renewal once I get the notice?
When you receive your renewal notification, the fastest way to complete it is to go online.
•
HUSKY A, B, and D members, visit accesshealthct.com
•
HUSKY C members, visit mydss.ct.gov
When you update or confirm your application details through Access Health CT, you will get a
final determination on whether your HUSKY Health coverage will be renewed or if you qualify for
another program. You will see that result on the final screen of the application, and you will also
receive a confirmation by mail (1-3 business days) or through your online account inbox.
What if I no longer qualify for HUSKY Health?
If you no longer qualify for HUSKY Health, you can shop for health and dental coverage through
Access Health CT. There are full coverage options available at little or no cost. Contact Access
Health CT to find out what you may qualify for:
•
Online at Access Health CT
•
Over the phone at 1-855-805-4325 (If you are deaf or hearing impaired, you may use the
TTY at 1-855-789-2428 or contact us at 1-855-805-4325 with a relay operator)
What do I need to do now?
Update your household and contact information! You can call us or follow the steps below to
make your updates online. Make sure we have the most up to date information about your
household, including your annual income and your contact information
•
If you don’t have any updates to report, wait for a notice telling you when it’s time to take
further action
•
There is no need to contact us until you receive your notice
|
What are the key takeaways from this text?
|
Continuous Enrollment Unwinding and HUSKY
Health Coverage
Written by Kecia Stauffer | Last published at: January 08, 2025
What is the Continuous Enrollment Unwinding?
During the pandemic, Connecti
|
Coverage Effective Dates for Qualified
Health Plans
Written by Yessenia Milan | Last published at: January 30, 2025
1. How are effective dates determined?
i. When you enroll during Open Enrollment determines when your health and/or dental coverage will
start:
For coverage starting January 1, 2025, you must enroll and complete your application by
December 15, 2024.
For coverage starting February 1, 2025, you must enroll and complete your application between
December 16, 2024 and January 15, 2025.
ii. Enrolling in health and/or dental insurance outside of the Open Enrollment requires a Qualifying
Life Event. You typically will have a period of 60 days from the Qualifying Life Event date, which is
referred to as a Special Enrollment Period, to enroll. The date your coverage will start will depend on
the type of Qualifying Life Event you had for your Special Enrollment Period.
iii. Connecticut residents that are eligible for the new Covered Connecticut Program can enroll at any
time. Your coverage will start on the first of the month after you complete your enrollment and
application.
2. Can I change my effective date?
Your coverage effective date is based on the date you enroll and cannot be changed. For more
information, call Access Health CT at 1-855-805-4325.
|
What is the main topic of this document?
|
Coverage Effective Dates for Qualified
Health Plans
Written by Yessenia Milan | Last published at: January 30, 2025
1. How are effective dates determined?
i. When you enroll during Open Enrollment det
|
Coverage Effective Dates for Qualified
Health Plans
Written by Yessenia Milan | Last published at: January 30, 2025
1. How are effective dates determined?
i. When you enroll during Open Enrollment determines when your health and/or dental coverage will
start:
For coverage starting January 1, 2025, you must enroll and complete your application by
December 15, 2024.
For coverage starting February 1, 2025, you must enroll and complete your application between
December 16, 2024 and January 15, 2025.
ii. Enrolling in health and/or dental insurance outside of the Open Enrollment requires a Qualifying
Life Event. You typically will have a period of 60 days from the Qualifying Life Event date, which is
referred to as a Special Enrollment Period, to enroll. The date your coverage will start will depend on
the type of Qualifying Life Event you had for your Special Enrollment Period.
iii. Connecticut residents that are eligible for the new Covered Connecticut Program can enroll at any
time. Your coverage will start on the first of the month after you complete your enrollment and
application.
2. Can I change my effective date?
Your coverage effective date is based on the date you enroll and cannot be changed. For more
information, call Access Health CT at 1-855-805-4325.
|
Who is mentioned in the document?
|
Coverage Effective Dates for Qualified
Health Plans
Written by Yessenia Milan | Last published at: January 30, 2025
1. How are effective dates determined?
i. When you enroll during Open Enrollment det
|
Coverage Effective Dates for Qualified
Health Plans
Written by Yessenia Milan | Last published at: January 30, 2025
1. How are effective dates determined?
i. When you enroll during Open Enrollment determines when your health and/or dental coverage will
start:
For coverage starting January 1, 2025, you must enroll and complete your application by
December 15, 2024.
For coverage starting February 1, 2025, you must enroll and complete your application between
December 16, 2024 and January 15, 2025.
ii. Enrolling in health and/or dental insurance outside of the Open Enrollment requires a Qualifying
Life Event. You typically will have a period of 60 days from the Qualifying Life Event date, which is
referred to as a Special Enrollment Period, to enroll. The date your coverage will start will depend on
the type of Qualifying Life Event you had for your Special Enrollment Period.
iii. Connecticut residents that are eligible for the new Covered Connecticut Program can enroll at any
time. Your coverage will start on the first of the month after you complete your enrollment and
application.
2. Can I change my effective date?
Your coverage effective date is based on the date you enroll and cannot be changed. For more
information, call Access Health CT at 1-855-805-4325.
|
What are the key takeaways from this text?
|
Coverage Effective Dates for Qualified
Health Plans
Written by Yessenia Milan | Last published at: January 30, 2025
1. How are effective dates determined?
i. When you enroll during Open Enrollment det
|
Covered CT Program
Written by Yessenia Milan | Last published at: January 08, 2025
Covered CT
Some Connecticut residents that meet specific eligibility requirements are paying $0 for their
health insurance coverage, thanks to the new Covered CT Program created by the State of
Connecticut. The Covered CT Program provides health insurance coverage, dental coverage
and Non-Emergency Medical Transportation (NEMT) administered by the Connecticut
Department of Social Services. This Program is for residents between the ages of 19–64.
Want to see if you qualify? Complete an application with Access Health CT online or with
some free help.
For eligible Connecticut residents enrolled in the Covered CT Program, the State of Connecticut
pays the customer’s portion of the monthly payment (premium) directly to their insurance
company (Anthem, ConnectiCare Benefits, Inc. and ConnectiCare Insurance Company, Inc.)
and also pays for the cost-sharing amounts (deductibles, co-pays, co-insurance and maximum
out-of-pocket costs) that customers would typically have to pay with a health insurance plan.
Residents must meet the following requirements to participate in the Covered CT
Program:
•
Have a household income up to and including 175% of the Federal Poverty Level (FPL)
and don't qualify for Medicaid due to income*
•
Be eligible for financial help, including Advance Premium Tax Credits (APTC) and Cost-
Sharing Reductions (CSRs), and use 100% of the financial help available to you
•
Enroll and remain enrolled in a Silver Plan for the duration of the plan year
*If your household income makes you eligible for HUSKY Health/Medicaid, you are not eligible
for the Covered CT Program. Medicaid provides comprehensive benefits, please contact the
Connecticut Department of Social Services for more information.
Income Guidelines for 2025 Coverage (For applications submitted on or after December
1, 2024)
Household
Size
1
2
3
4
5
6
7
8
Ineligible for
HUSKY/
Medicaid an
d have
household
income up
to and
including
175% FPL
$26,35
5
$35,77
0
$45,18
5
$54,60
0
$64,01
5
$73,43
0
$82,84
5
$92,26
0
How to Enroll in the Covered CT Program
Complete an application at AccessHealthCT.com and we will let you know if you qualify for the
Covered CT Program. You can also call our call center for free enrollment and eligibility help at
1-855-805-4325. If you are deaf or hearing impaired, you may use the TTY at 1-855-789-2428 or
contact us at 1-855-805-4325 with a relay operator.
Already enrolled through Access Health CT?
If you are enrolled in a Qualified Health Plan through Access Health CT, you can update
your application with any recent changes to your household information. You may
qualify if your household income or home address has changed since you enrolled.
FREQUENTLY ASKED QUESTIONS
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 CT Program, they may be eligible for a plan with
no premium (monthly payment) and no out-of-pocket expenses (what you pay for a
covered healthcare service).
Am I eligible if my income isn't the same every month?
Yes. The Covered CT Program income requirements are based on annual income, so you
will need to estimate what your total annual household income will be for the year. If you
experience a significant change in household income after you enroll, you must report it
to Access Health CT immediately.
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.
•
Please visit the Department of Social Services website for more information about Dental
and Non-Emergency Medical Transportation benefits.
Will eligible customers really have $0 premium and $0 cost-sharing plans through the
Covered CT 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. There will also be dental benefits and Non-Emergency Medical Transportation benefits
included at no additional cost.
I am comparing plans and the plans do not show $0 premium and $0 cost sharing. Why is
this?
When shopping for a plan, please be sure to:
1.
Complete your application
2.
Make sure you are eligible for the "Covered Connecticut Program" on the Eligibility
Determination screen
3.
Select a Silver Plan
4.
Select 100% of the Advance Premium Tax Credits (APTCs).
After completing these steps, you will see the premium of the Silver Plan update to $0 on your
plan purchase summary.
Please note, you will also see an alert at the top of your screen during Silver Plan and
APTC selection informing you of your potential eligibility for the Covered CT Program, even
though you have already confirmed your eligibility for the Program on the Eligibility
Determination screen; please disregard this message and continue Silver Plan and
APTC selection to complete enrollment into the Covered CT Program.
Is this financial help available only through Access Health CT?
Yes. This is the reason we encourage everyone to take a look at plans available through Access
Health CT, even if you already have other health insurance coverage.
How do I estimate my household income?
Please include all estimated income and disclose any unemployment benefits.
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.
If eligible customers do not elect to use all Advanced Premium Tax Credits (APTCs)
available to them, will they still benefit from the Covered CT Program?
No. Customers who want to participate in the Covered CT 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 CT
Program.
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 verification of
such information. You should always make sure you have accurately listed your annual
household income and that you provide verification documentation, if requested, to make sure
you receive the correct amount of financial assistance throughout the year. Always remember to
make updates to your household income and other information right away if there are any
changes during the year.
Are American Indians and Alaska Natives eligible for the Covered CT Program?
Yes.
When can Covered CT Program participants expect new identification card(s)?
You will get two identification cards after enrolling in the Covered CT Program.
You can expect a new identification card from your insurance company about one week after
enrollment. 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.
In addition, the Connecticut Department of Social Services will send an identification card to
Covered CT Program participants for their Dental and NEMT benefits approximately two weeks
after enrollment.
What if I enroll in the Covered CT Program but I already paid my premium (monthly
payment) to my insurance company for the next month?
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
I was enrolled in the Covered CT Program?
No. You are still responsible for any balances due for premiums, care or services received
before you enroll in the Covered CT Program.
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.
How do I use dental benefits after I enroll?
Please visit the Department of Social Services website for more information about dental benefits,
including details on benefits and how to find a provider.
How do I access Non-Emergency Medical Transportation after I enroll?
Please visit the Department of Social Services website for more information about Non-
Emergency Medical Transportation (NEMT) benefits.
|
What is the main topic of this document?
|
Covered CT Program
Written by Yessenia Milan | Last published at: January 08, 2025
Covered CT
Some Connecticut residents that meet specific eligibility requirements are paying $0 for their
health
|
Covered CT Program
Written by Yessenia Milan | Last published at: January 08, 2025
Covered CT
Some Connecticut residents that meet specific eligibility requirements are paying $0 for their
health insurance coverage, thanks to the new Covered CT Program created by the State of
Connecticut. The Covered CT Program provides health insurance coverage, dental coverage
and Non-Emergency Medical Transportation (NEMT) administered by the Connecticut
Department of Social Services. This Program is for residents between the ages of 19–64.
Want to see if you qualify? Complete an application with Access Health CT online or with
some free help.
For eligible Connecticut residents enrolled in the Covered CT Program, the State of Connecticut
pays the customer’s portion of the monthly payment (premium) directly to their insurance
company (Anthem, ConnectiCare Benefits, Inc. and ConnectiCare Insurance Company, Inc.)
and also pays for the cost-sharing amounts (deductibles, co-pays, co-insurance and maximum
out-of-pocket costs) that customers would typically have to pay with a health insurance plan.
Residents must meet the following requirements to participate in the Covered CT
Program:
•
Have a household income up to and including 175% of the Federal Poverty Level (FPL)
and don't qualify for Medicaid due to income*
•
Be eligible for financial help, including Advance Premium Tax Credits (APTC) and Cost-
Sharing Reductions (CSRs), and use 100% of the financial help available to you
•
Enroll and remain enrolled in a Silver Plan for the duration of the plan year
*If your household income makes you eligible for HUSKY Health/Medicaid, you are not eligible
for the Covered CT Program. Medicaid provides comprehensive benefits, please contact the
Connecticut Department of Social Services for more information.
Income Guidelines for 2025 Coverage (For applications submitted on or after December
1, 2024)
Household
Size
1
2
3
4
5
6
7
8
Ineligible for
HUSKY/
Medicaid an
d have
household
income up
to and
including
175% FPL
$26,35
5
$35,77
0
$45,18
5
$54,60
0
$64,01
5
$73,43
0
$82,84
5
$92,26
0
How to Enroll in the Covered CT Program
Complete an application at AccessHealthCT.com and we will let you know if you qualify for the
Covered CT Program. You can also call our call center for free enrollment and eligibility help at
1-855-805-4325. If you are deaf or hearing impaired, you may use the TTY at 1-855-789-2428 or
contact us at 1-855-805-4325 with a relay operator.
Already enrolled through Access Health CT?
If you are enrolled in a Qualified Health Plan through Access Health CT, you can update
your application with any recent changes to your household information. You may
qualify if your household income or home address has changed since you enrolled.
FREQUENTLY ASKED QUESTIONS
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 CT Program, they may be eligible for a plan with
no premium (monthly payment) and no out-of-pocket expenses (what you pay for a
covered healthcare service).
Am I eligible if my income isn't the same every month?
Yes. The Covered CT Program income requirements are based on annual income, so you
will need to estimate what your total annual household income will be for the year. If you
experience a significant change in household income after you enroll, you must report it
to Access Health CT immediately.
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.
•
Please visit the Department of Social Services website for more information about Dental
and Non-Emergency Medical Transportation benefits.
Will eligible customers really have $0 premium and $0 cost-sharing plans through the
Covered CT 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. There will also be dental benefits and Non-Emergency Medical Transportation benefits
included at no additional cost.
I am comparing plans and the plans do not show $0 premium and $0 cost sharing. Why is
this?
When shopping for a plan, please be sure to:
1.
Complete your application
2.
Make sure you are eligible for the "Covered Connecticut Program" on the Eligibility
Determination screen
3.
Select a Silver Plan
4.
Select 100% of the Advance Premium Tax Credits (APTCs).
After completing these steps, you will see the premium of the Silver Plan update to $0 on your
plan purchase summary.
Please note, you will also see an alert at the top of your screen during Silver Plan and
APTC selection informing you of your potential eligibility for the Covered CT Program, even
though you have already confirmed your eligibility for the Program on the Eligibility
Determination screen; please disregard this message and continue Silver Plan and
APTC selection to complete enrollment into the Covered CT Program.
Is this financial help available only through Access Health CT?
Yes. This is the reason we encourage everyone to take a look at plans available through Access
Health CT, even if you already have other health insurance coverage.
How do I estimate my household income?
Please include all estimated income and disclose any unemployment benefits.
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.
If eligible customers do not elect to use all Advanced Premium Tax Credits (APTCs)
available to them, will they still benefit from the Covered CT Program?
No. Customers who want to participate in the Covered CT 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 CT
Program.
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 verification of
such information. You should always make sure you have accurately listed your annual
household income and that you provide verification documentation, if requested, to make sure
you receive the correct amount of financial assistance throughout the year. Always remember to
make updates to your household income and other information right away if there are any
changes during the year.
Are American Indians and Alaska Natives eligible for the Covered CT Program?
Yes.
When can Covered CT Program participants expect new identification card(s)?
You will get two identification cards after enrolling in the Covered CT Program.
You can expect a new identification card from your insurance company about one week after
enrollment. 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.
In addition, the Connecticut Department of Social Services will send an identification card to
Covered CT Program participants for their Dental and NEMT benefits approximately two weeks
after enrollment.
What if I enroll in the Covered CT Program but I already paid my premium (monthly
payment) to my insurance company for the next month?
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
I was enrolled in the Covered CT Program?
No. You are still responsible for any balances due for premiums, care or services received
before you enroll in the Covered CT Program.
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.
How do I use dental benefits after I enroll?
Please visit the Department of Social Services website for more information about dental benefits,
including details on benefits and how to find a provider.
How do I access Non-Emergency Medical Transportation after I enroll?
Please visit the Department of Social Services website for more information about Non-
Emergency Medical Transportation (NEMT) benefits.
|
Who is mentioned in the document?
|
Covered CT Program
Written by Yessenia Milan | Last published at: January 08, 2025
Covered CT
Some Connecticut residents that meet specific eligibility requirements are paying $0 for their
health
|
Covered CT Program
Written by Yessenia Milan | Last published at: January 08, 2025
Covered CT
Some Connecticut residents that meet specific eligibility requirements are paying $0 for their
health insurance coverage, thanks to the new Covered CT Program created by the State of
Connecticut. The Covered CT Program provides health insurance coverage, dental coverage
and Non-Emergency Medical Transportation (NEMT) administered by the Connecticut
Department of Social Services. This Program is for residents between the ages of 19–64.
Want to see if you qualify? Complete an application with Access Health CT online or with
some free help.
For eligible Connecticut residents enrolled in the Covered CT Program, the State of Connecticut
pays the customer’s portion of the monthly payment (premium) directly to their insurance
company (Anthem, ConnectiCare Benefits, Inc. and ConnectiCare Insurance Company, Inc.)
and also pays for the cost-sharing amounts (deductibles, co-pays, co-insurance and maximum
out-of-pocket costs) that customers would typically have to pay with a health insurance plan.
Residents must meet the following requirements to participate in the Covered CT
Program:
•
Have a household income up to and including 175% of the Federal Poverty Level (FPL)
and don't qualify for Medicaid due to income*
•
Be eligible for financial help, including Advance Premium Tax Credits (APTC) and Cost-
Sharing Reductions (CSRs), and use 100% of the financial help available to you
•
Enroll and remain enrolled in a Silver Plan for the duration of the plan year
*If your household income makes you eligible for HUSKY Health/Medicaid, you are not eligible
for the Covered CT Program. Medicaid provides comprehensive benefits, please contact the
Connecticut Department of Social Services for more information.
Income Guidelines for 2025 Coverage (For applications submitted on or after December
1, 2024)
Household
Size
1
2
3
4
5
6
7
8
Ineligible for
HUSKY/
Medicaid an
d have
household
income up
to and
including
175% FPL
$26,35
5
$35,77
0
$45,18
5
$54,60
0
$64,01
5
$73,43
0
$82,84
5
$92,26
0
How to Enroll in the Covered CT Program
Complete an application at AccessHealthCT.com and we will let you know if you qualify for the
Covered CT Program. You can also call our call center for free enrollment and eligibility help at
1-855-805-4325. If you are deaf or hearing impaired, you may use the TTY at 1-855-789-2428 or
contact us at 1-855-805-4325 with a relay operator.
Already enrolled through Access Health CT?
If you are enrolled in a Qualified Health Plan through Access Health CT, you can update
your application with any recent changes to your household information. You may
qualify if your household income or home address has changed since you enrolled.
FREQUENTLY ASKED QUESTIONS
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 CT Program, they may be eligible for a plan with
no premium (monthly payment) and no out-of-pocket expenses (what you pay for a
covered healthcare service).
Am I eligible if my income isn't the same every month?
Yes. The Covered CT Program income requirements are based on annual income, so you
will need to estimate what your total annual household income will be for the year. If you
experience a significant change in household income after you enroll, you must report it
to Access Health CT immediately.
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.
•
Please visit the Department of Social Services website for more information about Dental
and Non-Emergency Medical Transportation benefits.
Will eligible customers really have $0 premium and $0 cost-sharing plans through the
Covered CT 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. There will also be dental benefits and Non-Emergency Medical Transportation benefits
included at no additional cost.
I am comparing plans and the plans do not show $0 premium and $0 cost sharing. Why is
this?
When shopping for a plan, please be sure to:
1.
Complete your application
2.
Make sure you are eligible for the "Covered Connecticut Program" on the Eligibility
Determination screen
3.
Select a Silver Plan
4.
Select 100% of the Advance Premium Tax Credits (APTCs).
After completing these steps, you will see the premium of the Silver Plan update to $0 on your
plan purchase summary.
Please note, you will also see an alert at the top of your screen during Silver Plan and
APTC selection informing you of your potential eligibility for the Covered CT Program, even
though you have already confirmed your eligibility for the Program on the Eligibility
Determination screen; please disregard this message and continue Silver Plan and
APTC selection to complete enrollment into the Covered CT Program.
Is this financial help available only through Access Health CT?
Yes. This is the reason we encourage everyone to take a look at plans available through Access
Health CT, even if you already have other health insurance coverage.
How do I estimate my household income?
Please include all estimated income and disclose any unemployment benefits.
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.
If eligible customers do not elect to use all Advanced Premium Tax Credits (APTCs)
available to them, will they still benefit from the Covered CT Program?
No. Customers who want to participate in the Covered CT 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 CT
Program.
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 verification of
such information. You should always make sure you have accurately listed your annual
household income and that you provide verification documentation, if requested, to make sure
you receive the correct amount of financial assistance throughout the year. Always remember to
make updates to your household income and other information right away if there are any
changes during the year.
Are American Indians and Alaska Natives eligible for the Covered CT Program?
Yes.
When can Covered CT Program participants expect new identification card(s)?
You will get two identification cards after enrolling in the Covered CT Program.
You can expect a new identification card from your insurance company about one week after
enrollment. 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.
In addition, the Connecticut Department of Social Services will send an identification card to
Covered CT Program participants for their Dental and NEMT benefits approximately two weeks
after enrollment.
What if I enroll in the Covered CT Program but I already paid my premium (monthly
payment) to my insurance company for the next month?
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
I was enrolled in the Covered CT Program?
No. You are still responsible for any balances due for premiums, care or services received
before you enroll in the Covered CT Program.
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.
How do I use dental benefits after I enroll?
Please visit the Department of Social Services website for more information about dental benefits,
including details on benefits and how to find a provider.
How do I access Non-Emergency Medical Transportation after I enroll?
Please visit the Department of Social Services website for more information about Non-
Emergency Medical Transportation (NEMT) benefits.
|
What are the key takeaways from this text?
|
Covered CT Program
Written by Yessenia Milan | Last published at: January 08, 2025
Covered CT
Some Connecticut residents that meet specific eligibility requirements are paying $0 for their
health
|
Creating Accounts and Linking Applications
Written by Kecia Stauffer | Last published at: August 26, 2024
Managing your Access Health CT application is easier with an online account. You can
use your online account in several ways, including making routine changes to your household
information and your application. With an online account you can also:
•
View important notices
•
Report changes to your household information, like your household income, home
and/or mailing address, and contact information
•
Provide an email address and opt in to receive SMS alerts
•
Add or remove a household member from your application
•
Cancel your coverage
•
Renew your coverage
•
Upload documents
•
Find Help from a broker or Certified Application Counselor (CAC)
Create an online account before you start your application so you can access your application at
any time. If you already started an application with Access Health CT, follow the steps below to
create an online account and link it to your current application.
Creating an Online Account
1.
Visit AccessHealthCT.com and click “Create Account” at the top
2.
Enter your First Name and Last Name exactly as they appear on your legal
documentation (such as state-issued ID, license, Social Security Card, or Green Card)
3.
Provide your Email Address. Make sure you have access to this email account; you will
receive important messages related to your Access Health CT online account
4.
Create a Password. A unique password must be 9 to 15 characters with at least one
number, one uppercase letter, one lowercase letter, and one special character (i.e., !, #,
%, etc.)
5.
Complete the Security Questions. Please select 4 different questions and answers. You
will be asked these questions if you forget your login information
6.
Security Image. You must check the box to proceed and complete the reCAPTCHA
security verification
7.
User Acceptance Agreement. You must check the box to proceed. Click here to view the
agreement
8.
Click Create Account
Linking Online Account with an Existing Application
Follow these steps to link your online account with your current application. Make sure you use
your most recent application. If you do not know which application to link to your online
account, please contact Access Health CT.
1.
Sign in and click on “Link an Existing Application”
2.
Enter the following information (it must match the information in your application and the
Eligibility Determination Notice that we mailed to you):
a.
First Name and Last Name
b. Date of Birth
c. City
d. State
e. ZIP Code
f. Your application ID number (This is included in all notices we send to your
household by mail)
3.
Click “Submit”
4.
Review your information
After you link your application to your account, you will see the status of your health and/or
dental coverage and will have the option to report changes, renew coverage, upload
documents, and view notices in your account inbox. In addition, if you wish to receive paperless
notifications in your account inbox instead of paper notifications by mail, you will have the option
to opt in to paperless notifications.
If you require assistance with adding the application to your account or have questions, please
call 1-855-805-4325. If you are deaf or hearing impaired, you may use the TTY at 1-855-789-
2428 or contact us at 1-855-805-4325 with a relay operator.
Make sure you have your application ID number and household information ready!
|
What is the main topic of this document?
|
Creating Accounts and Linking Applications
Written by Kecia Stauffer | Last published at: August 26, 2024
Managing your Access Health CT application is easier with an online account. You can
use
|
Creating Accounts and Linking Applications
Written by Kecia Stauffer | Last published at: August 26, 2024
Managing your Access Health CT application is easier with an online account. You can
use your online account in several ways, including making routine changes to your household
information and your application. With an online account you can also:
•
View important notices
•
Report changes to your household information, like your household income, home
and/or mailing address, and contact information
•
Provide an email address and opt in to receive SMS alerts
•
Add or remove a household member from your application
•
Cancel your coverage
•
Renew your coverage
•
Upload documents
•
Find Help from a broker or Certified Application Counselor (CAC)
Create an online account before you start your application so you can access your application at
any time. If you already started an application with Access Health CT, follow the steps below to
create an online account and link it to your current application.
Creating an Online Account
1.
Visit AccessHealthCT.com and click “Create Account” at the top
2.
Enter your First Name and Last Name exactly as they appear on your legal
documentation (such as state-issued ID, license, Social Security Card, or Green Card)
3.
Provide your Email Address. Make sure you have access to this email account; you will
receive important messages related to your Access Health CT online account
4.
Create a Password. A unique password must be 9 to 15 characters with at least one
number, one uppercase letter, one lowercase letter, and one special character (i.e., !, #,
%, etc.)
5.
Complete the Security Questions. Please select 4 different questions and answers. You
will be asked these questions if you forget your login information
6.
Security Image. You must check the box to proceed and complete the reCAPTCHA
security verification
7.
User Acceptance Agreement. You must check the box to proceed. Click here to view the
agreement
8.
Click Create Account
Linking Online Account with an Existing Application
Follow these steps to link your online account with your current application. Make sure you use
your most recent application. If you do not know which application to link to your online
account, please contact Access Health CT.
1.
Sign in and click on “Link an Existing Application”
2.
Enter the following information (it must match the information in your application and the
Eligibility Determination Notice that we mailed to you):
a.
First Name and Last Name
b. Date of Birth
c. City
d. State
e. ZIP Code
f. Your application ID number (This is included in all notices we send to your
household by mail)
3.
Click “Submit”
4.
Review your information
After you link your application to your account, you will see the status of your health and/or
dental coverage and will have the option to report changes, renew coverage, upload
documents, and view notices in your account inbox. In addition, if you wish to receive paperless
notifications in your account inbox instead of paper notifications by mail, you will have the option
to opt in to paperless notifications.
If you require assistance with adding the application to your account or have questions, please
call 1-855-805-4325. If you are deaf or hearing impaired, you may use the TTY at 1-855-789-
2428 or contact us at 1-855-805-4325 with a relay operator.
Make sure you have your application ID number and household information ready!
|
Who is mentioned in the document?
|
Creating Accounts and Linking Applications
Written by Kecia Stauffer | Last published at: August 26, 2024
Managing your Access Health CT application is easier with an online account. You can
use
|
Creating Accounts and Linking Applications
Written by Kecia Stauffer | Last published at: August 26, 2024
Managing your Access Health CT application is easier with an online account. You can
use your online account in several ways, including making routine changes to your household
information and your application. With an online account you can also:
•
View important notices
•
Report changes to your household information, like your household income, home
and/or mailing address, and contact information
•
Provide an email address and opt in to receive SMS alerts
•
Add or remove a household member from your application
•
Cancel your coverage
•
Renew your coverage
•
Upload documents
•
Find Help from a broker or Certified Application Counselor (CAC)
Create an online account before you start your application so you can access your application at
any time. If you already started an application with Access Health CT, follow the steps below to
create an online account and link it to your current application.
Creating an Online Account
1.
Visit AccessHealthCT.com and click “Create Account” at the top
2.
Enter your First Name and Last Name exactly as they appear on your legal
documentation (such as state-issued ID, license, Social Security Card, or Green Card)
3.
Provide your Email Address. Make sure you have access to this email account; you will
receive important messages related to your Access Health CT online account
4.
Create a Password. A unique password must be 9 to 15 characters with at least one
number, one uppercase letter, one lowercase letter, and one special character (i.e., !, #,
%, etc.)
5.
Complete the Security Questions. Please select 4 different questions and answers. You
will be asked these questions if you forget your login information
6.
Security Image. You must check the box to proceed and complete the reCAPTCHA
security verification
7.
User Acceptance Agreement. You must check the box to proceed. Click here to view the
agreement
8.
Click Create Account
Linking Online Account with an Existing Application
Follow these steps to link your online account with your current application. Make sure you use
your most recent application. If you do not know which application to link to your online
account, please contact Access Health CT.
1.
Sign in and click on “Link an Existing Application”
2.
Enter the following information (it must match the information in your application and the
Eligibility Determination Notice that we mailed to you):
a.
First Name and Last Name
b. Date of Birth
c. City
d. State
e. ZIP Code
f. Your application ID number (This is included in all notices we send to your
household by mail)
3.
Click “Submit”
4.
Review your information
After you link your application to your account, you will see the status of your health and/or
dental coverage and will have the option to report changes, renew coverage, upload
documents, and view notices in your account inbox. In addition, if you wish to receive paperless
notifications in your account inbox instead of paper notifications by mail, you will have the option
to opt in to paperless notifications.
If you require assistance with adding the application to your account or have questions, please
call 1-855-805-4325. If you are deaf or hearing impaired, you may use the TTY at 1-855-789-
2428 or contact us at 1-855-805-4325 with a relay operator.
Make sure you have your application ID number and household information ready!
|
What are the key takeaways from this text?
|
Creating Accounts and Linking Applications
Written by Kecia Stauffer | Last published at: August 26, 2024
Managing your Access Health CT application is easier with an online account. You can
use
|
Customer Service Update
Written by Yessenia Milan | Last published at: September 14, 2023
We are currently experiencing a high volume of escalated cases and requests to our customer
service team. We are working diligently to resolve issues and close cases as soon as possible,
but in the meantime, you may have a delay in getting your questions answered.
The best way to request help from our team, ask us a question or check on the status of your
application is to call us at 1-855-805-4325. We are also available via Live Chat
(https://www.accesshealthct.com/get-help/).
If you have an urgent medical issue, please let the customer service representative know when
you contact us. Thank you for your patience.
|
What is the main topic of this document?
|
Customer Service Update
Written by Yessenia Milan | Last published at: September 14, 2023
We are currently experiencing a high volume of escalated cases and requests to our customer
service team. W
|
Customer Service Update
Written by Yessenia Milan | Last published at: September 14, 2023
We are currently experiencing a high volume of escalated cases and requests to our customer
service team. We are working diligently to resolve issues and close cases as soon as possible,
but in the meantime, you may have a delay in getting your questions answered.
The best way to request help from our team, ask us a question or check on the status of your
application is to call us at 1-855-805-4325. We are also available via Live Chat
(https://www.accesshealthct.com/get-help/).
If you have an urgent medical issue, please let the customer service representative know when
you contact us. Thank you for your patience.
|
Who is mentioned in the document?
|
Customer Service Update
Written by Yessenia Milan | Last published at: September 14, 2023
We are currently experiencing a high volume of escalated cases and requests to our customer
service team. W
|
Customer Service Update
Written by Yessenia Milan | Last published at: September 14, 2023
We are currently experiencing a high volume of escalated cases and requests to our customer
service team. We are working diligently to resolve issues and close cases as soon as possible,
but in the meantime, you may have a delay in getting your questions answered.
The best way to request help from our team, ask us a question or check on the status of your
application is to call us at 1-855-805-4325. We are also available via Live Chat
(https://www.accesshealthct.com/get-help/).
If you have an urgent medical issue, please let the customer service representative know when
you contact us. Thank you for your patience.
|
What are the key takeaways from this text?
|
Customer Service Update
Written by Yessenia Milan | Last published at: September 14, 2023
We are currently experiencing a high volume of escalated cases and requests to our customer
service team. W
|
Deferred Action for Childhood Arrivals
(DACA)
Written by Kecia Stauffer | Last published at: August 20, 2024
Deferred Action for Childhood Arrivals (DACA) recipients are now eligible for insurance coverage
through Access Health CT.
Starting November 1, 2024, DACA recipients will be able to get health insurance coverage through state-
based marketplaces. This change in the law means DACA recipients living in Connecticut can apply for health
and/or dental insurance plans offered through Access Health CT. Depending on their household size and
income, they may qualify for financial help such as Advance Premium Tax Credits (APTCs) or Cost-Sharing
Reductions (CSRs).
There will be a Special Enrollment Period (SEP) starting November 1, 2024, to allow DACA recipients to enroll
in coverage that starts as soon as December 1, 2024. Moving forward, anyone who becomes a DACA
recipient will qualify for a 60-day SEP that starts on the day they are granted deferred action.
Remember, all members of your tax household (with legal immigration status or not) should be included in
your enrollment application. However, only those with a legal immigration status are eligible to receive health
and/or dental coverage through Access Health CT.
DACA recipients are not eligible to enroll in regular HUSKY Health programs, including Medicaid and the
Children’s Health Insurance Program (CHIP). However, there are State programs available for children and
pregnant individuals who do not qualify for regular Medicaid because of their immigration status. Eligibility for
these programs depends on your age and/or household income. Click here to learn more.
Access Health CT cannot answer questions about DACA eligibility. For more information on DACA,
visit https://www.uscis.gov/DACA.
|
What is the main topic of this document?
|
Deferred Action for Childhood Arrivals
(DACA)
Written by Kecia Stauffer | Last published at: August 20, 2024
Deferred Action for Childhood Arrivals (DACA) recipients are now eligible for insurance c
|
Deferred Action for Childhood Arrivals
(DACA)
Written by Kecia Stauffer | Last published at: August 20, 2024
Deferred Action for Childhood Arrivals (DACA) recipients are now eligible for insurance coverage
through Access Health CT.
Starting November 1, 2024, DACA recipients will be able to get health insurance coverage through state-
based marketplaces. This change in the law means DACA recipients living in Connecticut can apply for health
and/or dental insurance plans offered through Access Health CT. Depending on their household size and
income, they may qualify for financial help such as Advance Premium Tax Credits (APTCs) or Cost-Sharing
Reductions (CSRs).
There will be a Special Enrollment Period (SEP) starting November 1, 2024, to allow DACA recipients to enroll
in coverage that starts as soon as December 1, 2024. Moving forward, anyone who becomes a DACA
recipient will qualify for a 60-day SEP that starts on the day they are granted deferred action.
Remember, all members of your tax household (with legal immigration status or not) should be included in
your enrollment application. However, only those with a legal immigration status are eligible to receive health
and/or dental coverage through Access Health CT.
DACA recipients are not eligible to enroll in regular HUSKY Health programs, including Medicaid and the
Children’s Health Insurance Program (CHIP). However, there are State programs available for children and
pregnant individuals who do not qualify for regular Medicaid because of their immigration status. Eligibility for
these programs depends on your age and/or household income. Click here to learn more.
Access Health CT cannot answer questions about DACA eligibility. For more information on DACA,
visit https://www.uscis.gov/DACA.
|
Who is mentioned in the document?
|
Deferred Action for Childhood Arrivals
(DACA)
Written by Kecia Stauffer | Last published at: August 20, 2024
Deferred Action for Childhood Arrivals (DACA) recipients are now eligible for insurance c
|
Deferred Action for Childhood Arrivals
(DACA)
Written by Kecia Stauffer | Last published at: August 20, 2024
Deferred Action for Childhood Arrivals (DACA) recipients are now eligible for insurance coverage
through Access Health CT.
Starting November 1, 2024, DACA recipients will be able to get health insurance coverage through state-
based marketplaces. This change in the law means DACA recipients living in Connecticut can apply for health
and/or dental insurance plans offered through Access Health CT. Depending on their household size and
income, they may qualify for financial help such as Advance Premium Tax Credits (APTCs) or Cost-Sharing
Reductions (CSRs).
There will be a Special Enrollment Period (SEP) starting November 1, 2024, to allow DACA recipients to enroll
in coverage that starts as soon as December 1, 2024. Moving forward, anyone who becomes a DACA
recipient will qualify for a 60-day SEP that starts on the day they are granted deferred action.
Remember, all members of your tax household (with legal immigration status or not) should be included in
your enrollment application. However, only those with a legal immigration status are eligible to receive health
and/or dental coverage through Access Health CT.
DACA recipients are not eligible to enroll in regular HUSKY Health programs, including Medicaid and the
Children’s Health Insurance Program (CHIP). However, there are State programs available for children and
pregnant individuals who do not qualify for regular Medicaid because of their immigration status. Eligibility for
these programs depends on your age and/or household income. Click here to learn more.
Access Health CT cannot answer questions about DACA eligibility. For more information on DACA,
visit https://www.uscis.gov/DACA.
|
What are the key takeaways from this text?
|
Deferred Action for Childhood Arrivals
(DACA)
Written by Kecia Stauffer | Last published at: August 20, 2024
Deferred Action for Childhood Arrivals (DACA) recipients are now eligible for insurance c
|
Dental coverage through Access Health CT
Written by Yessenia Milan | Last published at: January 31, 2025
Dental and oral health are important to your overall health and well-being. You can get dental
coverage through Access Health CT in a few different ways.
All health insurance plans offered through Access Health CT include pediatric dental coverage
for anyone under 26 years old. It is also as an Essential Health Benefit under the ACA. Some
health plans and programs available through Access Health CT, like the Covered CT Program,
include dental coverage for adults. The HUSKY Health Program (Medicaid/CHIP programs)
includes dental coverage for children and adults.
If your current health insurance plan doesn’t include dental coverage, you can get a
stand-alone dental plan through Access Health CT! You can enroll during the Open
Enrollment Period that begins November 1 or during a Special Enrollment Period if you have a
Qualifying Life Event.
To enroll in dental coverage, call us at 1-855-805-4325 or compare dental options online. During
the enrollment process, you will now see health plan options followed by dental plans. If you are
not interested in a health plan, be sure to look for the "Skip to Dental Plans" button at the bottom
of the health plans shopping page.
Customers can sign in to manage their dental coverage here.
Important considerations to keep in mind when shopping for stand-alone dental
coverage:
•
All health insurance plans available through Access Health CT offer pediatric
dental coverage through age 26. Certain medical plans may include some limited adult
dental benefits, but these plans do not provide full dental coverage for adults. Stand-
alone plans are a great option for people who are over 26 years old and need dental
coverage.
•
Financial help does not apply to stand-alone dental plans. If you receive financial
help (also called Advanced Premium Tax Credits or APTCs) through Access Health CT,
that credit cannot be used to help pay for the costs of stand-alone dental plans.
•
If you voluntarily end your dental coverage, you may not be eligible to enroll again
until the next Open Enrollment Period. This includes voluntary termination for not
making premium payments, so be sure to pay your monthly bill (premium) to your
insurance company.
•
There is no out-of-pocket maximum for adults, some plans have a waiting period
before you can start getting covered services, and covered benefits will vary
between plans. Note: there is no waiting period for diagnostic and preventative
services. See below for more information.
More About Dental Plans
Plan Benefits & Coverage Areas
•
Adult Dental Coverage: Dental plans have three major coverage areas for adults:
Diagnostic & Preventive Services, Basic Restorative Services, and Major Services. Each
plan may offer different services and/or coverage, and these differences will have an
impact on the monthly cost of your plan. While shopping for plans, consumers can look
at the Plan Document to see what services are covered.
•
Pediatric Dental Coverage: Covered persons up to age 25 can get Dentally Necessary
Orthodontic Care in addition to Diagnostic & Preventive Services, Basic Restorative
Services, and Major Services.
Out-of-Pocket Maximum
An annual out-of-pocket maximum is the most a member will pay out of their pocket in a
coverage year. Adult dental benefits are not subject to an out-of-pocket maximum, so there is
no cap on what an adult must pay out of your own pocket. However, there is an out-of-pocket
maximum for children through age 25. Check your plan details for specific information.
Benefit Maximum
A Benefit Maximum is a limit on the total amount of covered services under your plan.
Child(ren) dental benefits (for covered persons through age 25) are not subject to a Benefit
Maximum. However, there is a Benefit Maximum for adults, age 26 and older. Check your plan
details for specific information. (An “Adult” is defined as a covered person age 26 and older,
and a “Child” refers to a covered person through age 26 who would be eligible for pediatric
benefits.)
Waiting Periods for New Members
A waiting period is the length of time you must be covered under this policy before you can use
your benefits. Certain types of services may have waiting periods under your policy, but
preventive and diagnostic services do not have waiting periods. You are eligible for
coverage for benefits once your waiting period is over. Waiting periods only apply to adult
benefits as specified within each plan.
Exceptions to Waiting Periods: Waiting Periods will be waived for newly enrolled adults (age
26 and older) when proof of 12 months of continuous prior coverage for those services is
provided from the prior dental insurance carrier and when the termination date is no more than
30 days prior to the effective date of this policy.
|
What is the main topic of this document?
|
Dental coverage through Access Health CT
Written by Yessenia Milan | Last published at: January 31, 2025
Dental and oral health are important to your overall health and well-being. You can get denta
|
Dental coverage through Access Health CT
Written by Yessenia Milan | Last published at: January 31, 2025
Dental and oral health are important to your overall health and well-being. You can get dental
coverage through Access Health CT in a few different ways.
All health insurance plans offered through Access Health CT include pediatric dental coverage
for anyone under 26 years old. It is also as an Essential Health Benefit under the ACA. Some
health plans and programs available through Access Health CT, like the Covered CT Program,
include dental coverage for adults. The HUSKY Health Program (Medicaid/CHIP programs)
includes dental coverage for children and adults.
If your current health insurance plan doesn’t include dental coverage, you can get a
stand-alone dental plan through Access Health CT! You can enroll during the Open
Enrollment Period that begins November 1 or during a Special Enrollment Period if you have a
Qualifying Life Event.
To enroll in dental coverage, call us at 1-855-805-4325 or compare dental options online. During
the enrollment process, you will now see health plan options followed by dental plans. If you are
not interested in a health plan, be sure to look for the "Skip to Dental Plans" button at the bottom
of the health plans shopping page.
Customers can sign in to manage their dental coverage here.
Important considerations to keep in mind when shopping for stand-alone dental
coverage:
•
All health insurance plans available through Access Health CT offer pediatric
dental coverage through age 26. Certain medical plans may include some limited adult
dental benefits, but these plans do not provide full dental coverage for adults. Stand-
alone plans are a great option for people who are over 26 years old and need dental
coverage.
•
Financial help does not apply to stand-alone dental plans. If you receive financial
help (also called Advanced Premium Tax Credits or APTCs) through Access Health CT,
that credit cannot be used to help pay for the costs of stand-alone dental plans.
•
If you voluntarily end your dental coverage, you may not be eligible to enroll again
until the next Open Enrollment Period. This includes voluntary termination for not
making premium payments, so be sure to pay your monthly bill (premium) to your
insurance company.
•
There is no out-of-pocket maximum for adults, some plans have a waiting period
before you can start getting covered services, and covered benefits will vary
between plans. Note: there is no waiting period for diagnostic and preventative
services. See below for more information.
More About Dental Plans
Plan Benefits & Coverage Areas
•
Adult Dental Coverage: Dental plans have three major coverage areas for adults:
Diagnostic & Preventive Services, Basic Restorative Services, and Major Services. Each
plan may offer different services and/or coverage, and these differences will have an
impact on the monthly cost of your plan. While shopping for plans, consumers can look
at the Plan Document to see what services are covered.
•
Pediatric Dental Coverage: Covered persons up to age 25 can get Dentally Necessary
Orthodontic Care in addition to Diagnostic & Preventive Services, Basic Restorative
Services, and Major Services.
Out-of-Pocket Maximum
An annual out-of-pocket maximum is the most a member will pay out of their pocket in a
coverage year. Adult dental benefits are not subject to an out-of-pocket maximum, so there is
no cap on what an adult must pay out of your own pocket. However, there is an out-of-pocket
maximum for children through age 25. Check your plan details for specific information.
Benefit Maximum
A Benefit Maximum is a limit on the total amount of covered services under your plan.
Child(ren) dental benefits (for covered persons through age 25) are not subject to a Benefit
Maximum. However, there is a Benefit Maximum for adults, age 26 and older. Check your plan
details for specific information. (An “Adult” is defined as a covered person age 26 and older,
and a “Child” refers to a covered person through age 26 who would be eligible for pediatric
benefits.)
Waiting Periods for New Members
A waiting period is the length of time you must be covered under this policy before you can use
your benefits. Certain types of services may have waiting periods under your policy, but
preventive and diagnostic services do not have waiting periods. You are eligible for
coverage for benefits once your waiting period is over. Waiting periods only apply to adult
benefits as specified within each plan.
Exceptions to Waiting Periods: Waiting Periods will be waived for newly enrolled adults (age
26 and older) when proof of 12 months of continuous prior coverage for those services is
provided from the prior dental insurance carrier and when the termination date is no more than
30 days prior to the effective date of this policy.
|
Who is mentioned in the document?
|
Dental coverage through Access Health CT
Written by Yessenia Milan | Last published at: January 31, 2025
Dental and oral health are important to your overall health and well-being. You can get denta
|
Dental coverage through Access Health CT
Written by Yessenia Milan | Last published at: January 31, 2025
Dental and oral health are important to your overall health and well-being. You can get dental
coverage through Access Health CT in a few different ways.
All health insurance plans offered through Access Health CT include pediatric dental coverage
for anyone under 26 years old. It is also as an Essential Health Benefit under the ACA. Some
health plans and programs available through Access Health CT, like the Covered CT Program,
include dental coverage for adults. The HUSKY Health Program (Medicaid/CHIP programs)
includes dental coverage for children and adults.
If your current health insurance plan doesn’t include dental coverage, you can get a
stand-alone dental plan through Access Health CT! You can enroll during the Open
Enrollment Period that begins November 1 or during a Special Enrollment Period if you have a
Qualifying Life Event.
To enroll in dental coverage, call us at 1-855-805-4325 or compare dental options online. During
the enrollment process, you will now see health plan options followed by dental plans. If you are
not interested in a health plan, be sure to look for the "Skip to Dental Plans" button at the bottom
of the health plans shopping page.
Customers can sign in to manage their dental coverage here.
Important considerations to keep in mind when shopping for stand-alone dental
coverage:
•
All health insurance plans available through Access Health CT offer pediatric
dental coverage through age 26. Certain medical plans may include some limited adult
dental benefits, but these plans do not provide full dental coverage for adults. Stand-
alone plans are a great option for people who are over 26 years old and need dental
coverage.
•
Financial help does not apply to stand-alone dental plans. If you receive financial
help (also called Advanced Premium Tax Credits or APTCs) through Access Health CT,
that credit cannot be used to help pay for the costs of stand-alone dental plans.
•
If you voluntarily end your dental coverage, you may not be eligible to enroll again
until the next Open Enrollment Period. This includes voluntary termination for not
making premium payments, so be sure to pay your monthly bill (premium) to your
insurance company.
•
There is no out-of-pocket maximum for adults, some plans have a waiting period
before you can start getting covered services, and covered benefits will vary
between plans. Note: there is no waiting period for diagnostic and preventative
services. See below for more information.
More About Dental Plans
Plan Benefits & Coverage Areas
•
Adult Dental Coverage: Dental plans have three major coverage areas for adults:
Diagnostic & Preventive Services, Basic Restorative Services, and Major Services. Each
plan may offer different services and/or coverage, and these differences will have an
impact on the monthly cost of your plan. While shopping for plans, consumers can look
at the Plan Document to see what services are covered.
•
Pediatric Dental Coverage: Covered persons up to age 25 can get Dentally Necessary
Orthodontic Care in addition to Diagnostic & Preventive Services, Basic Restorative
Services, and Major Services.
Out-of-Pocket Maximum
An annual out-of-pocket maximum is the most a member will pay out of their pocket in a
coverage year. Adult dental benefits are not subject to an out-of-pocket maximum, so there is
no cap on what an adult must pay out of your own pocket. However, there is an out-of-pocket
maximum for children through age 25. Check your plan details for specific information.
Benefit Maximum
A Benefit Maximum is a limit on the total amount of covered services under your plan.
Child(ren) dental benefits (for covered persons through age 25) are not subject to a Benefit
Maximum. However, there is a Benefit Maximum for adults, age 26 and older. Check your plan
details for specific information. (An “Adult” is defined as a covered person age 26 and older,
and a “Child” refers to a covered person through age 26 who would be eligible for pediatric
benefits.)
Waiting Periods for New Members
A waiting period is the length of time you must be covered under this policy before you can use
your benefits. Certain types of services may have waiting periods under your policy, but
preventive and diagnostic services do not have waiting periods. You are eligible for
coverage for benefits once your waiting period is over. Waiting periods only apply to adult
benefits as specified within each plan.
Exceptions to Waiting Periods: Waiting Periods will be waived for newly enrolled adults (age
26 and older) when proof of 12 months of continuous prior coverage for those services is
provided from the prior dental insurance carrier and when the termination date is no more than
30 days prior to the effective date of this policy.
|
What are the key takeaways from this text?
|
Dental coverage through Access Health CT
Written by Yessenia Milan | Last published at: January 31, 2025
Dental and oral health are important to your overall health and well-being. You can get denta
|
Differences with Metal Levels
Written by Yessenia Milan | Last published at: March 08, 2024
There are different plan options available at the Bronze, Silver, and Gold levels. Each metal
level offers a different degree of coverage, so you should look for the plan that best fits your
medical needs as well as your budget. Some types of plans may restrict your provider choices
or encourage you to get care from your plan's network of providers, while others pay a larger
share for services outside of the provider network. It's important that you understand the
differences between these metal levels, and that you should look beyond just the monthly
premium payment when comparing plans. Pay attention to your yearly deductible,
copayments, or coinsurance costs, and review the plan's network of providers. Plans with the
lowest monthly payments (premiums) are not always the cheapest option for you and your
family.
For more information on types of plans, differences between plans and how to sort your options,
click here or continue reading.
For information on Catastrophic Plans, click here.
To shop and compare plans now, go to AccessHealthCT.com and click "Compare Plans".
•
Gold Plans:Offer greater coverage but may come with a higher monthly price tag.
Many gold plans have low deductibles and often, low out-of-pocket costs when you
receive care.
–
Is this plan for you? They may be a good option for people who use services
more frequently or who want the assurance that if they need care that, they will
lower out-of-pocket costs.
•
Silver Plans:Tend to have moderate monthly payments (premiums). A number of
services with a copay or coinsurance right away when you use your Silver plan. Silver
plans also have separate, much smaller deductibles for prescription drugs which can
provide you with greater access to these benefits.
–
Is this plan for you? They may be a good option for people who may use
services from time to time or for people who qualify for Cost-Sharing Reductions
(CSRs).
–
Pay close attention to this: Cost-Sharing Reductions (CSRs) lower the amount
($) you pay out-of-pocket for deductibles, coinsurance, and copayments when
you get medical services. If you qualify for CSR's, you must enroll in a Silver level
plan to get these lower costs.
•
Bronze Plans: May have lower monthly premiums, but may require you to meet high
deductibles before the plan will start paying for the services you receive. This means
Bronze plans may be cheaper to have, but more expensive to use.
–
Is this plan for you? They may be a good option for people who do not think
they will need to use their coverage but want protection against the high costs of
serious health events or issues or for those who qualify to use pre-tax dollars to
pay for healthcare costs through a Health Savings Account (HSA).
Are There Other Coverage Options? Yes!
•
Health Coverage for individuals and families:
Access Health CT partners with the Department of Social Services to offer enrollment in HUSKY
Health programs- consisting of Medicaid, known as HUSKY A & D, and the Children's Health
Insurance Program (CHIP), known as HUSKY B. These programs are available at NO cost or
LOW cost. More information here.
•
Standalone Dental Plans:
All health insurance plans offered through Access Health CT include pediatric dental coverage
as an Essential Health Benefit. In Connecticut, pediatric dental coverage is available for anyone
under 26 years old. So, stand-alone dental plans can be an option for people who are over 26
years old and need dental coverage or for children not enrolled in health insurance plans
through Access Health CT. Learn About Dental Plans
•
Small Business Coverage:
We understand how important it is for you and other small business owners to offer your
employees quality healthcare coverage. Access Health CT are available to small businesses
that have 50 or fewer full-time equivalent employees, with flexible options that make quality
healthcare coverage possible- and we offer expert advice and support. Learn more or get a free
quote here.
|
What is the main topic of this document?
|
Differences with Metal Levels
Written by Yessenia Milan | Last published at: March 08, 2024
There are different plan options available at the Bronze, Silver, and Gold levels. Each metal
level offer
|
Differences with Metal Levels
Written by Yessenia Milan | Last published at: March 08, 2024
There are different plan options available at the Bronze, Silver, and Gold levels. Each metal
level offers a different degree of coverage, so you should look for the plan that best fits your
medical needs as well as your budget. Some types of plans may restrict your provider choices
or encourage you to get care from your plan's network of providers, while others pay a larger
share for services outside of the provider network. It's important that you understand the
differences between these metal levels, and that you should look beyond just the monthly
premium payment when comparing plans. Pay attention to your yearly deductible,
copayments, or coinsurance costs, and review the plan's network of providers. Plans with the
lowest monthly payments (premiums) are not always the cheapest option for you and your
family.
For more information on types of plans, differences between plans and how to sort your options,
click here or continue reading.
For information on Catastrophic Plans, click here.
To shop and compare plans now, go to AccessHealthCT.com and click "Compare Plans".
•
Gold Plans:Offer greater coverage but may come with a higher monthly price tag.
Many gold plans have low deductibles and often, low out-of-pocket costs when you
receive care.
–
Is this plan for you? They may be a good option for people who use services
more frequently or who want the assurance that if they need care that, they will
lower out-of-pocket costs.
•
Silver Plans:Tend to have moderate monthly payments (premiums). A number of
services with a copay or coinsurance right away when you use your Silver plan. Silver
plans also have separate, much smaller deductibles for prescription drugs which can
provide you with greater access to these benefits.
–
Is this plan for you? They may be a good option for people who may use
services from time to time or for people who qualify for Cost-Sharing Reductions
(CSRs).
–
Pay close attention to this: Cost-Sharing Reductions (CSRs) lower the amount
($) you pay out-of-pocket for deductibles, coinsurance, and copayments when
you get medical services. If you qualify for CSR's, you must enroll in a Silver level
plan to get these lower costs.
•
Bronze Plans: May have lower monthly premiums, but may require you to meet high
deductibles before the plan will start paying for the services you receive. This means
Bronze plans may be cheaper to have, but more expensive to use.
–
Is this plan for you? They may be a good option for people who do not think
they will need to use their coverage but want protection against the high costs of
serious health events or issues or for those who qualify to use pre-tax dollars to
pay for healthcare costs through a Health Savings Account (HSA).
Are There Other Coverage Options? Yes!
•
Health Coverage for individuals and families:
Access Health CT partners with the Department of Social Services to offer enrollment in HUSKY
Health programs- consisting of Medicaid, known as HUSKY A & D, and the Children's Health
Insurance Program (CHIP), known as HUSKY B. These programs are available at NO cost or
LOW cost. More information here.
•
Standalone Dental Plans:
All health insurance plans offered through Access Health CT include pediatric dental coverage
as an Essential Health Benefit. In Connecticut, pediatric dental coverage is available for anyone
under 26 years old. So, stand-alone dental plans can be an option for people who are over 26
years old and need dental coverage or for children not enrolled in health insurance plans
through Access Health CT. Learn About Dental Plans
•
Small Business Coverage:
We understand how important it is for you and other small business owners to offer your
employees quality healthcare coverage. Access Health CT are available to small businesses
that have 50 or fewer full-time equivalent employees, with flexible options that make quality
healthcare coverage possible- and we offer expert advice and support. Learn more or get a free
quote here.
|
Who is mentioned in the document?
|
Differences with Metal Levels
Written by Yessenia Milan | Last published at: March 08, 2024
There are different plan options available at the Bronze, Silver, and Gold levels. Each metal
level offer
|
Differences with Metal Levels
Written by Yessenia Milan | Last published at: March 08, 2024
There are different plan options available at the Bronze, Silver, and Gold levels. Each metal
level offers a different degree of coverage, so you should look for the plan that best fits your
medical needs as well as your budget. Some types of plans may restrict your provider choices
or encourage you to get care from your plan's network of providers, while others pay a larger
share for services outside of the provider network. It's important that you understand the
differences between these metal levels, and that you should look beyond just the monthly
premium payment when comparing plans. Pay attention to your yearly deductible,
copayments, or coinsurance costs, and review the plan's network of providers. Plans with the
lowest monthly payments (premiums) are not always the cheapest option for you and your
family.
For more information on types of plans, differences between plans and how to sort your options,
click here or continue reading.
For information on Catastrophic Plans, click here.
To shop and compare plans now, go to AccessHealthCT.com and click "Compare Plans".
•
Gold Plans:Offer greater coverage but may come with a higher monthly price tag.
Many gold plans have low deductibles and often, low out-of-pocket costs when you
receive care.
–
Is this plan for you? They may be a good option for people who use services
more frequently or who want the assurance that if they need care that, they will
lower out-of-pocket costs.
•
Silver Plans:Tend to have moderate monthly payments (premiums). A number of
services with a copay or coinsurance right away when you use your Silver plan. Silver
plans also have separate, much smaller deductibles for prescription drugs which can
provide you with greater access to these benefits.
–
Is this plan for you? They may be a good option for people who may use
services from time to time or for people who qualify for Cost-Sharing Reductions
(CSRs).
–
Pay close attention to this: Cost-Sharing Reductions (CSRs) lower the amount
($) you pay out-of-pocket for deductibles, coinsurance, and copayments when
you get medical services. If you qualify for CSR's, you must enroll in a Silver level
plan to get these lower costs.
•
Bronze Plans: May have lower monthly premiums, but may require you to meet high
deductibles before the plan will start paying for the services you receive. This means
Bronze plans may be cheaper to have, but more expensive to use.
–
Is this plan for you? They may be a good option for people who do not think
they will need to use their coverage but want protection against the high costs of
serious health events or issues or for those who qualify to use pre-tax dollars to
pay for healthcare costs through a Health Savings Account (HSA).
Are There Other Coverage Options? Yes!
•
Health Coverage for individuals and families:
Access Health CT partners with the Department of Social Services to offer enrollment in HUSKY
Health programs- consisting of Medicaid, known as HUSKY A & D, and the Children's Health
Insurance Program (CHIP), known as HUSKY B. These programs are available at NO cost or
LOW cost. More information here.
•
Standalone Dental Plans:
All health insurance plans offered through Access Health CT include pediatric dental coverage
as an Essential Health Benefit. In Connecticut, pediatric dental coverage is available for anyone
under 26 years old. So, stand-alone dental plans can be an option for people who are over 26
years old and need dental coverage or for children not enrolled in health insurance plans
through Access Health CT. Learn About Dental Plans
•
Small Business Coverage:
We understand how important it is for you and other small business owners to offer your
employees quality healthcare coverage. Access Health CT are available to small businesses
that have 50 or fewer full-time equivalent employees, with flexible options that make quality
healthcare coverage possible- and we offer expert advice and support. Learn more or get a free
quote here.
|
What are the key takeaways from this text?
|
Differences with Metal Levels
Written by Yessenia Milan | Last published at: March 08, 2024
There are different plan options available at the Bronze, Silver, and Gold levels. Each metal
level offer
|
Disabled Veteran
Written by Yessenia Milan | Last published at: December 22, 2023
No. Veteran's disability benefits should NOT be included in your household income.
Disability benefits are counted as part of your MAGI unless they are a veteran's disability
benefits.
Please talk to a tax advisor if you have questions.
|
What is the main topic of this document?
|
Disabled Veteran
Written by Yessenia Milan | Last published at: December 22, 2023
No. Veteran's disability benefits should NOT be included in your household income.
Disability benefits are counted
|
Disabled Veteran
Written by Yessenia Milan | Last published at: December 22, 2023
No. Veteran's disability benefits should NOT be included in your household income.
Disability benefits are counted as part of your MAGI unless they are a veteran's disability
benefits.
Please talk to a tax advisor if you have questions.
|
Who is mentioned in the document?
|
Disabled Veteran
Written by Yessenia Milan | Last published at: December 22, 2023
No. Veteran's disability benefits should NOT be included in your household income.
Disability benefits are counted
|
Disabled Veteran
Written by Yessenia Milan | Last published at: December 22, 2023
No. Veteran's disability benefits should NOT be included in your household income.
Disability benefits are counted as part of your MAGI unless they are a veteran's disability
benefits.
Please talk to a tax advisor if you have questions.
|
What are the key takeaways from this text?
|
Disabled Veteran
Written by Yessenia Milan | Last published at: December 22, 2023
No. Veteran's disability benefits should NOT be included in your household income.
Disability benefits are counted
|
Does Access Health CT offer a Catastrophic
Plan?
Written by Yessenia Milan | Last published at: April 26, 2023
Catastrophic plans are only available to people younger than 30 years old or to those who have
been granted a hardship or affordability exemption from Access Health CT. You are not eligible
to get financial help to pay for Catastrophic plans.
These plans have low monthly premiums and provide the lowest level of coverage, but they
have higher out-of-pocket costs than other types of plans.
When you fill out an application for coverage, you’ll see Catastrophic Plans listed as an option
only if you qualify for them. If you don’t qualify, you won’t see them as an option to select. An
exemption for hardship or affordability to purchase a catastrophic plan can only be granted by
Access Health CT. Click here to download the application and the instructions about how to
complete the form.
Is this plan for you?
This may be a good option for people who want protection from worst-case scenarios, like
getting seriously sick or injured, but you will pay most routine medical expenses yourself. These
plans have low monthly premiums, but also have high deductibles (your deductible is the
amount you pay for covered healthcare services before your insurance plan starts to pay).
Your deductible will be waived for your first 3 primary care visits, but you must meet the
plan deductible for all other covered services before the plan provides coverage. After you
spend the deductible amount, your insurance company pays for all covered services, with no
copayment or coinsurance. If you qualify for premium tax credits based on your household
income, they cannot be applied to a Catastrophic plan so you may want to consider
a Bronze or Silver plan which may be a better value. Be sure to compare.
For more information about the types of plans, you can get through Access Health CT, click
here.
|
What is the main topic of this document?
|
Does Access Health CT offer a Catastrophic
Plan?
Written by Yessenia Milan | Last published at: April 26, 2023
Catastrophic plans are only available to people younger than 30 years old or to those
|
Does Access Health CT offer a Catastrophic
Plan?
Written by Yessenia Milan | Last published at: April 26, 2023
Catastrophic plans are only available to people younger than 30 years old or to those who have
been granted a hardship or affordability exemption from Access Health CT. You are not eligible
to get financial help to pay for Catastrophic plans.
These plans have low monthly premiums and provide the lowest level of coverage, but they
have higher out-of-pocket costs than other types of plans.
When you fill out an application for coverage, you’ll see Catastrophic Plans listed as an option
only if you qualify for them. If you don’t qualify, you won’t see them as an option to select. An
exemption for hardship or affordability to purchase a catastrophic plan can only be granted by
Access Health CT. Click here to download the application and the instructions about how to
complete the form.
Is this plan for you?
This may be a good option for people who want protection from worst-case scenarios, like
getting seriously sick or injured, but you will pay most routine medical expenses yourself. These
plans have low monthly premiums, but also have high deductibles (your deductible is the
amount you pay for covered healthcare services before your insurance plan starts to pay).
Your deductible will be waived for your first 3 primary care visits, but you must meet the
plan deductible for all other covered services before the plan provides coverage. After you
spend the deductible amount, your insurance company pays for all covered services, with no
copayment or coinsurance. If you qualify for premium tax credits based on your household
income, they cannot be applied to a Catastrophic plan so you may want to consider
a Bronze or Silver plan which may be a better value. Be sure to compare.
For more information about the types of plans, you can get through Access Health CT, click
here.
|
Who is mentioned in the document?
|
Does Access Health CT offer a Catastrophic
Plan?
Written by Yessenia Milan | Last published at: April 26, 2023
Catastrophic plans are only available to people younger than 30 years old or to those
|
Does Access Health CT offer a Catastrophic
Plan?
Written by Yessenia Milan | Last published at: April 26, 2023
Catastrophic plans are only available to people younger than 30 years old or to those who have
been granted a hardship or affordability exemption from Access Health CT. You are not eligible
to get financial help to pay for Catastrophic plans.
These plans have low monthly premiums and provide the lowest level of coverage, but they
have higher out-of-pocket costs than other types of plans.
When you fill out an application for coverage, you’ll see Catastrophic Plans listed as an option
only if you qualify for them. If you don’t qualify, you won’t see them as an option to select. An
exemption for hardship or affordability to purchase a catastrophic plan can only be granted by
Access Health CT. Click here to download the application and the instructions about how to
complete the form.
Is this plan for you?
This may be a good option for people who want protection from worst-case scenarios, like
getting seriously sick or injured, but you will pay most routine medical expenses yourself. These
plans have low monthly premiums, but also have high deductibles (your deductible is the
amount you pay for covered healthcare services before your insurance plan starts to pay).
Your deductible will be waived for your first 3 primary care visits, but you must meet the
plan deductible for all other covered services before the plan provides coverage. After you
spend the deductible amount, your insurance company pays for all covered services, with no
copayment or coinsurance. If you qualify for premium tax credits based on your household
income, they cannot be applied to a Catastrophic plan so you may want to consider
a Bronze or Silver plan which may be a better value. Be sure to compare.
For more information about the types of plans, you can get through Access Health CT, click
here.
|
What are the key takeaways from this text?
|
Does Access Health CT offer a Catastrophic
Plan?
Written by Yessenia Milan | Last published at: April 26, 2023
Catastrophic plans are only available to people younger than 30 years old or to those
|
Eligibility for Medicaid (HUSKY Health) & CHIP
Written by Yessenia Milan | Last published at: November 01, 2024
How do I know if I qualify for HUSKY Health?
Find out if you qualify for HUSKY Health by completing an application with Access Health CT or
the Department of Social Services. For detailed program rules, please visit: How to Qualify
(ct.gov)
HUSKY A
Medicaid for children and teens up to age 19, parents or relative
caregivers of any age with a dependent child(ren) under age 19, pregnant
and post-partum individuals of any age, and individuals formerly in foster
care up to age 26.
HUSKY B
Children’s Health Insurance Program (CHIP) for uninsured children and
teens up to age 19 who have too much income to qualify for
Medicaid. HUSKY B also provides prenatal care to individuals of any age
who do not qualify for Medicaid due to immigration status.
HUSKY C
Medicaid for adults age 65 and older as well as adults with disabilities,
and those requiring long-term services and supports through home and
community based services or residential or skilled nursing facilities. In
addition to income limits, HUSKY C also has asset limits.
HUSKY D
Medicaid for low-income adults between the ages of 19 and 64 without
dependent children.
State HUSKY A
Postpartum
12 months of postpartum-care to recently pregnant non-citizen individuals
of any age who do not qualify for Medicaid due to immigration status.
State HUSKY A
and State
HUSKY B
State-funded HUSKY coverage for children aged 0-15, who do not qualify
for regular HUSKY A and HUSKY B due to immigration status.
HUSKY Health coverage is available to those who are U.S. citizens, naturalized citizens, Lawful
Permanent Residents (LPRs), and other immigrants. For more information, please visit:
https://www.accesshealthct.com/immigration-status/.
Deferred Action for Childhood Arrivals (DACA) recipients are not eligible to enroll in regular
HUSKY Health programs, including Medicaid and the Children’s Health Insurance Program
(CHIP). However, there are State programs (listed above) available for children and pregnant
individuals who do not qualify for regular Medicaid because of their immigration status. Eligibility
for these programs depends on your household income.
|
What is the main topic of this document?
|
Eligibility for Medicaid (HUSKY Health) & CHIP
Written by Yessenia Milan | Last published at: November 01, 2024
How do I know if I qualify for HUSKY Health?
Find out if you qualify for HUSKY Hea
|
Eligibility for Medicaid (HUSKY Health) & CHIP
Written by Yessenia Milan | Last published at: November 01, 2024
How do I know if I qualify for HUSKY Health?
Find out if you qualify for HUSKY Health by completing an application with Access Health CT or
the Department of Social Services. For detailed program rules, please visit: How to Qualify
(ct.gov)
HUSKY A
Medicaid for children and teens up to age 19, parents or relative
caregivers of any age with a dependent child(ren) under age 19, pregnant
and post-partum individuals of any age, and individuals formerly in foster
care up to age 26.
HUSKY B
Children’s Health Insurance Program (CHIP) for uninsured children and
teens up to age 19 who have too much income to qualify for
Medicaid. HUSKY B also provides prenatal care to individuals of any age
who do not qualify for Medicaid due to immigration status.
HUSKY C
Medicaid for adults age 65 and older as well as adults with disabilities,
and those requiring long-term services and supports through home and
community based services or residential or skilled nursing facilities. In
addition to income limits, HUSKY C also has asset limits.
HUSKY D
Medicaid for low-income adults between the ages of 19 and 64 without
dependent children.
State HUSKY A
Postpartum
12 months of postpartum-care to recently pregnant non-citizen individuals
of any age who do not qualify for Medicaid due to immigration status.
State HUSKY A
and State
HUSKY B
State-funded HUSKY coverage for children aged 0-15, who do not qualify
for regular HUSKY A and HUSKY B due to immigration status.
HUSKY Health coverage is available to those who are U.S. citizens, naturalized citizens, Lawful
Permanent Residents (LPRs), and other immigrants. For more information, please visit:
https://www.accesshealthct.com/immigration-status/.
Deferred Action for Childhood Arrivals (DACA) recipients are not eligible to enroll in regular
HUSKY Health programs, including Medicaid and the Children’s Health Insurance Program
(CHIP). However, there are State programs (listed above) available for children and pregnant
individuals who do not qualify for regular Medicaid because of their immigration status. Eligibility
for these programs depends on your household income.
|
Who is mentioned in the document?
|
Eligibility for Medicaid (HUSKY Health) & CHIP
Written by Yessenia Milan | Last published at: November 01, 2024
How do I know if I qualify for HUSKY Health?
Find out if you qualify for HUSKY Hea
|
Eligibility for Medicaid (HUSKY Health) & CHIP
Written by Yessenia Milan | Last published at: November 01, 2024
How do I know if I qualify for HUSKY Health?
Find out if you qualify for HUSKY Health by completing an application with Access Health CT or
the Department of Social Services. For detailed program rules, please visit: How to Qualify
(ct.gov)
HUSKY A
Medicaid for children and teens up to age 19, parents or relative
caregivers of any age with a dependent child(ren) under age 19, pregnant
and post-partum individuals of any age, and individuals formerly in foster
care up to age 26.
HUSKY B
Children’s Health Insurance Program (CHIP) for uninsured children and
teens up to age 19 who have too much income to qualify for
Medicaid. HUSKY B also provides prenatal care to individuals of any age
who do not qualify for Medicaid due to immigration status.
HUSKY C
Medicaid for adults age 65 and older as well as adults with disabilities,
and those requiring long-term services and supports through home and
community based services or residential or skilled nursing facilities. In
addition to income limits, HUSKY C also has asset limits.
HUSKY D
Medicaid for low-income adults between the ages of 19 and 64 without
dependent children.
State HUSKY A
Postpartum
12 months of postpartum-care to recently pregnant non-citizen individuals
of any age who do not qualify for Medicaid due to immigration status.
State HUSKY A
and State
HUSKY B
State-funded HUSKY coverage for children aged 0-15, who do not qualify
for regular HUSKY A and HUSKY B due to immigration status.
HUSKY Health coverage is available to those who are U.S. citizens, naturalized citizens, Lawful
Permanent Residents (LPRs), and other immigrants. For more information, please visit:
https://www.accesshealthct.com/immigration-status/.
Deferred Action for Childhood Arrivals (DACA) recipients are not eligible to enroll in regular
HUSKY Health programs, including Medicaid and the Children’s Health Insurance Program
(CHIP). However, there are State programs (listed above) available for children and pregnant
individuals who do not qualify for regular Medicaid because of their immigration status. Eligibility
for these programs depends on your household income.
|
What are the key takeaways from this text?
|
Eligibility for Medicaid (HUSKY Health) & CHIP
Written by Yessenia Milan | Last published at: November 01, 2024
How do I know if I qualify for HUSKY Health?
Find out if you qualify for HUSKY Hea
|
Eligibility- Children
Written by Yessenia Milan | Last published at: December 22, 2023
The Affordable Care Act allows parents to keep their adult children on their health insurance
plan until age 26.
|
What is the main topic of this document?
|
Eligibility- Children
Written by Yessenia Milan | Last published at: December 22, 2023
The Affordable Care Act allows parents to keep their adult children on their health insurance
plan until age 2
|
Eligibility- Children
Written by Yessenia Milan | Last published at: December 22, 2023
The Affordable Care Act allows parents to keep their adult children on their health insurance
plan until age 26.
|
Who is mentioned in the document?
|
Eligibility- Children
Written by Yessenia Milan | Last published at: December 22, 2023
The Affordable Care Act allows parents to keep their adult children on their health insurance
plan until age 2
|
Eligibility- Children
Written by Yessenia Milan | Last published at: December 22, 2023
The Affordable Care Act allows parents to keep their adult children on their health insurance
plan until age 26.
|
What are the key takeaways from this text?
|
Eligibility- Children
Written by Yessenia Milan | Last published at: December 22, 2023
The Affordable Care Act allows parents to keep their adult children on their health insurance
plan until age 2
|
Employer Sponsored Coverage
Written by Yessenia Milan | Last published at: February 03, 2025
If you are being offered coverage through an employer, or through a family member's employer,
you may still be able to enroll through Access Health CT and get help with paying for healthcare
coverage. Families with offers of employer health coverage may have new opportunities for
savings, even if before they weren't eligible.
Can I enroll through Access Health CT if my employer offers health insurance?
Yes, you can still enroll in a private health insurance plan (Qualified Health Plan) through Access
Health CT, however, if the employer's coverage is considered affordable and meets the Minimum
Value Standard, you will not be eligible to receive financial help (a Premium Tax Credit (PTC) or
Cost-Sharing Reduction (CSR)), regardless of your household income.
•
Affordable: A health insurance plan is deemed "affordable" if the employee's
premium contribution toward the least-expensive plan for coverage is equal to or less
than 8.39% of the household's Modified Adjusted Gross Income in 2024.
•
Minimum Value Standards: A health plan meets minimum value standards if it pays at
least 60% of the total cost of medical services including substantial coverage for
physician and inpatient hospital services.
How is Affordability calculated?
Access Health CT will use the information you provide in your application for health coverage to
determine if your employer’s coverage is “affordable”.
Make sure to contact the Human Resources department at your employer to gather all
information required in our application. Not entering enough information regarding your
employer’s coverage offered will delay determination of your eligibility for the Premium Tax
Credit (PTC) until all necessary information is provided and we can determine that you do
indeed qualify. You can use the Employer Coverage Tool from healthcare.gov to gather
information about your employer.
My employer doesn’t offer coverage, but my spouse’s employer does. Am I still eligible
for individual medical coverage through Access Health CT?
Yes, you can enroll in a plan through Access Health CT. However, if the plan offered by your
spouse’s employer is offered to you – and the plan is considered affordable and meets the
Minimum Value Standard – you may not be eligible for some financial help through Access
Health CT.
A health insurance plan is considered to be affordable for the employee, if the premium cost to
the employee alone meets the affordability percentage. Under a new federal law, family
members may also qualify for financial assistance now. The cost of the employer plan for
additional family members (the employee's spouse and/or dependents) will now be considered
as the measure of affordability for those people.
You should fill out the employer-sponsored coverage section of the Access Health CT
application and answer all the questions. The enrollment and eligibility system will produce an
accurate determination. If you do not know the details of your employer's (or your
spouse's employer) health insurance, you should check with the employer and update your
Access Health CT application with this information.
A recent job or job-based coverage loss could mean you were offered COBRA, click here
to learn more.
|
What is the main topic of this document?
|
Employer Sponsored Coverage
Written by Yessenia Milan | Last published at: February 03, 2025
If you are being offered coverage through an employer, or through a family member's employer,
you may st
|
Employer Sponsored Coverage
Written by Yessenia Milan | Last published at: February 03, 2025
If you are being offered coverage through an employer, or through a family member's employer,
you may still be able to enroll through Access Health CT and get help with paying for healthcare
coverage. Families with offers of employer health coverage may have new opportunities for
savings, even if before they weren't eligible.
Can I enroll through Access Health CT if my employer offers health insurance?
Yes, you can still enroll in a private health insurance plan (Qualified Health Plan) through Access
Health CT, however, if the employer's coverage is considered affordable and meets the Minimum
Value Standard, you will not be eligible to receive financial help (a Premium Tax Credit (PTC) or
Cost-Sharing Reduction (CSR)), regardless of your household income.
•
Affordable: A health insurance plan is deemed "affordable" if the employee's
premium contribution toward the least-expensive plan for coverage is equal to or less
than 8.39% of the household's Modified Adjusted Gross Income in 2024.
•
Minimum Value Standards: A health plan meets minimum value standards if it pays at
least 60% of the total cost of medical services including substantial coverage for
physician and inpatient hospital services.
How is Affordability calculated?
Access Health CT will use the information you provide in your application for health coverage to
determine if your employer’s coverage is “affordable”.
Make sure to contact the Human Resources department at your employer to gather all
information required in our application. Not entering enough information regarding your
employer’s coverage offered will delay determination of your eligibility for the Premium Tax
Credit (PTC) until all necessary information is provided and we can determine that you do
indeed qualify. You can use the Employer Coverage Tool from healthcare.gov to gather
information about your employer.
My employer doesn’t offer coverage, but my spouse’s employer does. Am I still eligible
for individual medical coverage through Access Health CT?
Yes, you can enroll in a plan through Access Health CT. However, if the plan offered by your
spouse’s employer is offered to you – and the plan is considered affordable and meets the
Minimum Value Standard – you may not be eligible for some financial help through Access
Health CT.
A health insurance plan is considered to be affordable for the employee, if the premium cost to
the employee alone meets the affordability percentage. Under a new federal law, family
members may also qualify for financial assistance now. The cost of the employer plan for
additional family members (the employee's spouse and/or dependents) will now be considered
as the measure of affordability for those people.
You should fill out the employer-sponsored coverage section of the Access Health CT
application and answer all the questions. The enrollment and eligibility system will produce an
accurate determination. If you do not know the details of your employer's (or your
spouse's employer) health insurance, you should check with the employer and update your
Access Health CT application with this information.
A recent job or job-based coverage loss could mean you were offered COBRA, click here
to learn more.
|
Who is mentioned in the document?
|
Employer Sponsored Coverage
Written by Yessenia Milan | Last published at: February 03, 2025
If you are being offered coverage through an employer, or through a family member's employer,
you may st
|
Employer Sponsored Coverage
Written by Yessenia Milan | Last published at: February 03, 2025
If you are being offered coverage through an employer, or through a family member's employer,
you may still be able to enroll through Access Health CT and get help with paying for healthcare
coverage. Families with offers of employer health coverage may have new opportunities for
savings, even if before they weren't eligible.
Can I enroll through Access Health CT if my employer offers health insurance?
Yes, you can still enroll in a private health insurance plan (Qualified Health Plan) through Access
Health CT, however, if the employer's coverage is considered affordable and meets the Minimum
Value Standard, you will not be eligible to receive financial help (a Premium Tax Credit (PTC) or
Cost-Sharing Reduction (CSR)), regardless of your household income.
•
Affordable: A health insurance plan is deemed "affordable" if the employee's
premium contribution toward the least-expensive plan for coverage is equal to or less
than 8.39% of the household's Modified Adjusted Gross Income in 2024.
•
Minimum Value Standards: A health plan meets minimum value standards if it pays at
least 60% of the total cost of medical services including substantial coverage for
physician and inpatient hospital services.
How is Affordability calculated?
Access Health CT will use the information you provide in your application for health coverage to
determine if your employer’s coverage is “affordable”.
Make sure to contact the Human Resources department at your employer to gather all
information required in our application. Not entering enough information regarding your
employer’s coverage offered will delay determination of your eligibility for the Premium Tax
Credit (PTC) until all necessary information is provided and we can determine that you do
indeed qualify. You can use the Employer Coverage Tool from healthcare.gov to gather
information about your employer.
My employer doesn’t offer coverage, but my spouse’s employer does. Am I still eligible
for individual medical coverage through Access Health CT?
Yes, you can enroll in a plan through Access Health CT. However, if the plan offered by your
spouse’s employer is offered to you – and the plan is considered affordable and meets the
Minimum Value Standard – you may not be eligible for some financial help through Access
Health CT.
A health insurance plan is considered to be affordable for the employee, if the premium cost to
the employee alone meets the affordability percentage. Under a new federal law, family
members may also qualify for financial assistance now. The cost of the employer plan for
additional family members (the employee's spouse and/or dependents) will now be considered
as the measure of affordability for those people.
You should fill out the employer-sponsored coverage section of the Access Health CT
application and answer all the questions. The enrollment and eligibility system will produce an
accurate determination. If you do not know the details of your employer's (or your
spouse's employer) health insurance, you should check with the employer and update your
Access Health CT application with this information.
A recent job or job-based coverage loss could mean you were offered COBRA, click here
to learn more.
|
What are the key takeaways from this text?
|
Employer Sponsored Coverage
Written by Yessenia Milan | Last published at: February 03, 2025
If you are being offered coverage through an employer, or through a family member's employer,
you may st
|
Enrollment: Contact Access Health CT
Written by Yessenia Milan | Last published at: January 16, 2025
The Open Enrollment Period for 2026 health and dental insurance coverage begins November
1, 2025.
Residents may be able to enroll at any time through Access Health CT if they:
•
Are an American Indian or Alaska Native
•
Qualify for HUSKY Health (Medicaid/Children's Health Insurance Program)
•
Qualify for the Covered CT Program
•
Experience a Qualifying Life Event like losing health coverage through your job, getting
married, or moving to Connecticut from another state or country
We Are Here to Help
•
Call us at 1-855-805-4325. Hours of Operation (Holiday hours may vary, check website
for details)
•
Live Chat available at AccessHealthCT.com
•
Visit one of our Enrollment Locations
•
Find a Broker or Certified Application Counselor (CAC) near you
Call Center Days & Hours of Operation
Monday – Friday: 8:00 a.m. – 4:00 p.m.
What documents/information do I need to enroll?
You should have the following information for yourself and anyone in your household (even if
they don't need coverage):
• Dates of Birth
• Social Security Numbers
• Visa, green card, or immigration documents
• Most recent W2 and/or Form 1040, 1099
• Pay-stubs, Profit & Loss Statements or other employment information
• Current insurance coverage (policy numbers for any current health insurance plans covering
members of your household)
Download our Enrollment Checklist:
English
Spanish
Haitian Creole
Polish
What information do I need to provide when calling to update my application or if I have
an escalated issue?
•
Full name
•
Date of Birth
•
Address
•
Social Security Number
In order to make changes or receive information about an Access Health CT account or
application, you must be the primary applicant, authorized representative, or broker on the
application. If you are not a primary applicant or are not an authorized representative. Access
Health CT cannot release information or make changes to your Access Health CT account.
Why? This information is needed to verify that we are speaking with someone authorized to
make changes, receive information about the Access Health CT account/application, and to
protect the privacy and security of customer information.
How long will the enrollment process take?
For those individuals or smaller households that do not require assistance, we estimate that it
may take about 30–45 minutes to complete the enrollment process online.
For larger households, those with complex situations or eligibility issues, it may take longer.
Please contact Access Health CT at 1-855-805-4325 if you need any assistance.
How do I enroll through Access Heath CT?
We realize that not everyone has regular access to the same type of technology or may prefer a
personal approach to discuss their healthcare coverage options. We're here to help! You can
get the coverage you need online, over the phone, or in person.
•
Apply online at AccessHealthCT.com – it's an easy and convenient way to compare the
available plans and see if you qualify for financial help.
•
Apply in-person with a trained and certified Insurance Broker or a Certified Application
Counselor (CAC). Click here to find one near you.
•
Call us at 1-855-805-4325 to speak with a trained Enrollment Specialist who can answer
your questions and guide you through the enrollment process in many different
languages.
Visit AccessHealthCT.com to learn more about the enrollment process and what you should look
for when you shop. We have resources available in many languages spoken by Connecticut
residents.
What phone number should I call if I have questions about my enrollment?
For any enrollment or general questions, please call Access Health CT at 1-855-805-4325.
Customers who are deaf or hearing impaired may use TTY at 1-855-789-2428 or call 1-855-
805-4325 with a relay operator.
If you have questions about your monthly bill or insurance benefits, you should contact your
insurance company. (Their phone number is located on the back of your insurance card)
Qualified Health Plans (QHP)
ConnectiCare: 1-800-251-7722
Anthem: 1-855-738-6644
HUSKY Health/Medicaid
DSS Client Information Line & Benefit Center: 1-855-626-6632
HUSKY Health Member Services: 1-800-859-9889
HUSKY B Premium Billing: 1-800-656-6684
|
What is the main topic of this document?
|
Enrollment: Contact Access Health CT
Written by Yessenia Milan | Last published at: January 16, 2025
The Open Enrollment Period for 2026 health and dental insurance coverage begins November
1, 2
|
Enrollment: Contact Access Health CT
Written by Yessenia Milan | Last published at: January 16, 2025
The Open Enrollment Period for 2026 health and dental insurance coverage begins November
1, 2025.
Residents may be able to enroll at any time through Access Health CT if they:
•
Are an American Indian or Alaska Native
•
Qualify for HUSKY Health (Medicaid/Children's Health Insurance Program)
•
Qualify for the Covered CT Program
•
Experience a Qualifying Life Event like losing health coverage through your job, getting
married, or moving to Connecticut from another state or country
We Are Here to Help
•
Call us at 1-855-805-4325. Hours of Operation (Holiday hours may vary, check website
for details)
•
Live Chat available at AccessHealthCT.com
•
Visit one of our Enrollment Locations
•
Find a Broker or Certified Application Counselor (CAC) near you
Call Center Days & Hours of Operation
Monday – Friday: 8:00 a.m. – 4:00 p.m.
What documents/information do I need to enroll?
You should have the following information for yourself and anyone in your household (even if
they don't need coverage):
• Dates of Birth
• Social Security Numbers
• Visa, green card, or immigration documents
• Most recent W2 and/or Form 1040, 1099
• Pay-stubs, Profit & Loss Statements or other employment information
• Current insurance coverage (policy numbers for any current health insurance plans covering
members of your household)
Download our Enrollment Checklist:
English
Spanish
Haitian Creole
Polish
What information do I need to provide when calling to update my application or if I have
an escalated issue?
•
Full name
•
Date of Birth
•
Address
•
Social Security Number
In order to make changes or receive information about an Access Health CT account or
application, you must be the primary applicant, authorized representative, or broker on the
application. If you are not a primary applicant or are not an authorized representative. Access
Health CT cannot release information or make changes to your Access Health CT account.
Why? This information is needed to verify that we are speaking with someone authorized to
make changes, receive information about the Access Health CT account/application, and to
protect the privacy and security of customer information.
How long will the enrollment process take?
For those individuals or smaller households that do not require assistance, we estimate that it
may take about 30–45 minutes to complete the enrollment process online.
For larger households, those with complex situations or eligibility issues, it may take longer.
Please contact Access Health CT at 1-855-805-4325 if you need any assistance.
How do I enroll through Access Heath CT?
We realize that not everyone has regular access to the same type of technology or may prefer a
personal approach to discuss their healthcare coverage options. We're here to help! You can
get the coverage you need online, over the phone, or in person.
•
Apply online at AccessHealthCT.com – it's an easy and convenient way to compare the
available plans and see if you qualify for financial help.
•
Apply in-person with a trained and certified Insurance Broker or a Certified Application
Counselor (CAC). Click here to find one near you.
•
Call us at 1-855-805-4325 to speak with a trained Enrollment Specialist who can answer
your questions and guide you through the enrollment process in many different
languages.
Visit AccessHealthCT.com to learn more about the enrollment process and what you should look
for when you shop. We have resources available in many languages spoken by Connecticut
residents.
What phone number should I call if I have questions about my enrollment?
For any enrollment or general questions, please call Access Health CT at 1-855-805-4325.
Customers who are deaf or hearing impaired may use TTY at 1-855-789-2428 or call 1-855-
805-4325 with a relay operator.
If you have questions about your monthly bill or insurance benefits, you should contact your
insurance company. (Their phone number is located on the back of your insurance card)
Qualified Health Plans (QHP)
ConnectiCare: 1-800-251-7722
Anthem: 1-855-738-6644
HUSKY Health/Medicaid
DSS Client Information Line & Benefit Center: 1-855-626-6632
HUSKY Health Member Services: 1-800-859-9889
HUSKY B Premium Billing: 1-800-656-6684
|
Who is mentioned in the document?
|
Enrollment: Contact Access Health CT
Written by Yessenia Milan | Last published at: January 16, 2025
The Open Enrollment Period for 2026 health and dental insurance coverage begins November
1, 2
|
Enrollment: Contact Access Health CT
Written by Yessenia Milan | Last published at: January 16, 2025
The Open Enrollment Period for 2026 health and dental insurance coverage begins November
1, 2025.
Residents may be able to enroll at any time through Access Health CT if they:
•
Are an American Indian or Alaska Native
•
Qualify for HUSKY Health (Medicaid/Children's Health Insurance Program)
•
Qualify for the Covered CT Program
•
Experience a Qualifying Life Event like losing health coverage through your job, getting
married, or moving to Connecticut from another state or country
We Are Here to Help
•
Call us at 1-855-805-4325. Hours of Operation (Holiday hours may vary, check website
for details)
•
Live Chat available at AccessHealthCT.com
•
Visit one of our Enrollment Locations
•
Find a Broker or Certified Application Counselor (CAC) near you
Call Center Days & Hours of Operation
Monday – Friday: 8:00 a.m. – 4:00 p.m.
What documents/information do I need to enroll?
You should have the following information for yourself and anyone in your household (even if
they don't need coverage):
• Dates of Birth
• Social Security Numbers
• Visa, green card, or immigration documents
• Most recent W2 and/or Form 1040, 1099
• Pay-stubs, Profit & Loss Statements or other employment information
• Current insurance coverage (policy numbers for any current health insurance plans covering
members of your household)
Download our Enrollment Checklist:
English
Spanish
Haitian Creole
Polish
What information do I need to provide when calling to update my application or if I have
an escalated issue?
•
Full name
•
Date of Birth
•
Address
•
Social Security Number
In order to make changes or receive information about an Access Health CT account or
application, you must be the primary applicant, authorized representative, or broker on the
application. If you are not a primary applicant or are not an authorized representative. Access
Health CT cannot release information or make changes to your Access Health CT account.
Why? This information is needed to verify that we are speaking with someone authorized to
make changes, receive information about the Access Health CT account/application, and to
protect the privacy and security of customer information.
How long will the enrollment process take?
For those individuals or smaller households that do not require assistance, we estimate that it
may take about 30–45 minutes to complete the enrollment process online.
For larger households, those with complex situations or eligibility issues, it may take longer.
Please contact Access Health CT at 1-855-805-4325 if you need any assistance.
How do I enroll through Access Heath CT?
We realize that not everyone has regular access to the same type of technology or may prefer a
personal approach to discuss their healthcare coverage options. We're here to help! You can
get the coverage you need online, over the phone, or in person.
•
Apply online at AccessHealthCT.com – it's an easy and convenient way to compare the
available plans and see if you qualify for financial help.
•
Apply in-person with a trained and certified Insurance Broker or a Certified Application
Counselor (CAC). Click here to find one near you.
•
Call us at 1-855-805-4325 to speak with a trained Enrollment Specialist who can answer
your questions and guide you through the enrollment process in many different
languages.
Visit AccessHealthCT.com to learn more about the enrollment process and what you should look
for when you shop. We have resources available in many languages spoken by Connecticut
residents.
What phone number should I call if I have questions about my enrollment?
For any enrollment or general questions, please call Access Health CT at 1-855-805-4325.
Customers who are deaf or hearing impaired may use TTY at 1-855-789-2428 or call 1-855-
805-4325 with a relay operator.
If you have questions about your monthly bill or insurance benefits, you should contact your
insurance company. (Their phone number is located on the back of your insurance card)
Qualified Health Plans (QHP)
ConnectiCare: 1-800-251-7722
Anthem: 1-855-738-6644
HUSKY Health/Medicaid
DSS Client Information Line & Benefit Center: 1-855-626-6632
HUSKY Health Member Services: 1-800-859-9889
HUSKY B Premium Billing: 1-800-656-6684
|
What are the key takeaways from this text?
|
Enrollment: Contact Access Health CT
Written by Yessenia Milan | Last published at: January 16, 2025
The Open Enrollment Period for 2026 health and dental insurance coverage begins November
1, 2
|
Essential Health Benefits
Written by Yessenia Milan | Last published at: October 24, 2024
Read this article to find out what benefits are covered by every health plan available through
Access Health CT. If you're paying for health insurance, you should know what is included with
your plan and what services you can get at no cost to you. This information does not apply to
our Dental Insurance plans.
All health insurance plans offered through Access Health CT provide coverage for the same set
of Essential Health Benefits. Essential health benefits are minimum requirements for all
plans available through Access Health CT. While the cost for certain benefits may vary
depending on the selected plan, you can be assured that all plans will provide coverage for:
•
–
Ambulatory patient services (outpatient care you get without being admitted to a
hospital)
–
Emergency room coverage
–
Hospitalization (such as surgery)
–
Maternity and newborn care (care before and after your baby is born)
–
Mental health and substance abuse services, including behavioral health
treatment (includes counseling and psychotherapy)
–
Prescription drug coverage
–
Rehabilitative and habilitative services and devices (services and devices to help
people with injuries, disabilities, or chronic conditions gain or recover mental and
physical skills)
–
Laboratory service coverage
–
Preventive and wellness services and chronic disease management
–
Pediatric services (including oral and vision care for people under the age of 26)
Plans must also include the following benefits:
•
–
Birth control coverage
–
Breastfeeding coverage
Some plans offer many additional covered benefits. Specific services covered in each benefit
category can vary, so check the Plan Details to see what is covered. Plans may offer additional
benefits, including:
•
–
Dental coverage
–
Vision coverage
–
Medical management programs (for specific needs like weight management,
back pain, and diabetes)
Preventive Care
Most health plans must cover a set of preventive services — like vaccines and health
screenings — at no cost to you. These services are free only when delivered by a doctor or
other provider in your plan's network.
Getting preventive care, like annual checkups which can help you detect or prevent illnesses or
diseases from becoming major issues, are the best way to keep your healthcare costs
low. Often, you can start using your benefits right away, without worrying about paying
a deductible. You can look at your plan documents to identify those benefits, or check with your
insurance company to see which benefits your plan covers.
Looking for a Plan?
You should always review the full plan information before enrolling in a plan to make sure it
meets your needs.
When choosing a plan, think about costs beyond your monthly payment (premium). Pay
attention to yearly deductible, co-payments, or co-insurance costs and review the plan's network
of providers and prescription drug coverage. For more on comparing health plans, click here.
To compare plans and enroll, visit AccessHealthCT.com.
If you're already enrolled and want to explore all the benefits of your plan, get in touch
with your insurance company.
|
What is the main topic of this document?
|
Essential Health Benefits
Written by Yessenia Milan | Last published at: October 24, 2024
Read this article to find out what benefits are covered by every health plan available through
Access Healt
|
Essential Health Benefits
Written by Yessenia Milan | Last published at: October 24, 2024
Read this article to find out what benefits are covered by every health plan available through
Access Health CT. If you're paying for health insurance, you should know what is included with
your plan and what services you can get at no cost to you. This information does not apply to
our Dental Insurance plans.
All health insurance plans offered through Access Health CT provide coverage for the same set
of Essential Health Benefits. Essential health benefits are minimum requirements for all
plans available through Access Health CT. While the cost for certain benefits may vary
depending on the selected plan, you can be assured that all plans will provide coverage for:
•
–
Ambulatory patient services (outpatient care you get without being admitted to a
hospital)
–
Emergency room coverage
–
Hospitalization (such as surgery)
–
Maternity and newborn care (care before and after your baby is born)
–
Mental health and substance abuse services, including behavioral health
treatment (includes counseling and psychotherapy)
–
Prescription drug coverage
–
Rehabilitative and habilitative services and devices (services and devices to help
people with injuries, disabilities, or chronic conditions gain or recover mental and
physical skills)
–
Laboratory service coverage
–
Preventive and wellness services and chronic disease management
–
Pediatric services (including oral and vision care for people under the age of 26)
Plans must also include the following benefits:
•
–
Birth control coverage
–
Breastfeeding coverage
Some plans offer many additional covered benefits. Specific services covered in each benefit
category can vary, so check the Plan Details to see what is covered. Plans may offer additional
benefits, including:
•
–
Dental coverage
–
Vision coverage
–
Medical management programs (for specific needs like weight management,
back pain, and diabetes)
Preventive Care
Most health plans must cover a set of preventive services — like vaccines and health
screenings — at no cost to you. These services are free only when delivered by a doctor or
other provider in your plan's network.
Getting preventive care, like annual checkups which can help you detect or prevent illnesses or
diseases from becoming major issues, are the best way to keep your healthcare costs
low. Often, you can start using your benefits right away, without worrying about paying
a deductible. You can look at your plan documents to identify those benefits, or check with your
insurance company to see which benefits your plan covers.
Looking for a Plan?
You should always review the full plan information before enrolling in a plan to make sure it
meets your needs.
When choosing a plan, think about costs beyond your monthly payment (premium). Pay
attention to yearly deductible, co-payments, or co-insurance costs and review the plan's network
of providers and prescription drug coverage. For more on comparing health plans, click here.
To compare plans and enroll, visit AccessHealthCT.com.
If you're already enrolled and want to explore all the benefits of your plan, get in touch
with your insurance company.
|
Who is mentioned in the document?
|
Essential Health Benefits
Written by Yessenia Milan | Last published at: October 24, 2024
Read this article to find out what benefits are covered by every health plan available through
Access Healt
|
Essential Health Benefits
Written by Yessenia Milan | Last published at: October 24, 2024
Read this article to find out what benefits are covered by every health plan available through
Access Health CT. If you're paying for health insurance, you should know what is included with
your plan and what services you can get at no cost to you. This information does not apply to
our Dental Insurance plans.
All health insurance plans offered through Access Health CT provide coverage for the same set
of Essential Health Benefits. Essential health benefits are minimum requirements for all
plans available through Access Health CT. While the cost for certain benefits may vary
depending on the selected plan, you can be assured that all plans will provide coverage for:
•
–
Ambulatory patient services (outpatient care you get without being admitted to a
hospital)
–
Emergency room coverage
–
Hospitalization (such as surgery)
–
Maternity and newborn care (care before and after your baby is born)
–
Mental health and substance abuse services, including behavioral health
treatment (includes counseling and psychotherapy)
–
Prescription drug coverage
–
Rehabilitative and habilitative services and devices (services and devices to help
people with injuries, disabilities, or chronic conditions gain or recover mental and
physical skills)
–
Laboratory service coverage
–
Preventive and wellness services and chronic disease management
–
Pediatric services (including oral and vision care for people under the age of 26)
Plans must also include the following benefits:
•
–
Birth control coverage
–
Breastfeeding coverage
Some plans offer many additional covered benefits. Specific services covered in each benefit
category can vary, so check the Plan Details to see what is covered. Plans may offer additional
benefits, including:
•
–
Dental coverage
–
Vision coverage
–
Medical management programs (for specific needs like weight management,
back pain, and diabetes)
Preventive Care
Most health plans must cover a set of preventive services — like vaccines and health
screenings — at no cost to you. These services are free only when delivered by a doctor or
other provider in your plan's network.
Getting preventive care, like annual checkups which can help you detect or prevent illnesses or
diseases from becoming major issues, are the best way to keep your healthcare costs
low. Often, you can start using your benefits right away, without worrying about paying
a deductible. You can look at your plan documents to identify those benefits, or check with your
insurance company to see which benefits your plan covers.
Looking for a Plan?
You should always review the full plan information before enrolling in a plan to make sure it
meets your needs.
When choosing a plan, think about costs beyond your monthly payment (premium). Pay
attention to yearly deductible, co-payments, or co-insurance costs and review the plan's network
of providers and prescription drug coverage. For more on comparing health plans, click here.
To compare plans and enroll, visit AccessHealthCT.com.
If you're already enrolled and want to explore all the benefits of your plan, get in touch
with your insurance company.
|
What are the key takeaways from this text?
|
Essential Health Benefits
Written by Yessenia Milan | Last published at: October 24, 2024
Read this article to find out what benefits are covered by every health plan available through
Access Healt
|
Exemptions from the ACA Individual Mandate
Written by Yessenia Milan | Last published at: November 22, 2023
Starting January 1, 2014, the individual shared responsibility provision of the Patient Protection
and Affordable Care Act (ACA) required individuals to have Minimum Essential Health
Coverage (MEC) each month (known as the "Individual Mandate"), or pay a financial penalty for
failure to have MEC (known as the "Shared Responsibility Payment"). Individuals, however,
could qualify for an exemption from the Individual Mandate and avoid paying the financial
penalty for failure to have MEC. There are several types of exemptions, including, for example,
exemptions based on membership in certain religious sects and exemptions based on hardship
and affordability.
Under the Tax Cuts and Jobs Act, the Shared Responsibility Payment was reduced to $0,
effective for months after December 31, 2018. Therefore, starting with the 2019 tax year,
individuals do not need to pay the Shared Responsibility Payment if they do not have MEC or
qualify for an exemption from the Individual Mandate.
Because the Individual Mandate remains in place despite the reduction of the Shared
Responsibility Payment to $0, an exemption for hardship or affordability is required for those
individuals over the age of 30 looking to purchase a catastrophic health plan.
Claiming a Hardship or Affordability Exemption from the Individual Mandate to Purchase
a Catastrophic Health Plan
An exemption for hardship or affordability from the Individual Mandate is required for those
individuals over the age of 30 looking to purchase a catastrophic health plan. If you're under
30, you don't need an exemption to enroll in a catastrophic plan.
An exemption for hardship or affordability to purchase a catastrophic plan can only be granted
by Access Health CT. Click here to download the application and the instructions about how to
complete the form.
For tax year 2024, you can claim an Affordability Exemption ONLY if the lowest-cost
coverage available to you through Access Health CT or through an employer-sponsored plan
would cost you more than 8.39% of your household's Modified Adjusted Gross Income in 2024.
A hardship exemption may be granted for various reasons, including, for example:
•
Bankruptcy
•
Eviction
•
Natural Disaster
•
Religious beliefs
•
Financial Hardship
|
What is the main topic of this document?
|
Exemptions from the ACA Individual Mandate
Written by Yessenia Milan | Last published at: November 22, 2023
Starting January 1, 2014, the individual shared responsibility provision of the Patient Pr
|
Exemptions from the ACA Individual Mandate
Written by Yessenia Milan | Last published at: November 22, 2023
Starting January 1, 2014, the individual shared responsibility provision of the Patient Protection
and Affordable Care Act (ACA) required individuals to have Minimum Essential Health
Coverage (MEC) each month (known as the "Individual Mandate"), or pay a financial penalty for
failure to have MEC (known as the "Shared Responsibility Payment"). Individuals, however,
could qualify for an exemption from the Individual Mandate and avoid paying the financial
penalty for failure to have MEC. There are several types of exemptions, including, for example,
exemptions based on membership in certain religious sects and exemptions based on hardship
and affordability.
Under the Tax Cuts and Jobs Act, the Shared Responsibility Payment was reduced to $0,
effective for months after December 31, 2018. Therefore, starting with the 2019 tax year,
individuals do not need to pay the Shared Responsibility Payment if they do not have MEC or
qualify for an exemption from the Individual Mandate.
Because the Individual Mandate remains in place despite the reduction of the Shared
Responsibility Payment to $0, an exemption for hardship or affordability is required for those
individuals over the age of 30 looking to purchase a catastrophic health plan.
Claiming a Hardship or Affordability Exemption from the Individual Mandate to Purchase
a Catastrophic Health Plan
An exemption for hardship or affordability from the Individual Mandate is required for those
individuals over the age of 30 looking to purchase a catastrophic health plan. If you're under
30, you don't need an exemption to enroll in a catastrophic plan.
An exemption for hardship or affordability to purchase a catastrophic plan can only be granted
by Access Health CT. Click here to download the application and the instructions about how to
complete the form.
For tax year 2024, you can claim an Affordability Exemption ONLY if the lowest-cost
coverage available to you through Access Health CT or through an employer-sponsored plan
would cost you more than 8.39% of your household's Modified Adjusted Gross Income in 2024.
A hardship exemption may be granted for various reasons, including, for example:
•
Bankruptcy
•
Eviction
•
Natural Disaster
•
Religious beliefs
•
Financial Hardship
|
Who is mentioned in the document?
|
Exemptions from the ACA Individual Mandate
Written by Yessenia Milan | Last published at: November 22, 2023
Starting January 1, 2014, the individual shared responsibility provision of the Patient Pr
|
Exemptions from the ACA Individual Mandate
Written by Yessenia Milan | Last published at: November 22, 2023
Starting January 1, 2014, the individual shared responsibility provision of the Patient Protection
and Affordable Care Act (ACA) required individuals to have Minimum Essential Health
Coverage (MEC) each month (known as the "Individual Mandate"), or pay a financial penalty for
failure to have MEC (known as the "Shared Responsibility Payment"). Individuals, however,
could qualify for an exemption from the Individual Mandate and avoid paying the financial
penalty for failure to have MEC. There are several types of exemptions, including, for example,
exemptions based on membership in certain religious sects and exemptions based on hardship
and affordability.
Under the Tax Cuts and Jobs Act, the Shared Responsibility Payment was reduced to $0,
effective for months after December 31, 2018. Therefore, starting with the 2019 tax year,
individuals do not need to pay the Shared Responsibility Payment if they do not have MEC or
qualify for an exemption from the Individual Mandate.
Because the Individual Mandate remains in place despite the reduction of the Shared
Responsibility Payment to $0, an exemption for hardship or affordability is required for those
individuals over the age of 30 looking to purchase a catastrophic health plan.
Claiming a Hardship or Affordability Exemption from the Individual Mandate to Purchase
a Catastrophic Health Plan
An exemption for hardship or affordability from the Individual Mandate is required for those
individuals over the age of 30 looking to purchase a catastrophic health plan. If you're under
30, you don't need an exemption to enroll in a catastrophic plan.
An exemption for hardship or affordability to purchase a catastrophic plan can only be granted
by Access Health CT. Click here to download the application and the instructions about how to
complete the form.
For tax year 2024, you can claim an Affordability Exemption ONLY if the lowest-cost
coverage available to you through Access Health CT or through an employer-sponsored plan
would cost you more than 8.39% of your household's Modified Adjusted Gross Income in 2024.
A hardship exemption may be granted for various reasons, including, for example:
•
Bankruptcy
•
Eviction
•
Natural Disaster
•
Religious beliefs
•
Financial Hardship
|
What are the key takeaways from this text?
|
Exemptions from the ACA Individual Mandate
Written by Yessenia Milan | Last published at: November 22, 2023
Starting January 1, 2014, the individual shared responsibility provision of the Patient Pr
|
Financial Help and Low/No-Cost Programs
Written by Yessenia Milan | Last published at: October 25, 2024
Most people qualify for some type of financial help, low-cost or free coverage thanks to new
laws and programs, including the Inflation Reduction Act (IRA) and new Covered CT Program.
Even people who weren’t eligible in the past may qualify for new financial help.
Complete One Application to See Your Options
Access Health CT is the only place where you can qualify for financial help to lower your health
insurance costs or, if eligible, enroll into free or low-cost coverage through HUSKY Health
(Medicaid/Children’s Health Insurance Program). Before you begin an application, you can use
the Compare Plans tool to enter some basic information about your household—like your tax
household size, home address, and household income—to understand your coverage and
financial help options.
It is our mission to increase the number of insured residents in Connecticut. We partner with the
Department of Social Services to offer a single application process for healthcare coverage to
residents. Whether you qualify for a HUSKY Health Program or for a Qualified Health Plan
(QHP) through a private insurance company, you can expect the same free help through
Access Health CT—online, by phone, or in-person.
Most people get financial help for coverage through a Qualified Health Plan (QHP) or no- or low-
cost coverage through a HUSKY Health Program.
Your Coverage & Financial Help Options
1. HUSKY Health Programs: Medicaid and the Children’s Health Insurance Program
(CHIP)
You may be eligible for HUSKY Health Programs (Medicaid/CHIP), which offer no- or low-cost
healthcare coverage if your household meets the income requirements, and you are:
•
Currently pregnant
•
A single Connecticut resident who has no children, or who has children age 19 or older
•
Parents or caregivers of Medicaid-eligible children
•
A Medicaid-eligible child (under 19)
•
For more information about HUSKY Health Programs, click here.
2. Financial Help Available Only For Qualified Health Plans Offered Through Access
Health CT
If you do not qualify for a free or low-cost program through Medicaid or HUSKY Health
Programs, you may be able to enroll in a health insurance plan with financial help to lower your
healthcare costs.
If you enroll in a Qualified Health Plan (QHP) through Access Health CT, there are two types of
financial help you may qualify for:
•
Premium Tax Credits (PTC) which you can take in advance (APTC) or claim on your
federal income tax return
•
Cost-Sharing Reductions (CSR)
Financial Help Options for QHPs
What It Does...
Premium Tax Credits (PTC), also called
Advance Premium Tax Credits (APTCs)
Reduces your monthly payments (premium) or
claim when you file your federal income taxes
Cost-Sharing Reductions (CSR)
Reduces what you pay out of your own pocket
when you use your plan
More About Financial Help Available Only Through Access Health CT
1. (Advance) Premium Tax Credits
What is it? Premium Tax Credits (PTC), also called Advance Premium Tax Credits (APTC), can
be distributed monthly or when you file your federal income taxes. When used in advance,
Premium Tax Credits can help lower your monthly payments (known as premiums) when you
enroll through Access Health CT. To qualify for a Premium Tax Credit, you:
•
Cannot be eligible for other affordable healthcare coverage through your employer or a
government-sponsored program, such as Medicaid, Tricare, Medicare, or VA benefits
•
Must be a Connecticut resident and a citizen or lawful resident of the United States, and
not in prison (other than pending final disposition of charges)
•
Must enroll in a Qualified Health Plan (QHP) offered through Access Health CT
•
If you are married, you must file a joint tax return (unless you are a victim of domestic
abuse or spousal abandonment)
•
You must not be claimed as a dependent on anyone else's return
•
You must file a Form 1040 income tax return at least for the year that you got APTCs
and must file IRS Form 8962 to make sure that you got the correct amount of APTCs
during the year.
How does financial help work? When you apply through Access Health CT and we determine
that you are eligible for Premium Tax Credits, you will be given the option to take the credits in
advance (that’s the A in APTC), or you can wait until your annual federal income tax filing to
reconcile your household income and Premium Tax Credits. When enrolling online, you can use
the sliding scale (on the Advance Premium Tax Credit selection page) in your application to
choose how much of the tax credit to take in advance - you can take all, some, or none of the
Premium Tax Credits.
In general, there are two ways you can take advantage of Premium Tax Credits:
•
In Advance: When you choose to take Advance Premium Tax Credits, the tax credit is
paid directly from the federal government to your insurance company to help lower your
monthly payments (known as premiums). It’s important that you estimate your annual
household income accurately and contact Access Health CT if your income changes
significantly from the amount you provided in your application. When you file your federal
income taxes (IRS Form 1040) and Form 8962, the IRS will compare your actual
household income for the tax year with the estimated income you reported in your
application. If the details do not match, then you could owe the IRS for overpayments of
APTC.
•
When You File Federal Income Tax Return (IRS Form 1040): You may be able to claim
the Premium Tax Credit (PTC) that you didn't take in advance when you file your tax
return. It's important to remember that your ability to claim the PTC depends on
providing us an accurate estimate of your household income when you complete your
application. When you file your taxes, the IRS will compare what you told us in your
application to what your return shows for income, which can impact how much PTC you
can claim.
What else is important to know?
Your family's modified adjusted gross income (also known as MAGI), will determine whether you
received too much or too little financial help throughout the year. It is important that your MAGI
estimate is accurate on your application to avoid owing the IRS, so it is important that you
update your MAGI estimate anytime it changes during the year.
2. Cost-Sharing Reductions (CSR)
What is it? Cost-Sharing Reductions (CSR) lower the amount you pay out-of-pocket for
deductibles, co-insurance, and co-payments when you get medical services. If you qualify for
CSR, you must enroll in a Silver level plan to get these lower costs. Cost Sharing Reductions
(CSR) are only available to individuals and families who have a MAGI is between 0% and 250%
of the Federal Poverty Level.
CSR plans only exist at the Silver level of plans. For more information about plan types and
metal levels, click here.
How does it work?
During your enrollment process, you will provide basic information, like estimated MAGI,
address, and age to determine if you qualify for financial help or are eligible for no- or low-cost
coverage. If you are eligible for Cost-Sharing Reductions, you will need to select a plan at the
Silver level to take advantage of this type of financial help. Once you enroll, you will have
access to reduced out-of-pocket costs for services when you use your plan.
Related Topics:
•
Reporting Changes to Household Information
•
Financial Help and Your Taxes
|
What is the main topic of this document?
|
Financial Help and Low/No-Cost Programs
Written by Yessenia Milan | Last published at: October 25, 2024
Most people qualify for some type of financial help, low-cost or free coverage thanks to new
|
Financial Help and Low/No-Cost Programs
Written by Yessenia Milan | Last published at: October 25, 2024
Most people qualify for some type of financial help, low-cost or free coverage thanks to new
laws and programs, including the Inflation Reduction Act (IRA) and new Covered CT Program.
Even people who weren’t eligible in the past may qualify for new financial help.
Complete One Application to See Your Options
Access Health CT is the only place where you can qualify for financial help to lower your health
insurance costs or, if eligible, enroll into free or low-cost coverage through HUSKY Health
(Medicaid/Children’s Health Insurance Program). Before you begin an application, you can use
the Compare Plans tool to enter some basic information about your household—like your tax
household size, home address, and household income—to understand your coverage and
financial help options.
It is our mission to increase the number of insured residents in Connecticut. We partner with the
Department of Social Services to offer a single application process for healthcare coverage to
residents. Whether you qualify for a HUSKY Health Program or for a Qualified Health Plan
(QHP) through a private insurance company, you can expect the same free help through
Access Health CT—online, by phone, or in-person.
Most people get financial help for coverage through a Qualified Health Plan (QHP) or no- or low-
cost coverage through a HUSKY Health Program.
Your Coverage & Financial Help Options
1. HUSKY Health Programs: Medicaid and the Children’s Health Insurance Program
(CHIP)
You may be eligible for HUSKY Health Programs (Medicaid/CHIP), which offer no- or low-cost
healthcare coverage if your household meets the income requirements, and you are:
•
Currently pregnant
•
A single Connecticut resident who has no children, or who has children age 19 or older
•
Parents or caregivers of Medicaid-eligible children
•
A Medicaid-eligible child (under 19)
•
For more information about HUSKY Health Programs, click here.
2. Financial Help Available Only For Qualified Health Plans Offered Through Access
Health CT
If you do not qualify for a free or low-cost program through Medicaid or HUSKY Health
Programs, you may be able to enroll in a health insurance plan with financial help to lower your
healthcare costs.
If you enroll in a Qualified Health Plan (QHP) through Access Health CT, there are two types of
financial help you may qualify for:
•
Premium Tax Credits (PTC) which you can take in advance (APTC) or claim on your
federal income tax return
•
Cost-Sharing Reductions (CSR)
Financial Help Options for QHPs
What It Does...
Premium Tax Credits (PTC), also called
Advance Premium Tax Credits (APTCs)
Reduces your monthly payments (premium) or
claim when you file your federal income taxes
Cost-Sharing Reductions (CSR)
Reduces what you pay out of your own pocket
when you use your plan
More About Financial Help Available Only Through Access Health CT
1. (Advance) Premium Tax Credits
What is it? Premium Tax Credits (PTC), also called Advance Premium Tax Credits (APTC), can
be distributed monthly or when you file your federal income taxes. When used in advance,
Premium Tax Credits can help lower your monthly payments (known as premiums) when you
enroll through Access Health CT. To qualify for a Premium Tax Credit, you:
•
Cannot be eligible for other affordable healthcare coverage through your employer or a
government-sponsored program, such as Medicaid, Tricare, Medicare, or VA benefits
•
Must be a Connecticut resident and a citizen or lawful resident of the United States, and
not in prison (other than pending final disposition of charges)
•
Must enroll in a Qualified Health Plan (QHP) offered through Access Health CT
•
If you are married, you must file a joint tax return (unless you are a victim of domestic
abuse or spousal abandonment)
•
You must not be claimed as a dependent on anyone else's return
•
You must file a Form 1040 income tax return at least for the year that you got APTCs
and must file IRS Form 8962 to make sure that you got the correct amount of APTCs
during the year.
How does financial help work? When you apply through Access Health CT and we determine
that you are eligible for Premium Tax Credits, you will be given the option to take the credits in
advance (that’s the A in APTC), or you can wait until your annual federal income tax filing to
reconcile your household income and Premium Tax Credits. When enrolling online, you can use
the sliding scale (on the Advance Premium Tax Credit selection page) in your application to
choose how much of the tax credit to take in advance - you can take all, some, or none of the
Premium Tax Credits.
In general, there are two ways you can take advantage of Premium Tax Credits:
•
In Advance: When you choose to take Advance Premium Tax Credits, the tax credit is
paid directly from the federal government to your insurance company to help lower your
monthly payments (known as premiums). It’s important that you estimate your annual
household income accurately and contact Access Health CT if your income changes
significantly from the amount you provided in your application. When you file your federal
income taxes (IRS Form 1040) and Form 8962, the IRS will compare your actual
household income for the tax year with the estimated income you reported in your
application. If the details do not match, then you could owe the IRS for overpayments of
APTC.
•
When You File Federal Income Tax Return (IRS Form 1040): You may be able to claim
the Premium Tax Credit (PTC) that you didn't take in advance when you file your tax
return. It's important to remember that your ability to claim the PTC depends on
providing us an accurate estimate of your household income when you complete your
application. When you file your taxes, the IRS will compare what you told us in your
application to what your return shows for income, which can impact how much PTC you
can claim.
What else is important to know?
Your family's modified adjusted gross income (also known as MAGI), will determine whether you
received too much or too little financial help throughout the year. It is important that your MAGI
estimate is accurate on your application to avoid owing the IRS, so it is important that you
update your MAGI estimate anytime it changes during the year.
2. Cost-Sharing Reductions (CSR)
What is it? Cost-Sharing Reductions (CSR) lower the amount you pay out-of-pocket for
deductibles, co-insurance, and co-payments when you get medical services. If you qualify for
CSR, you must enroll in a Silver level plan to get these lower costs. Cost Sharing Reductions
(CSR) are only available to individuals and families who have a MAGI is between 0% and 250%
of the Federal Poverty Level.
CSR plans only exist at the Silver level of plans. For more information about plan types and
metal levels, click here.
How does it work?
During your enrollment process, you will provide basic information, like estimated MAGI,
address, and age to determine if you qualify for financial help or are eligible for no- or low-cost
coverage. If you are eligible for Cost-Sharing Reductions, you will need to select a plan at the
Silver level to take advantage of this type of financial help. Once you enroll, you will have
access to reduced out-of-pocket costs for services when you use your plan.
Related Topics:
•
Reporting Changes to Household Information
•
Financial Help and Your Taxes
|
Who is mentioned in the document?
|
Financial Help and Low/No-Cost Programs
Written by Yessenia Milan | Last published at: October 25, 2024
Most people qualify for some type of financial help, low-cost or free coverage thanks to new
|
Financial Help and Low/No-Cost Programs
Written by Yessenia Milan | Last published at: October 25, 2024
Most people qualify for some type of financial help, low-cost or free coverage thanks to new
laws and programs, including the Inflation Reduction Act (IRA) and new Covered CT Program.
Even people who weren’t eligible in the past may qualify for new financial help.
Complete One Application to See Your Options
Access Health CT is the only place where you can qualify for financial help to lower your health
insurance costs or, if eligible, enroll into free or low-cost coverage through HUSKY Health
(Medicaid/Children’s Health Insurance Program). Before you begin an application, you can use
the Compare Plans tool to enter some basic information about your household—like your tax
household size, home address, and household income—to understand your coverage and
financial help options.
It is our mission to increase the number of insured residents in Connecticut. We partner with the
Department of Social Services to offer a single application process for healthcare coverage to
residents. Whether you qualify for a HUSKY Health Program or for a Qualified Health Plan
(QHP) through a private insurance company, you can expect the same free help through
Access Health CT—online, by phone, or in-person.
Most people get financial help for coverage through a Qualified Health Plan (QHP) or no- or low-
cost coverage through a HUSKY Health Program.
Your Coverage & Financial Help Options
1. HUSKY Health Programs: Medicaid and the Children’s Health Insurance Program
(CHIP)
You may be eligible for HUSKY Health Programs (Medicaid/CHIP), which offer no- or low-cost
healthcare coverage if your household meets the income requirements, and you are:
•
Currently pregnant
•
A single Connecticut resident who has no children, or who has children age 19 or older
•
Parents or caregivers of Medicaid-eligible children
•
A Medicaid-eligible child (under 19)
•
For more information about HUSKY Health Programs, click here.
2. Financial Help Available Only For Qualified Health Plans Offered Through Access
Health CT
If you do not qualify for a free or low-cost program through Medicaid or HUSKY Health
Programs, you may be able to enroll in a health insurance plan with financial help to lower your
healthcare costs.
If you enroll in a Qualified Health Plan (QHP) through Access Health CT, there are two types of
financial help you may qualify for:
•
Premium Tax Credits (PTC) which you can take in advance (APTC) or claim on your
federal income tax return
•
Cost-Sharing Reductions (CSR)
Financial Help Options for QHPs
What It Does...
Premium Tax Credits (PTC), also called
Advance Premium Tax Credits (APTCs)
Reduces your monthly payments (premium) or
claim when you file your federal income taxes
Cost-Sharing Reductions (CSR)
Reduces what you pay out of your own pocket
when you use your plan
More About Financial Help Available Only Through Access Health CT
1. (Advance) Premium Tax Credits
What is it? Premium Tax Credits (PTC), also called Advance Premium Tax Credits (APTC), can
be distributed monthly or when you file your federal income taxes. When used in advance,
Premium Tax Credits can help lower your monthly payments (known as premiums) when you
enroll through Access Health CT. To qualify for a Premium Tax Credit, you:
•
Cannot be eligible for other affordable healthcare coverage through your employer or a
government-sponsored program, such as Medicaid, Tricare, Medicare, or VA benefits
•
Must be a Connecticut resident and a citizen or lawful resident of the United States, and
not in prison (other than pending final disposition of charges)
•
Must enroll in a Qualified Health Plan (QHP) offered through Access Health CT
•
If you are married, you must file a joint tax return (unless you are a victim of domestic
abuse or spousal abandonment)
•
You must not be claimed as a dependent on anyone else's return
•
You must file a Form 1040 income tax return at least for the year that you got APTCs
and must file IRS Form 8962 to make sure that you got the correct amount of APTCs
during the year.
How does financial help work? When you apply through Access Health CT and we determine
that you are eligible for Premium Tax Credits, you will be given the option to take the credits in
advance (that’s the A in APTC), or you can wait until your annual federal income tax filing to
reconcile your household income and Premium Tax Credits. When enrolling online, you can use
the sliding scale (on the Advance Premium Tax Credit selection page) in your application to
choose how much of the tax credit to take in advance - you can take all, some, or none of the
Premium Tax Credits.
In general, there are two ways you can take advantage of Premium Tax Credits:
•
In Advance: When you choose to take Advance Premium Tax Credits, the tax credit is
paid directly from the federal government to your insurance company to help lower your
monthly payments (known as premiums). It’s important that you estimate your annual
household income accurately and contact Access Health CT if your income changes
significantly from the amount you provided in your application. When you file your federal
income taxes (IRS Form 1040) and Form 8962, the IRS will compare your actual
household income for the tax year with the estimated income you reported in your
application. If the details do not match, then you could owe the IRS for overpayments of
APTC.
•
When You File Federal Income Tax Return (IRS Form 1040): You may be able to claim
the Premium Tax Credit (PTC) that you didn't take in advance when you file your tax
return. It's important to remember that your ability to claim the PTC depends on
providing us an accurate estimate of your household income when you complete your
application. When you file your taxes, the IRS will compare what you told us in your
application to what your return shows for income, which can impact how much PTC you
can claim.
What else is important to know?
Your family's modified adjusted gross income (also known as MAGI), will determine whether you
received too much or too little financial help throughout the year. It is important that your MAGI
estimate is accurate on your application to avoid owing the IRS, so it is important that you
update your MAGI estimate anytime it changes during the year.
2. Cost-Sharing Reductions (CSR)
What is it? Cost-Sharing Reductions (CSR) lower the amount you pay out-of-pocket for
deductibles, co-insurance, and co-payments when you get medical services. If you qualify for
CSR, you must enroll in a Silver level plan to get these lower costs. Cost Sharing Reductions
(CSR) are only available to individuals and families who have a MAGI is between 0% and 250%
of the Federal Poverty Level.
CSR plans only exist at the Silver level of plans. For more information about plan types and
metal levels, click here.
How does it work?
During your enrollment process, you will provide basic information, like estimated MAGI,
address, and age to determine if you qualify for financial help or are eligible for no- or low-cost
coverage. If you are eligible for Cost-Sharing Reductions, you will need to select a plan at the
Silver level to take advantage of this type of financial help. Once you enroll, you will have
access to reduced out-of-pocket costs for services when you use your plan.
Related Topics:
•
Reporting Changes to Household Information
•
Financial Help and Your Taxes
|
What are the key takeaways from this text?
|
Financial Help and Low/No-Cost Programs
Written by Yessenia Milan | Last published at: October 25, 2024
Most people qualify for some type of financial help, low-cost or free coverage thanks to new
|
Form 1095-A
Written by Yessenia Milan | Last published at: January 15, 2025
If you or anyone in your household enrolls in a Qualified Health Plan (QHP) through Access
Health CT, you will receive a Form 1095-A from Access Health CT. You will need this Form to
complete your federal income tax return — even if you did not receive financial help
(Advance Premium Tax Credits) or were only enrolled in a Qualified Health Plan for one
month. Individuals enrolled in a Catastrophic plan will not receive a Form 1095-A and they do
not need to include information about their Catastrophic plan in their federal income tax return.
Access Health CT mails a Form1095-A to the primary tax filer in a household by January 31 of
each year. Form 1095-A will have information about the prior coverage year (ex: if you had
coverage in 2024, the Form 1095-A will be issued by January 31, 2025).
Did You Know? If you have an online account, you can view or print your Form 1095-A online!
Sign in at AccessHealthCT.com and click "Get My Tax Forms."
If you do not receive your Form 1095-A by March 31, 2025, you should consider filing for an extension
to file your federal income tax return with the Internal Revenue Service (IRS). For most people, the
deadline to file their federal income tax return or file for an extension is April 15, 2025.
What is Form 1095-A?
Form 1095-A is a tax form issued by Access Health CT. It is sent to the primary tax filer in a
household and will include all members of the household who were enrolled in a Qualified
Health Plan.
Form 1095-A shows:
•
Who had qualified coverage in your household
•
Your household plan information and the monthly payment (known as a premium)
•
The amount of money paid to your insurance company to help lower your monthly costs
(known as Advance Premium Tax Credits or APTCs).
Who will receive Form 1095-A from Access Health CT?
The primary tax filer in a household, where at least one household member was enrolled in a
Qualified Health Plan (QHP) through Access Health CT in the previous calendar year.
Who Will NOT receive a Form 1095-A from Access Health CT?
1.
Individuals who were enrolled in a Catastrophic plan through Access Health CT will NOT
receive a Form 1095-A for their coverage.
2.
Individuals who had HUSKY Health Coverage (Medicaid or the Children's Health
Insurance Program (CHIP)) can request a Form 1095-B from the Connecticut
Department of Social Services, not Access Health CT.
3.
You should expect a Form 1095-C if you were enrolled in coverage through your
employer or through Medicare. If you have questions, please contact your employer or
the Centers for Medicare and Medicaid Services (CMS).
4.
Why is Form 1095-A Important?
Form 1095-A is used by a primary tax filer to:
•
Reconcile Advance Premium Tax Credits (APTCs) on their federal income tax return by
completing IRS Form 8962, which the IRS uses to determine whether you received the
correct amount of APTCs. Please see a tax professional for help with completing Form
8962.
Where can I find my Form 1095-A?
Sign in to your Access Health CT account and click “Get My Tax Forms.” (If you don't find your
Form 1095-A, you can also click "Read My Messages" and type "1095" in the search bar to
retrieve your Form 1095-A. If you cannot locate your Form, please contact us). You may need to
reset your password if it’s been a while since you logged in.
Remember when filing your taxes:
•
If you received Advance Premium Tax Credits (APTCs) and you do not file your tax
return with Form 8962 to reconcile your APTC amounts, you may not be able to receive
APTCs in future years until you complete Form 8962 and file it with your federal income
tax return.
•
If you filed your federal income tax return electronically and it was rejected for a missing
Form 8962, you may need to resubmit your return with a completed Form 8962 or an
explanation for why you are missing the form, and then attach it to your return when you
refile. Learn how to correct an electronically filed return rejected for a missing Form 8962,
here.
•
If your filing or income information has changed since you applied for health coverage,
you may have to pay back some or all of the Advance Premium Tax Credit amounts
(financial help) you received.
More About Form 1095-A
When does it arrive?
Each year, Form 1095-A is sent by Access Health CT by
January 31 with information about the prior coverage year (ex:
For coverage in the year 2024, Form 1095-A will be sent by
January 31, 2025). If you do not receive your Form 1095-A
by February 15, please contact Access Health CT.
How does it arrive?
Form 1095-A is sent to customers by mail and is made available in
their online account.
Form 1095-A CANNOT be emailed or faxed. If you’ve misplaced your
Form 1095-A, please contact us for assistance.
What should customers
do with the form?
Check the information on your Form 1095-A. Make sure the
information is up-to-date for everyone covered under your plan.
That includes your name, home address, health plan
information and Advance Premium Tax Credit amounts (if
applicable). If any of the information in Form 1095-A is wrong,
please call us at 1-855-805-4325 (TTY users should call 1-855-
789-2428 or contact us at 1-855-805-4325 with a relay
operator).
Why do the monthly
payments (premiums) on
Form 1095-A NOT match
the premium bill from
your insurance company?
•
The premium amount in Column A of your Form 1095-A
may show an amount different than what you paid all
year because amounts in Column A show only the
portion of your premium that covers Essential Health
Benefits.
•
Plans sold through Access Health CT are required to
cover Essential Health Benefits.
•
Insurance companies may offer benefits in addition to
the Essential Health Benefits, so the premium paid may
be different than the amount listed in Column A to cover
these additional benefits.
To view or print your Form
1095-A online
Sign in to your Access Health CT account and click “Get My Tax
Forms.” (If you don't find your Form 1095-A in your inbox, click "Read
My Messages" and then type "1095" in the search bar.)
You may need to reset your password if it’s been a while since you
logged in.
For questions, reprints, or
errors in your Form 1095-
A
Call us at 1-855-805-4325. If you are deaf or hearing impaired,
you may use the TTY at 1-885-789-8424 or contact us at 1-
855-805-4325 with a relay operator.
Online Account Access
If you are locked out of your online account or if you need to create
one, you must call us at 1-855-805-4325 (TTY users should call 1-
855-789-2428 or contact us at 1-855-805-4325 with a relay operator).
Some related topics:
•
Information for Customers with a Qualified Health Plan
•
Form 1095-B and Form 1095-C
•
Learn More about Estimating Your Income
•
Financial Help: Advance Premium Tax Credits (APTCs)
|
What is the main topic of this document?
|
Form 1095-A
Written by Yessenia Milan | Last published at: January 15, 2025
If you or anyone in your household enrolls in a Qualified Health Plan (QHP) through Access
Health CT, you will receive
|
Form 1095-A
Written by Yessenia Milan | Last published at: January 15, 2025
If you or anyone in your household enrolls in a Qualified Health Plan (QHP) through Access
Health CT, you will receive a Form 1095-A from Access Health CT. You will need this Form to
complete your federal income tax return — even if you did not receive financial help
(Advance Premium Tax Credits) or were only enrolled in a Qualified Health Plan for one
month. Individuals enrolled in a Catastrophic plan will not receive a Form 1095-A and they do
not need to include information about their Catastrophic plan in their federal income tax return.
Access Health CT mails a Form1095-A to the primary tax filer in a household by January 31 of
each year. Form 1095-A will have information about the prior coverage year (ex: if you had
coverage in 2024, the Form 1095-A will be issued by January 31, 2025).
Did You Know? If you have an online account, you can view or print your Form 1095-A online!
Sign in at AccessHealthCT.com and click "Get My Tax Forms."
If you do not receive your Form 1095-A by March 31, 2025, you should consider filing for an extension
to file your federal income tax return with the Internal Revenue Service (IRS). For most people, the
deadline to file their federal income tax return or file for an extension is April 15, 2025.
What is Form 1095-A?
Form 1095-A is a tax form issued by Access Health CT. It is sent to the primary tax filer in a
household and will include all members of the household who were enrolled in a Qualified
Health Plan.
Form 1095-A shows:
•
Who had qualified coverage in your household
•
Your household plan information and the monthly payment (known as a premium)
•
The amount of money paid to your insurance company to help lower your monthly costs
(known as Advance Premium Tax Credits or APTCs).
Who will receive Form 1095-A from Access Health CT?
The primary tax filer in a household, where at least one household member was enrolled in a
Qualified Health Plan (QHP) through Access Health CT in the previous calendar year.
Who Will NOT receive a Form 1095-A from Access Health CT?
1.
Individuals who were enrolled in a Catastrophic plan through Access Health CT will NOT
receive a Form 1095-A for their coverage.
2.
Individuals who had HUSKY Health Coverage (Medicaid or the Children's Health
Insurance Program (CHIP)) can request a Form 1095-B from the Connecticut
Department of Social Services, not Access Health CT.
3.
You should expect a Form 1095-C if you were enrolled in coverage through your
employer or through Medicare. If you have questions, please contact your employer or
the Centers for Medicare and Medicaid Services (CMS).
4.
Why is Form 1095-A Important?
Form 1095-A is used by a primary tax filer to:
•
Reconcile Advance Premium Tax Credits (APTCs) on their federal income tax return by
completing IRS Form 8962, which the IRS uses to determine whether you received the
correct amount of APTCs. Please see a tax professional for help with completing Form
8962.
Where can I find my Form 1095-A?
Sign in to your Access Health CT account and click “Get My Tax Forms.” (If you don't find your
Form 1095-A, you can also click "Read My Messages" and type "1095" in the search bar to
retrieve your Form 1095-A. If you cannot locate your Form, please contact us). You may need to
reset your password if it’s been a while since you logged in.
Remember when filing your taxes:
•
If you received Advance Premium Tax Credits (APTCs) and you do not file your tax
return with Form 8962 to reconcile your APTC amounts, you may not be able to receive
APTCs in future years until you complete Form 8962 and file it with your federal income
tax return.
•
If you filed your federal income tax return electronically and it was rejected for a missing
Form 8962, you may need to resubmit your return with a completed Form 8962 or an
explanation for why you are missing the form, and then attach it to your return when you
refile. Learn how to correct an electronically filed return rejected for a missing Form 8962,
here.
•
If your filing or income information has changed since you applied for health coverage,
you may have to pay back some or all of the Advance Premium Tax Credit amounts
(financial help) you received.
More About Form 1095-A
When does it arrive?
Each year, Form 1095-A is sent by Access Health CT by
January 31 with information about the prior coverage year (ex:
For coverage in the year 2024, Form 1095-A will be sent by
January 31, 2025). If you do not receive your Form 1095-A
by February 15, please contact Access Health CT.
How does it arrive?
Form 1095-A is sent to customers by mail and is made available in
their online account.
Form 1095-A CANNOT be emailed or faxed. If you’ve misplaced your
Form 1095-A, please contact us for assistance.
What should customers
do with the form?
Check the information on your Form 1095-A. Make sure the
information is up-to-date for everyone covered under your plan.
That includes your name, home address, health plan
information and Advance Premium Tax Credit amounts (if
applicable). If any of the information in Form 1095-A is wrong,
please call us at 1-855-805-4325 (TTY users should call 1-855-
789-2428 or contact us at 1-855-805-4325 with a relay
operator).
Why do the monthly
payments (premiums) on
Form 1095-A NOT match
the premium bill from
your insurance company?
•
The premium amount in Column A of your Form 1095-A
may show an amount different than what you paid all
year because amounts in Column A show only the
portion of your premium that covers Essential Health
Benefits.
•
Plans sold through Access Health CT are required to
cover Essential Health Benefits.
•
Insurance companies may offer benefits in addition to
the Essential Health Benefits, so the premium paid may
be different than the amount listed in Column A to cover
these additional benefits.
To view or print your Form
1095-A online
Sign in to your Access Health CT account and click “Get My Tax
Forms.” (If you don't find your Form 1095-A in your inbox, click "Read
My Messages" and then type "1095" in the search bar.)
You may need to reset your password if it’s been a while since you
logged in.
For questions, reprints, or
errors in your Form 1095-
A
Call us at 1-855-805-4325. If you are deaf or hearing impaired,
you may use the TTY at 1-885-789-8424 or contact us at 1-
855-805-4325 with a relay operator.
Online Account Access
If you are locked out of your online account or if you need to create
one, you must call us at 1-855-805-4325 (TTY users should call 1-
855-789-2428 or contact us at 1-855-805-4325 with a relay operator).
Some related topics:
•
Information for Customers with a Qualified Health Plan
•
Form 1095-B and Form 1095-C
•
Learn More about Estimating Your Income
•
Financial Help: Advance Premium Tax Credits (APTCs)
|
Who is mentioned in the document?
|
Form 1095-A
Written by Yessenia Milan | Last published at: January 15, 2025
If you or anyone in your household enrolls in a Qualified Health Plan (QHP) through Access
Health CT, you will receive
|
Form 1095-A
Written by Yessenia Milan | Last published at: January 15, 2025
If you or anyone in your household enrolls in a Qualified Health Plan (QHP) through Access
Health CT, you will receive a Form 1095-A from Access Health CT. You will need this Form to
complete your federal income tax return — even if you did not receive financial help
(Advance Premium Tax Credits) or were only enrolled in a Qualified Health Plan for one
month. Individuals enrolled in a Catastrophic plan will not receive a Form 1095-A and they do
not need to include information about their Catastrophic plan in their federal income tax return.
Access Health CT mails a Form1095-A to the primary tax filer in a household by January 31 of
each year. Form 1095-A will have information about the prior coverage year (ex: if you had
coverage in 2024, the Form 1095-A will be issued by January 31, 2025).
Did You Know? If you have an online account, you can view or print your Form 1095-A online!
Sign in at AccessHealthCT.com and click "Get My Tax Forms."
If you do not receive your Form 1095-A by March 31, 2025, you should consider filing for an extension
to file your federal income tax return with the Internal Revenue Service (IRS). For most people, the
deadline to file their federal income tax return or file for an extension is April 15, 2025.
What is Form 1095-A?
Form 1095-A is a tax form issued by Access Health CT. It is sent to the primary tax filer in a
household and will include all members of the household who were enrolled in a Qualified
Health Plan.
Form 1095-A shows:
•
Who had qualified coverage in your household
•
Your household plan information and the monthly payment (known as a premium)
•
The amount of money paid to your insurance company to help lower your monthly costs
(known as Advance Premium Tax Credits or APTCs).
Who will receive Form 1095-A from Access Health CT?
The primary tax filer in a household, where at least one household member was enrolled in a
Qualified Health Plan (QHP) through Access Health CT in the previous calendar year.
Who Will NOT receive a Form 1095-A from Access Health CT?
1.
Individuals who were enrolled in a Catastrophic plan through Access Health CT will NOT
receive a Form 1095-A for their coverage.
2.
Individuals who had HUSKY Health Coverage (Medicaid or the Children's Health
Insurance Program (CHIP)) can request a Form 1095-B from the Connecticut
Department of Social Services, not Access Health CT.
3.
You should expect a Form 1095-C if you were enrolled in coverage through your
employer or through Medicare. If you have questions, please contact your employer or
the Centers for Medicare and Medicaid Services (CMS).
4.
Why is Form 1095-A Important?
Form 1095-A is used by a primary tax filer to:
•
Reconcile Advance Premium Tax Credits (APTCs) on their federal income tax return by
completing IRS Form 8962, which the IRS uses to determine whether you received the
correct amount of APTCs. Please see a tax professional for help with completing Form
8962.
Where can I find my Form 1095-A?
Sign in to your Access Health CT account and click “Get My Tax Forms.” (If you don't find your
Form 1095-A, you can also click "Read My Messages" and type "1095" in the search bar to
retrieve your Form 1095-A. If you cannot locate your Form, please contact us). You may need to
reset your password if it’s been a while since you logged in.
Remember when filing your taxes:
•
If you received Advance Premium Tax Credits (APTCs) and you do not file your tax
return with Form 8962 to reconcile your APTC amounts, you may not be able to receive
APTCs in future years until you complete Form 8962 and file it with your federal income
tax return.
•
If you filed your federal income tax return electronically and it was rejected for a missing
Form 8962, you may need to resubmit your return with a completed Form 8962 or an
explanation for why you are missing the form, and then attach it to your return when you
refile. Learn how to correct an electronically filed return rejected for a missing Form 8962,
here.
•
If your filing or income information has changed since you applied for health coverage,
you may have to pay back some or all of the Advance Premium Tax Credit amounts
(financial help) you received.
More About Form 1095-A
When does it arrive?
Each year, Form 1095-A is sent by Access Health CT by
January 31 with information about the prior coverage year (ex:
For coverage in the year 2024, Form 1095-A will be sent by
January 31, 2025). If you do not receive your Form 1095-A
by February 15, please contact Access Health CT.
How does it arrive?
Form 1095-A is sent to customers by mail and is made available in
their online account.
Form 1095-A CANNOT be emailed or faxed. If you’ve misplaced your
Form 1095-A, please contact us for assistance.
What should customers
do with the form?
Check the information on your Form 1095-A. Make sure the
information is up-to-date for everyone covered under your plan.
That includes your name, home address, health plan
information and Advance Premium Tax Credit amounts (if
applicable). If any of the information in Form 1095-A is wrong,
please call us at 1-855-805-4325 (TTY users should call 1-855-
789-2428 or contact us at 1-855-805-4325 with a relay
operator).
Why do the monthly
payments (premiums) on
Form 1095-A NOT match
the premium bill from
your insurance company?
•
The premium amount in Column A of your Form 1095-A
may show an amount different than what you paid all
year because amounts in Column A show only the
portion of your premium that covers Essential Health
Benefits.
•
Plans sold through Access Health CT are required to
cover Essential Health Benefits.
•
Insurance companies may offer benefits in addition to
the Essential Health Benefits, so the premium paid may
be different than the amount listed in Column A to cover
these additional benefits.
To view or print your Form
1095-A online
Sign in to your Access Health CT account and click “Get My Tax
Forms.” (If you don't find your Form 1095-A in your inbox, click "Read
My Messages" and then type "1095" in the search bar.)
You may need to reset your password if it’s been a while since you
logged in.
For questions, reprints, or
errors in your Form 1095-
A
Call us at 1-855-805-4325. If you are deaf or hearing impaired,
you may use the TTY at 1-885-789-8424 or contact us at 1-
855-805-4325 with a relay operator.
Online Account Access
If you are locked out of your online account or if you need to create
one, you must call us at 1-855-805-4325 (TTY users should call 1-
855-789-2428 or contact us at 1-855-805-4325 with a relay operator).
Some related topics:
•
Information for Customers with a Qualified Health Plan
•
Form 1095-B and Form 1095-C
•
Learn More about Estimating Your Income
•
Financial Help: Advance Premium Tax Credits (APTCs)
|
What are the key takeaways from this text?
|
Form 1095-A
Written by Yessenia Milan | Last published at: January 15, 2025
If you or anyone in your household enrolls in a Qualified Health Plan (QHP) through Access
Health CT, you will receive
|
Form 1095-C
Written by Yessenia Milan | Last published at: January 16, 2025
A 1095-C is a tax form issued by an employer to an employee (and other eligible household
members) to show information about the healthcare coverage the employee had. You should
expect a Form 1095-C if you had coverage through your employer or through Medicare.
The IRS requires all 1095-C's to be issued by January 31st.
If you have questions about your 1095-C form, please contact your employer or the Centers for
Medicare and Medicaid Services (CMS).
|
What is the main topic of this document?
|
Form 1095-C
Written by Yessenia Milan | Last published at: January 16, 2025
A 1095-C is a tax form issued by an employer to an employee (and other eligible household
members) to show information ab
|
Form 1095-C
Written by Yessenia Milan | Last published at: January 16, 2025
A 1095-C is a tax form issued by an employer to an employee (and other eligible household
members) to show information about the healthcare coverage the employee had. You should
expect a Form 1095-C if you had coverage through your employer or through Medicare.
The IRS requires all 1095-C's to be issued by January 31st.
If you have questions about your 1095-C form, please contact your employer or the Centers for
Medicare and Medicaid Services (CMS).
|
Who is mentioned in the document?
|
Form 1095-C
Written by Yessenia Milan | Last published at: January 16, 2025
A 1095-C is a tax form issued by an employer to an employee (and other eligible household
members) to show information ab
|
Form 1095-C
Written by Yessenia Milan | Last published at: January 16, 2025
A 1095-C is a tax form issued by an employer to an employee (and other eligible household
members) to show information about the healthcare coverage the employee had. You should
expect a Form 1095-C if you had coverage through your employer or through Medicare.
The IRS requires all 1095-C's to be issued by January 31st.
If you have questions about your 1095-C form, please contact your employer or the Centers for
Medicare and Medicaid Services (CMS).
|
What are the key takeaways from this text?
|
Form 1095-C
Written by Yessenia Milan | Last published at: January 16, 2025
A 1095-C is a tax form issued by an employer to an employee (and other eligible household
members) to show information ab
|
Help With Your Verifications
Written by Yessenia Milan | Last published at: January 30, 2025
This article has a list of documents that can be used to verify your eligibility or other
information. You can also see general information about verifications and instructions
for uploading documents. If you still have questions, find help or call us at 1-855-805-4325
(TTY 1-855-789-2428 or contact us at 1-855-805-4325 with a relay operator).
If you received a letter from us asking you to submit documents to confirm your eligibility for
healthcare coverage, follow the steps described below. Even if you have enrolled and started
using your plan, you may lose your coverage or financial help if we don't receive these
documents from you by the deadline indicated in the letter.
The letter you receive will tell you what kind of information we need, such as:
•
Proof of Income
•
Proof of Identity
•
Proof of U.S. Citizenship or U.S. National Status
•
Proof of Lawful Presence/Immigration Status
•
Proof of Eligibility for Financial Help
•
Proof of Qualifying Life Event for Special Enrollment
Please see below for more information regarding what documents you can provide for each
category.
Income
To verify your income, send us any of the following documents:
Employer Wages (Earned Income)
Pay stub must include:
•
Your full name (first name, last name, middle name or middle initial, if available) or other
identifying information (i.e. your Social Security number (SSN)).
•
Date of the pay stub – To verify annual income, the pay stub you submit must be dated
within six (6) months of the application date.
•
Pay period – The pay stub pay period must be within six (6) months of the date Access
Health CT receives the application.
•
Duration of pay period – The total amount of time that pay stubs are meant to capture for
verification purposes is one month of pay or four (4) weeks of time. Pay stubs may show
different periods of work time, but all submitted pay stubs need to show a total duration
of a month. It is recommended that you submit consecutive pay stubs to satisfy the
verification requirement.
•
Company name – The pay stubs you submit should all be from the same company. You
may submit pay stubs from different companies, but they need to cover a distinct
monthly period, as opposed to being added together as a single income for the same
monthly period.
•
Income amount – The gross income amount from all submitted pay stubs is verified
against the annual income reported in the application.
U.S. Individual Income Tax Return
U.S. Individual Income Tax Return: Form 1040, 1040NR, 1040A, 1040ES, 1040NR-EZ,
1040EZ, with original 1040 from previous year, with any appropriate Schedules (i.e. Schedule
C, Schedule F, Schedule SE, Schedule E). It must include:
•
Your full name (first name, last name, middle name or middle initial if available).
•
Your SSN; if filed jointly, submit SSN of your spouse as well.
•
Annual income amount.
•
Tax year – tax returns must be from previous year.
Sample 1040 can be viewed here.
Sample Schedule C can be viewed here.
Sample Schedule E can be viewed here.
Wage and Tax Statement
Wage and Tax Statement (W-2 and/or 1099, including 1099 MISC, 1099G, 1099R, 1099SSA,
1099DIV, 1099B, 1099INT). It must include:
•
Your full name (first name, last name, middle name or middle initial, if available.
•
Gross annual income amount.
•
Tax year – must be from the previous calendar year.
•
Employer name (if applicable).
Sample W-2 can be viewed here.
Sample 1099-MISC can be viewed here.
Employer Statement
Employer Statement cannot be used for the self-employment income. It must:
•
Be on company letterhead or state the name of the company.
•
Be signed by the employer.
•
Be no older than six (6) months of the application date.
•
Include the following information:
–
Name of employer or company.
–
Name of person writing the letter.
–
Employer or company address.
–
Employer or company telephone number.
–
Date of the letter.
–
The start date and, if applicable, the end date of the employee’s employment or
period of pay (i.e. weekly, bi-weekly, monthly, or annually).
–
The total amount earned during the employee’s employment or applicable period
of pay.
Sample Employer Statement Letter can be viewed here.
Self-employment income
Self-empolyment income (includes farm income)
Self-employment profit and loss statement or ledger documentation (the most recent quarterly
or year-to-date profit and loss statement, or a self-employment ledger) must be no older than
twelve (12) months of the application date. It must contain:
•
Your first and last name and company name.
•
Dates covered and the net income from profit/loss.
Sample Income Statement/Profit and Loss Statement can be viewed here.
NOTE: This is a sample of profit and loss statement. Not all the fields in this template are
mandatory. You may consider completing the fields that are applicable to your business.
Sample Schedule C can be viewed here.
Other
Below are other documents that you can use to verify your annual income. Dates of documents
must be no older than one (1) year of the application date.
•
Annuity statements
•
Statements of pension distribution from any government or private source.
•
Prizes, settlements, and awards, including alimony received and court-ordered awards
letters.
•
Proof of taxable gifts and contributions.
•
Proof of taxable scholarships or grants.
•
Proof of inheritances in cash or property.
•
Proof of strike pay and other benefits from unions.
•
Sales receipts or other proof of money received from the sale, exchange or replacement
of things you own.
•
Interest and dividends income statement.
•
Royalty or residual income statement or Form 1099-MISC.
•
Letter, deposit, or other proof of deferred compensation payments.
•
Social Security Administration Statements (Social Security Benefits Letter).
•
Retirement, Survivors Disability Insurance (RSDI), Social Security Retirement, Social
Security Disability Insurance (SSDI).
–
It must contain your first and last name, benefit amount, and frequency of pay.
•
Unemployment Benefits Letter
–
It must contain your first and last name, source agency, weekly benefits amount,
and duration (start and end date), if applicable.
Click here to download a fillable Attestation of Non-Income Form
Identity
To verify your identity, send us any of the following documents:
Voter registration card
Voter registration card
Identification card issued by the federal, state, or local
government
Identification card issued by the federal, state, or local government that contains a photograph.
Sample Hartford ID card can be viewed here.
U.S. military card, draft record, or military dependent’s
identification card
U.S. military card, draft record or military dependent's identification card.
U.S. or foreign passport, U.S. passport card, or identification
card issued by a foreign embassy or consulate
U.S. or foreign passport, U.S. passport card (expired passport may be used), or identification
card issued by a foreign embassy or consulate that contains a photograph.
Certificate of Naturalization (Form N-550 or N-570) or
Certificate of U.S. Citizenship (Form N-560 or N-561)
Certificate of Naturalization (Form N-550 or N- 570) or Certificate of U.S. Citizenship (Form N-
560 or N-561)
Permanent Resident Card or Alien Registration Receipt Card
(Form I-551)
Permanent Resident Card or Alien Registration Receipt Card (Form I-551).
Sample Green Card can be viewed here.
Employment Authorization Document
Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for applying
for healthcare coverage through the Exchange.
Sample Employment Authorization Card (EAD) can be viewed here.
Native American Tribal Document
Native American tribal document with photograph.
For children under the age of 16
•
A clinic, doctor, or school record.
•
In the absence of othe aforementioned records, a written statement signed under
penalty of perjury by the parents or guardian stating date and place of birth. An Affidavit
of Identity Form (for each child on the application) - Click here to download an Affidavit of
Identity form for a child, which you can complete on your computer or mobile device.
Affidavits must be signed in the presence of a Notary Public or Commisioner of the
Superior Court.
Affidavit of Identity (Individual/Applicant)
Affidavit of Identity (Individual/Applicant)
Affidavits must be signed in the presence of a Notary Public or Commissioner of the Superior
Court.
Click here to download an Affidavit of Identity form for an individual, which you can complete on
your computer or mobile device.
U.S. Coast Guard Merchant Mariner card
U.S. Coast Guard Merchant Mariner card
Finding of identity from a federal agency or state government
agency
Finding of identity from a federal agency or state government agency
Finding of identity from a federal agency or state government agency including but not limited to
public assistance, law enforcement, internal revenue or tax bureau, or corrections agency, if the
agency has verified and certified your identity.
Driver's License issued by a Canadian government authority
Driver's License issued by a Canadian government authority
Sample Canadian Driver’s License can be viewed here.
Driver’s license issued by a state or territory
Driver’s license issued by a state or territory
Driver’s license issued by a state or territory showing either a photograph of you or other
identifying information such as your name, age, sex, race, height, weight or eye color.
Sample CT Driver License can be viewed here.
All documents that you submit for verification of identity must match your name and birth date
and, if applicable, the name and birth date of each member of your household included on the
application.
U.S. Citizenship or U.S. National Status
To verify your citizenship, send us any of the following documents:
One of these documents:
Plus one of these documents (that has
a photograph or other information such
as a name, race, height, weight eye color
or address)
U.S. Passport or U.S. Passport
Card
U.S. Passport or U.S. Passport Card
U.S. Passport or U.S. Passport Card, current or expired
(issued without limitation).
U.S. Birth Certificate
U.S. Birth Certificate
Sample U.S. Birth Certificate can be viewed here.
Certification of Report of Birth
Certification of Report of Birth
Certificate of U.S. Citizenship
Certificate of U.S. Citizenship
•
Form N-560
•
Form N-561
Certificate of Naturalization
Certificate of Naturalization
•
Forms N-550, N-570
American Indian or Alaska Native
Tribe Documents
American Indian or Alaska Native tribe documents
Documentary evidence issued by a federally recognized
American Indian or Alaska Native tribe. Documents must
identify the individual by name and confirm the individual’s
membership, enrollment, or affiliation with a tribe.
Acceptable documents include but are not limited to:
•
Tribal enrollment card
•
Certificate of Degree of Indian Blood
•
Tribal census document
•
Documents on Tribal letterhead, issued under
the signature of the appropriate Tribal official.
Consular Report or Certificate of
Child Born Abroad
Consular Report or Certificate of Child Born Abroad
•
Department of State Form FS-545
Driver's License
Driver's License
Driver's license issued by a state or
territory or ID card issued by the federal,
state, or local government
School identification
card
School identification card
U.S. military card
U.S. military card
U.S. military card or draft record or
military dependent's identification card
Driver's License
Driver's License
Driver's license issued by a state or
territory or ID card issued by the federal,
state, or local government
U.S. Coast Guard
Merchant Mariner card
U.S. Coast Guard Merchant Mariner card
Voter Registration Card
Voter Registration Card
Medical/Care Document
Medical/Care Document
A clinic, doctor, hospital, or school
record, including preschool or day care
records (for children under 19 years old)
Matching Documents
Matching Documents
2 documents containing consistent
information that proves your identity, like
employer IDs, high school and college
•
Department of State Form FS-240
•
Department of State Form DS-1350
U.S. Citizen Identification Card
U.S. Citizen Identification Card
U.S. Citizen Identification Card (I-197 or the prior version I-
179)
Federal or State census record
showing U.S. citizenship or U.S.
place of birth
Federal or State census record showing U.S. citizenship or
U.S. place of birth
Northern Marianas Identification
Card
Northern Marianas Identification Card.
Adoption Decree
Adoption Decree
•
A final adoption decree showing the child’s
name and U.S. place of birth; or
•
If the adoption is not finalized, a statement
from a state-approved adoption agency that
shows the child’s name, U.S. place of birth,
and birthdate or age (the adoption agency
must state in the certification that the source
of the place of birth information is an original
birth certificate).
Documentation that a child meets
the requirements of section 101 of
the Child Citizenship Act of 2000
Documentation that a child meets the requirements of
section 101 of the Child Citizenship Act of 2000 (8 U.S.C.
1431).
diplomas, marriage certificates, divorce
decrees, property deeds, or titles
U.S. military records showing a
U.S. place of birth
U.S. military records showing a U.S. place of birth.
Evidence of U.S. Civil Service
employment before June 1, 1976
Evidence of U.S. Civil Service employment before June 1,
1976.
All documents that you submit for verification of citizenship must match your name and birth
date and, if applicable, the name and birth date of each member of your household included on
the application.
Lawful Presence/Immigration Status
To verify your lawful presence or immigration status, send us any of the following documents:
Permanent Resident Card ("Green Card", I-551)
Permanent Resident Card ("Green Card", I-551)
Sample Green Card can be viewed here.
Temporary I-551 Stamp (on passport or I-94, I-94A)
Temporary I-551 Stamp (on passport or I-94, I-94A).
Immigrant Visa (with temporary I-551 language)
Immigrant Visa (with temporary I-551 language)
Sample Immigrant Visa with temporary I-551 stamp can be viewed here.
Employment Authorization Card (EAD or I-766)
Employment Authorization Card (EAD or I-766)
Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for applying
for healthcare coverage through the Exchange.
Sample Employment Authorization Card (EAD) can be viewed here.
Arrival/Departure Record (I-94 or I-94A)
Arrival/Departure Record (I-94 or I-94A).
Arrival/Departure Record in foreign passport (I-94)
Arrival/Departure Record in foreign passport (I-94).
Unexpired foreign passport
Unexpired foreign passport.
Country of issuance Reentry Permit (I-327)
Country of issuance Reentry Permit (I-327)
Refugee Travel Document (I-571)
Refugee travel document (I-571).
Certificate of Eligibility for Nonimmigrant (F-1) Student
Status (I-20)
Certificate of Eligibility for Nonimmigrant (F-1) Student Status (I-20).
Certificate of Eligibility for Exchange Visitor (J-1) Status
(DS2019)
Certificate of Eligibility for Exchange Visitor (J-1) Status (DS2019).
Notice of Action (I-797)
Notice of Action (I-797).
In general, all of these documents will follow the same rules for document acceptability used for
verification of the household’s lawful presence. This means a submitted document must have
the following to be accepted:
•
Your full name (first name, last name, and middle name or middle initial if available).
•
An expiration date that has not passed.
•
An alien number that is the same on the application as it is on the provided immigration
document.
Eligibility for Financial Help
To verify your proof of eligibility for financial help, send us any of the following documents:
Proof of Eligibility for Financial Help
Proof of Eligibility for Financial Help
Your eligibility for financial help from Access Health CT might be affected if:
•
your income has changed since you enrolled in your current healthcare coverage
•
you didn’t give consent for us to verify your income with the IRS
•
you didn’t file taxes last year
If any of the above happened, please provide the following documents so we can determine
whether or not you are still eligible for financial help:
1.
Your most recent completed, signed, and filed Federal Tax Return (IRS Form 1040
pages 1 and 2)
2.
IRS Form 8962 (from the same year as your Form 1040)
3.
One of the following to verify that you filed your taxes with the IRS:
a.
copy of certified mail or return receipt
b.
copy of e-mail confirmation of electronic filing
c.
copy of proof of mailing
Sample 1040 can be viewed here.
For information about IRS Form 8962 please visit IRS
website:
For information about IRS Form 8962 please visit IRS website:
https://www.irs.gov/forms-pubs-search?search=8962
Qualifying Life Event for Special Enrollment
To be eligible for a Special Enrollment Period, you must have a Qualifying Life Event. If you
received a letter from us asking you to verify your Qualifying Life Event, please select the
applicable event below for more information on how to confirm your Qualifying Life Event and
complete your Special Enrollment.
Loss of Minimum Essential Health Coverage
Loss of Minimum Essential Health Coverage
Provide a coverage termination letter from employer, HR department, or healthcare coverage
administrator of your terminated coverage. Termination letters must include:
•
Your first and last name
•
An insurance coverage end date that happened or will happen within 60 days of your
Access Health CT application date.
•
The last day of coverage in the termination letter must be the same as the coverage end
date you list on your application.
•
Name of employer or healthcare coverage administrator
•
Name and signature of authorized person issuing the letter
Please note: If your coverage termination letter says that you did not pay your premiums or that
you chose to terminate your coverage, you will not be eligible for Special Enrollment.
A recent move to Connecticut from another state or country
A recent move to Connecticut from another state or country
A piece of mail demonstrating your move to Connecticut:
•
Proof of your address change from another state
•
A recent utility bill from your previous address AND a utility bill from your new
Connecticut residence (2 documents)
•
If moving from another U.S. state, proof of minimum essential coverage for at least one
day during the 60 days before your move is required. This is not required if you are
moving from another country.
Becoming pregnant, giving birth, foster care, or adopting a
baby
Becoming pregnant, giving birth, foster care, or adopting a baby
•
A letter of Certification of Pregnancy
•
A copy of adoption confirmation documents
•
A copy of foster care confirmation documents
No longer eligible for Premium Tax Credits (APTC) or a Cost-
Sharing Reduction (CSR)
No longer eligible for Premium Tax Credits (APTC) or a Cost-Sharing Reduction (CSR)
No documents needed to verify this event.
Gain/change to Health Reimbursement Arrangement (HRA) &
Qualified Small Employer Health Reimbursement
Arrangement (QSEHRA)
Gain of Health Reimbursement Arrangement (HRA) or Qualified Small Employer Health
Reimbursement Arrangement (QSEHRA) or a change in employer contributions to a HRA or
QSEHRA
Provide the letter from your employer, HR department, or healthcare coverage administrator
that explains the gain of Health Reimbursement Arrangement (HRA) or Qualified Small
Employer Health Reimbursement Arrangement (QSEHRA) or a change in employer
contributions to a HRA or QSEHRA.
The letter must include:
•
Your first and last name
•
Name of employer
•
Name and signature of authorized person issuing the letter
•
Date of eligibility or change in contribution
Recently Married
A copy of your marriage license/certificate AND proof of minimum essential coverage for one
day during the 60 days before your marriage (either spouse)
Newly eligible for Premium Tax Credits due to decrease in
household income (Modified Adjusted Gross Income, or
MAGI)
Newly eligible for Premium Tax Credits due to decrease in household income (Modified
Adjusted Gross Income, or MAGI)
•
Letter of attestation of decrease in household income [PDF]
•
Proof of minimum essential coverage that was not obtained through Access Health CT
within 60 days of the decrease in household income.
Gain of Eligible Immigration Status or Citizenship
Gain of Eligible Immigration Status or Citizenship
You may need one or more of these documents, to confirm lawful presence/immigration status:
•
Permanent Resident Card (“Green Card”, I-551)
•
Temporary I-551 Stamp (on passport or I-94, I-94A)
•
Immigrant Visa (with temporary I-551 language)
•
Employment Authorization Card (EAD or I-766)
•
Arrival/Departure Record (I-94 or I-94A)
•
Arrival/Departure Record in foreign passport (I-94)
•
Unexpired foreign passport
•
Country of issuance Reentry Permit (I-327)
•
Refugee travel document (I-571)
•
Certificate of Eligibility for Nonimmigrant (F-1) Student Status (I-20)
•
Certificate of Eligibility for Exchange Visitor (J-1) Status (DS2019)
•
Notice of Action (I-797)
|
What is the main topic of this document?
|
Help With Your Verifications
Written by Yessenia Milan | Last published at: January 30, 2025
This article has a list of documents that can be used to verify your eligibility or other
information
|
Help With Your Verifications
Written by Yessenia Milan | Last published at: January 30, 2025
This article has a list of documents that can be used to verify your eligibility or other
information. You can also see general information about verifications and instructions
for uploading documents. If you still have questions, find help or call us at 1-855-805-4325
(TTY 1-855-789-2428 or contact us at 1-855-805-4325 with a relay operator).
If you received a letter from us asking you to submit documents to confirm your eligibility for
healthcare coverage, follow the steps described below. Even if you have enrolled and started
using your plan, you may lose your coverage or financial help if we don't receive these
documents from you by the deadline indicated in the letter.
The letter you receive will tell you what kind of information we need, such as:
•
Proof of Income
•
Proof of Identity
•
Proof of U.S. Citizenship or U.S. National Status
•
Proof of Lawful Presence/Immigration Status
•
Proof of Eligibility for Financial Help
•
Proof of Qualifying Life Event for Special Enrollment
Please see below for more information regarding what documents you can provide for each
category.
Income
To verify your income, send us any of the following documents:
Employer Wages (Earned Income)
Pay stub must include:
•
Your full name (first name, last name, middle name or middle initial, if available) or other
identifying information (i.e. your Social Security number (SSN)).
•
Date of the pay stub – To verify annual income, the pay stub you submit must be dated
within six (6) months of the application date.
•
Pay period – The pay stub pay period must be within six (6) months of the date Access
Health CT receives the application.
•
Duration of pay period – The total amount of time that pay stubs are meant to capture for
verification purposes is one month of pay or four (4) weeks of time. Pay stubs may show
different periods of work time, but all submitted pay stubs need to show a total duration
of a month. It is recommended that you submit consecutive pay stubs to satisfy the
verification requirement.
•
Company name – The pay stubs you submit should all be from the same company. You
may submit pay stubs from different companies, but they need to cover a distinct
monthly period, as opposed to being added together as a single income for the same
monthly period.
•
Income amount – The gross income amount from all submitted pay stubs is verified
against the annual income reported in the application.
U.S. Individual Income Tax Return
U.S. Individual Income Tax Return: Form 1040, 1040NR, 1040A, 1040ES, 1040NR-EZ,
1040EZ, with original 1040 from previous year, with any appropriate Schedules (i.e. Schedule
C, Schedule F, Schedule SE, Schedule E). It must include:
•
Your full name (first name, last name, middle name or middle initial if available).
•
Your SSN; if filed jointly, submit SSN of your spouse as well.
•
Annual income amount.
•
Tax year – tax returns must be from previous year.
Sample 1040 can be viewed here.
Sample Schedule C can be viewed here.
Sample Schedule E can be viewed here.
Wage and Tax Statement
Wage and Tax Statement (W-2 and/or 1099, including 1099 MISC, 1099G, 1099R, 1099SSA,
1099DIV, 1099B, 1099INT). It must include:
•
Your full name (first name, last name, middle name or middle initial, if available.
•
Gross annual income amount.
•
Tax year – must be from the previous calendar year.
•
Employer name (if applicable).
Sample W-2 can be viewed here.
Sample 1099-MISC can be viewed here.
Employer Statement
Employer Statement cannot be used for the self-employment income. It must:
•
Be on company letterhead or state the name of the company.
•
Be signed by the employer.
•
Be no older than six (6) months of the application date.
•
Include the following information:
–
Name of employer or company.
–
Name of person writing the letter.
–
Employer or company address.
–
Employer or company telephone number.
–
Date of the letter.
–
The start date and, if applicable, the end date of the employee’s employment or
period of pay (i.e. weekly, bi-weekly, monthly, or annually).
–
The total amount earned during the employee’s employment or applicable period
of pay.
Sample Employer Statement Letter can be viewed here.
Self-employment income
Self-empolyment income (includes farm income)
Self-employment profit and loss statement or ledger documentation (the most recent quarterly
or year-to-date profit and loss statement, or a self-employment ledger) must be no older than
twelve (12) months of the application date. It must contain:
•
Your first and last name and company name.
•
Dates covered and the net income from profit/loss.
Sample Income Statement/Profit and Loss Statement can be viewed here.
NOTE: This is a sample of profit and loss statement. Not all the fields in this template are
mandatory. You may consider completing the fields that are applicable to your business.
Sample Schedule C can be viewed here.
Other
Below are other documents that you can use to verify your annual income. Dates of documents
must be no older than one (1) year of the application date.
•
Annuity statements
•
Statements of pension distribution from any government or private source.
•
Prizes, settlements, and awards, including alimony received and court-ordered awards
letters.
•
Proof of taxable gifts and contributions.
•
Proof of taxable scholarships or grants.
•
Proof of inheritances in cash or property.
•
Proof of strike pay and other benefits from unions.
•
Sales receipts or other proof of money received from the sale, exchange or replacement
of things you own.
•
Interest and dividends income statement.
•
Royalty or residual income statement or Form 1099-MISC.
•
Letter, deposit, or other proof of deferred compensation payments.
•
Social Security Administration Statements (Social Security Benefits Letter).
•
Retirement, Survivors Disability Insurance (RSDI), Social Security Retirement, Social
Security Disability Insurance (SSDI).
–
It must contain your first and last name, benefit amount, and frequency of pay.
•
Unemployment Benefits Letter
–
It must contain your first and last name, source agency, weekly benefits amount,
and duration (start and end date), if applicable.
Click here to download a fillable Attestation of Non-Income Form
Identity
To verify your identity, send us any of the following documents:
Voter registration card
Voter registration card
Identification card issued by the federal, state, or local
government
Identification card issued by the federal, state, or local government that contains a photograph.
Sample Hartford ID card can be viewed here.
U.S. military card, draft record, or military dependent’s
identification card
U.S. military card, draft record or military dependent's identification card.
U.S. or foreign passport, U.S. passport card, or identification
card issued by a foreign embassy or consulate
U.S. or foreign passport, U.S. passport card (expired passport may be used), or identification
card issued by a foreign embassy or consulate that contains a photograph.
Certificate of Naturalization (Form N-550 or N-570) or
Certificate of U.S. Citizenship (Form N-560 or N-561)
Certificate of Naturalization (Form N-550 or N- 570) or Certificate of U.S. Citizenship (Form N-
560 or N-561)
Permanent Resident Card or Alien Registration Receipt Card
(Form I-551)
Permanent Resident Card or Alien Registration Receipt Card (Form I-551).
Sample Green Card can be viewed here.
Employment Authorization Document
Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for applying
for healthcare coverage through the Exchange.
Sample Employment Authorization Card (EAD) can be viewed here.
Native American Tribal Document
Native American tribal document with photograph.
For children under the age of 16
•
A clinic, doctor, or school record.
•
In the absence of othe aforementioned records, a written statement signed under
penalty of perjury by the parents or guardian stating date and place of birth. An Affidavit
of Identity Form (for each child on the application) - Click here to download an Affidavit of
Identity form for a child, which you can complete on your computer or mobile device.
Affidavits must be signed in the presence of a Notary Public or Commisioner of the
Superior Court.
Affidavit of Identity (Individual/Applicant)
Affidavit of Identity (Individual/Applicant)
Affidavits must be signed in the presence of a Notary Public or Commissioner of the Superior
Court.
Click here to download an Affidavit of Identity form for an individual, which you can complete on
your computer or mobile device.
U.S. Coast Guard Merchant Mariner card
U.S. Coast Guard Merchant Mariner card
Finding of identity from a federal agency or state government
agency
Finding of identity from a federal agency or state government agency
Finding of identity from a federal agency or state government agency including but not limited to
public assistance, law enforcement, internal revenue or tax bureau, or corrections agency, if the
agency has verified and certified your identity.
Driver's License issued by a Canadian government authority
Driver's License issued by a Canadian government authority
Sample Canadian Driver’s License can be viewed here.
Driver’s license issued by a state or territory
Driver’s license issued by a state or territory
Driver’s license issued by a state or territory showing either a photograph of you or other
identifying information such as your name, age, sex, race, height, weight or eye color.
Sample CT Driver License can be viewed here.
All documents that you submit for verification of identity must match your name and birth date
and, if applicable, the name and birth date of each member of your household included on the
application.
U.S. Citizenship or U.S. National Status
To verify your citizenship, send us any of the following documents:
One of these documents:
Plus one of these documents (that has
a photograph or other information such
as a name, race, height, weight eye color
or address)
U.S. Passport or U.S. Passport
Card
U.S. Passport or U.S. Passport Card
U.S. Passport or U.S. Passport Card, current or expired
(issued without limitation).
U.S. Birth Certificate
U.S. Birth Certificate
Sample U.S. Birth Certificate can be viewed here.
Certification of Report of Birth
Certification of Report of Birth
Certificate of U.S. Citizenship
Certificate of U.S. Citizenship
•
Form N-560
•
Form N-561
Certificate of Naturalization
Certificate of Naturalization
•
Forms N-550, N-570
American Indian or Alaska Native
Tribe Documents
American Indian or Alaska Native tribe documents
Documentary evidence issued by a federally recognized
American Indian or Alaska Native tribe. Documents must
identify the individual by name and confirm the individual’s
membership, enrollment, or affiliation with a tribe.
Acceptable documents include but are not limited to:
•
Tribal enrollment card
•
Certificate of Degree of Indian Blood
•
Tribal census document
•
Documents on Tribal letterhead, issued under
the signature of the appropriate Tribal official.
Consular Report or Certificate of
Child Born Abroad
Consular Report or Certificate of Child Born Abroad
•
Department of State Form FS-545
Driver's License
Driver's License
Driver's license issued by a state or
territory or ID card issued by the federal,
state, or local government
School identification
card
School identification card
U.S. military card
U.S. military card
U.S. military card or draft record or
military dependent's identification card
Driver's License
Driver's License
Driver's license issued by a state or
territory or ID card issued by the federal,
state, or local government
U.S. Coast Guard
Merchant Mariner card
U.S. Coast Guard Merchant Mariner card
Voter Registration Card
Voter Registration Card
Medical/Care Document
Medical/Care Document
A clinic, doctor, hospital, or school
record, including preschool or day care
records (for children under 19 years old)
Matching Documents
Matching Documents
2 documents containing consistent
information that proves your identity, like
employer IDs, high school and college
•
Department of State Form FS-240
•
Department of State Form DS-1350
U.S. Citizen Identification Card
U.S. Citizen Identification Card
U.S. Citizen Identification Card (I-197 or the prior version I-
179)
Federal or State census record
showing U.S. citizenship or U.S.
place of birth
Federal or State census record showing U.S. citizenship or
U.S. place of birth
Northern Marianas Identification
Card
Northern Marianas Identification Card.
Adoption Decree
Adoption Decree
•
A final adoption decree showing the child’s
name and U.S. place of birth; or
•
If the adoption is not finalized, a statement
from a state-approved adoption agency that
shows the child’s name, U.S. place of birth,
and birthdate or age (the adoption agency
must state in the certification that the source
of the place of birth information is an original
birth certificate).
Documentation that a child meets
the requirements of section 101 of
the Child Citizenship Act of 2000
Documentation that a child meets the requirements of
section 101 of the Child Citizenship Act of 2000 (8 U.S.C.
1431).
diplomas, marriage certificates, divorce
decrees, property deeds, or titles
U.S. military records showing a
U.S. place of birth
U.S. military records showing a U.S. place of birth.
Evidence of U.S. Civil Service
employment before June 1, 1976
Evidence of U.S. Civil Service employment before June 1,
1976.
All documents that you submit for verification of citizenship must match your name and birth
date and, if applicable, the name and birth date of each member of your household included on
the application.
Lawful Presence/Immigration Status
To verify your lawful presence or immigration status, send us any of the following documents:
Permanent Resident Card ("Green Card", I-551)
Permanent Resident Card ("Green Card", I-551)
Sample Green Card can be viewed here.
Temporary I-551 Stamp (on passport or I-94, I-94A)
Temporary I-551 Stamp (on passport or I-94, I-94A).
Immigrant Visa (with temporary I-551 language)
Immigrant Visa (with temporary I-551 language)
Sample Immigrant Visa with temporary I-551 stamp can be viewed here.
Employment Authorization Card (EAD or I-766)
Employment Authorization Card (EAD or I-766)
Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for applying
for healthcare coverage through the Exchange.
Sample Employment Authorization Card (EAD) can be viewed here.
Arrival/Departure Record (I-94 or I-94A)
Arrival/Departure Record (I-94 or I-94A).
Arrival/Departure Record in foreign passport (I-94)
Arrival/Departure Record in foreign passport (I-94).
Unexpired foreign passport
Unexpired foreign passport.
Country of issuance Reentry Permit (I-327)
Country of issuance Reentry Permit (I-327)
Refugee Travel Document (I-571)
Refugee travel document (I-571).
Certificate of Eligibility for Nonimmigrant (F-1) Student
Status (I-20)
Certificate of Eligibility for Nonimmigrant (F-1) Student Status (I-20).
Certificate of Eligibility for Exchange Visitor (J-1) Status
(DS2019)
Certificate of Eligibility for Exchange Visitor (J-1) Status (DS2019).
Notice of Action (I-797)
Notice of Action (I-797).
In general, all of these documents will follow the same rules for document acceptability used for
verification of the household’s lawful presence. This means a submitted document must have
the following to be accepted:
•
Your full name (first name, last name, and middle name or middle initial if available).
•
An expiration date that has not passed.
•
An alien number that is the same on the application as it is on the provided immigration
document.
Eligibility for Financial Help
To verify your proof of eligibility for financial help, send us any of the following documents:
Proof of Eligibility for Financial Help
Proof of Eligibility for Financial Help
Your eligibility for financial help from Access Health CT might be affected if:
•
your income has changed since you enrolled in your current healthcare coverage
•
you didn’t give consent for us to verify your income with the IRS
•
you didn’t file taxes last year
If any of the above happened, please provide the following documents so we can determine
whether or not you are still eligible for financial help:
1.
Your most recent completed, signed, and filed Federal Tax Return (IRS Form 1040
pages 1 and 2)
2.
IRS Form 8962 (from the same year as your Form 1040)
3.
One of the following to verify that you filed your taxes with the IRS:
a.
copy of certified mail or return receipt
b.
copy of e-mail confirmation of electronic filing
c.
copy of proof of mailing
Sample 1040 can be viewed here.
For information about IRS Form 8962 please visit IRS
website:
For information about IRS Form 8962 please visit IRS website:
https://www.irs.gov/forms-pubs-search?search=8962
Qualifying Life Event for Special Enrollment
To be eligible for a Special Enrollment Period, you must have a Qualifying Life Event. If you
received a letter from us asking you to verify your Qualifying Life Event, please select the
applicable event below for more information on how to confirm your Qualifying Life Event and
complete your Special Enrollment.
Loss of Minimum Essential Health Coverage
Loss of Minimum Essential Health Coverage
Provide a coverage termination letter from employer, HR department, or healthcare coverage
administrator of your terminated coverage. Termination letters must include:
•
Your first and last name
•
An insurance coverage end date that happened or will happen within 60 days of your
Access Health CT application date.
•
The last day of coverage in the termination letter must be the same as the coverage end
date you list on your application.
•
Name of employer or healthcare coverage administrator
•
Name and signature of authorized person issuing the letter
Please note: If your coverage termination letter says that you did not pay your premiums or that
you chose to terminate your coverage, you will not be eligible for Special Enrollment.
A recent move to Connecticut from another state or country
A recent move to Connecticut from another state or country
A piece of mail demonstrating your move to Connecticut:
•
Proof of your address change from another state
•
A recent utility bill from your previous address AND a utility bill from your new
Connecticut residence (2 documents)
•
If moving from another U.S. state, proof of minimum essential coverage for at least one
day during the 60 days before your move is required. This is not required if you are
moving from another country.
Becoming pregnant, giving birth, foster care, or adopting a
baby
Becoming pregnant, giving birth, foster care, or adopting a baby
•
A letter of Certification of Pregnancy
•
A copy of adoption confirmation documents
•
A copy of foster care confirmation documents
No longer eligible for Premium Tax Credits (APTC) or a Cost-
Sharing Reduction (CSR)
No longer eligible for Premium Tax Credits (APTC) or a Cost-Sharing Reduction (CSR)
No documents needed to verify this event.
Gain/change to Health Reimbursement Arrangement (HRA) &
Qualified Small Employer Health Reimbursement
Arrangement (QSEHRA)
Gain of Health Reimbursement Arrangement (HRA) or Qualified Small Employer Health
Reimbursement Arrangement (QSEHRA) or a change in employer contributions to a HRA or
QSEHRA
Provide the letter from your employer, HR department, or healthcare coverage administrator
that explains the gain of Health Reimbursement Arrangement (HRA) or Qualified Small
Employer Health Reimbursement Arrangement (QSEHRA) or a change in employer
contributions to a HRA or QSEHRA.
The letter must include:
•
Your first and last name
•
Name of employer
•
Name and signature of authorized person issuing the letter
•
Date of eligibility or change in contribution
Recently Married
A copy of your marriage license/certificate AND proof of minimum essential coverage for one
day during the 60 days before your marriage (either spouse)
Newly eligible for Premium Tax Credits due to decrease in
household income (Modified Adjusted Gross Income, or
MAGI)
Newly eligible for Premium Tax Credits due to decrease in household income (Modified
Adjusted Gross Income, or MAGI)
•
Letter of attestation of decrease in household income [PDF]
•
Proof of minimum essential coverage that was not obtained through Access Health CT
within 60 days of the decrease in household income.
Gain of Eligible Immigration Status or Citizenship
Gain of Eligible Immigration Status or Citizenship
You may need one or more of these documents, to confirm lawful presence/immigration status:
•
Permanent Resident Card (“Green Card”, I-551)
•
Temporary I-551 Stamp (on passport or I-94, I-94A)
•
Immigrant Visa (with temporary I-551 language)
•
Employment Authorization Card (EAD or I-766)
•
Arrival/Departure Record (I-94 or I-94A)
•
Arrival/Departure Record in foreign passport (I-94)
•
Unexpired foreign passport
•
Country of issuance Reentry Permit (I-327)
•
Refugee travel document (I-571)
•
Certificate of Eligibility for Nonimmigrant (F-1) Student Status (I-20)
•
Certificate of Eligibility for Exchange Visitor (J-1) Status (DS2019)
•
Notice of Action (I-797)
|
Who is mentioned in the document?
|
Help With Your Verifications
Written by Yessenia Milan | Last published at: January 30, 2025
This article has a list of documents that can be used to verify your eligibility or other
information
|
Help With Your Verifications
Written by Yessenia Milan | Last published at: January 30, 2025
This article has a list of documents that can be used to verify your eligibility or other
information. You can also see general information about verifications and instructions
for uploading documents. If you still have questions, find help or call us at 1-855-805-4325
(TTY 1-855-789-2428 or contact us at 1-855-805-4325 with a relay operator).
If you received a letter from us asking you to submit documents to confirm your eligibility for
healthcare coverage, follow the steps described below. Even if you have enrolled and started
using your plan, you may lose your coverage or financial help if we don't receive these
documents from you by the deadline indicated in the letter.
The letter you receive will tell you what kind of information we need, such as:
•
Proof of Income
•
Proof of Identity
•
Proof of U.S. Citizenship or U.S. National Status
•
Proof of Lawful Presence/Immigration Status
•
Proof of Eligibility for Financial Help
•
Proof of Qualifying Life Event for Special Enrollment
Please see below for more information regarding what documents you can provide for each
category.
Income
To verify your income, send us any of the following documents:
Employer Wages (Earned Income)
Pay stub must include:
•
Your full name (first name, last name, middle name or middle initial, if available) or other
identifying information (i.e. your Social Security number (SSN)).
•
Date of the pay stub – To verify annual income, the pay stub you submit must be dated
within six (6) months of the application date.
•
Pay period – The pay stub pay period must be within six (6) months of the date Access
Health CT receives the application.
•
Duration of pay period – The total amount of time that pay stubs are meant to capture for
verification purposes is one month of pay or four (4) weeks of time. Pay stubs may show
different periods of work time, but all submitted pay stubs need to show a total duration
of a month. It is recommended that you submit consecutive pay stubs to satisfy the
verification requirement.
•
Company name – The pay stubs you submit should all be from the same company. You
may submit pay stubs from different companies, but they need to cover a distinct
monthly period, as opposed to being added together as a single income for the same
monthly period.
•
Income amount – The gross income amount from all submitted pay stubs is verified
against the annual income reported in the application.
U.S. Individual Income Tax Return
U.S. Individual Income Tax Return: Form 1040, 1040NR, 1040A, 1040ES, 1040NR-EZ,
1040EZ, with original 1040 from previous year, with any appropriate Schedules (i.e. Schedule
C, Schedule F, Schedule SE, Schedule E). It must include:
•
Your full name (first name, last name, middle name or middle initial if available).
•
Your SSN; if filed jointly, submit SSN of your spouse as well.
•
Annual income amount.
•
Tax year – tax returns must be from previous year.
Sample 1040 can be viewed here.
Sample Schedule C can be viewed here.
Sample Schedule E can be viewed here.
Wage and Tax Statement
Wage and Tax Statement (W-2 and/or 1099, including 1099 MISC, 1099G, 1099R, 1099SSA,
1099DIV, 1099B, 1099INT). It must include:
•
Your full name (first name, last name, middle name or middle initial, if available.
•
Gross annual income amount.
•
Tax year – must be from the previous calendar year.
•
Employer name (if applicable).
Sample W-2 can be viewed here.
Sample 1099-MISC can be viewed here.
Employer Statement
Employer Statement cannot be used for the self-employment income. It must:
•
Be on company letterhead or state the name of the company.
•
Be signed by the employer.
•
Be no older than six (6) months of the application date.
•
Include the following information:
–
Name of employer or company.
–
Name of person writing the letter.
–
Employer or company address.
–
Employer or company telephone number.
–
Date of the letter.
–
The start date and, if applicable, the end date of the employee’s employment or
period of pay (i.e. weekly, bi-weekly, monthly, or annually).
–
The total amount earned during the employee’s employment or applicable period
of pay.
Sample Employer Statement Letter can be viewed here.
Self-employment income
Self-empolyment income (includes farm income)
Self-employment profit and loss statement or ledger documentation (the most recent quarterly
or year-to-date profit and loss statement, or a self-employment ledger) must be no older than
twelve (12) months of the application date. It must contain:
•
Your first and last name and company name.
•
Dates covered and the net income from profit/loss.
Sample Income Statement/Profit and Loss Statement can be viewed here.
NOTE: This is a sample of profit and loss statement. Not all the fields in this template are
mandatory. You may consider completing the fields that are applicable to your business.
Sample Schedule C can be viewed here.
Other
Below are other documents that you can use to verify your annual income. Dates of documents
must be no older than one (1) year of the application date.
•
Annuity statements
•
Statements of pension distribution from any government or private source.
•
Prizes, settlements, and awards, including alimony received and court-ordered awards
letters.
•
Proof of taxable gifts and contributions.
•
Proof of taxable scholarships or grants.
•
Proof of inheritances in cash or property.
•
Proof of strike pay and other benefits from unions.
•
Sales receipts or other proof of money received from the sale, exchange or replacement
of things you own.
•
Interest and dividends income statement.
•
Royalty or residual income statement or Form 1099-MISC.
•
Letter, deposit, or other proof of deferred compensation payments.
•
Social Security Administration Statements (Social Security Benefits Letter).
•
Retirement, Survivors Disability Insurance (RSDI), Social Security Retirement, Social
Security Disability Insurance (SSDI).
–
It must contain your first and last name, benefit amount, and frequency of pay.
•
Unemployment Benefits Letter
–
It must contain your first and last name, source agency, weekly benefits amount,
and duration (start and end date), if applicable.
Click here to download a fillable Attestation of Non-Income Form
Identity
To verify your identity, send us any of the following documents:
Voter registration card
Voter registration card
Identification card issued by the federal, state, or local
government
Identification card issued by the federal, state, or local government that contains a photograph.
Sample Hartford ID card can be viewed here.
U.S. military card, draft record, or military dependent’s
identification card
U.S. military card, draft record or military dependent's identification card.
U.S. or foreign passport, U.S. passport card, or identification
card issued by a foreign embassy or consulate
U.S. or foreign passport, U.S. passport card (expired passport may be used), or identification
card issued by a foreign embassy or consulate that contains a photograph.
Certificate of Naturalization (Form N-550 or N-570) or
Certificate of U.S. Citizenship (Form N-560 or N-561)
Certificate of Naturalization (Form N-550 or N- 570) or Certificate of U.S. Citizenship (Form N-
560 or N-561)
Permanent Resident Card or Alien Registration Receipt Card
(Form I-551)
Permanent Resident Card or Alien Registration Receipt Card (Form I-551).
Sample Green Card can be viewed here.
Employment Authorization Document
Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for applying
for healthcare coverage through the Exchange.
Sample Employment Authorization Card (EAD) can be viewed here.
Native American Tribal Document
Native American tribal document with photograph.
For children under the age of 16
•
A clinic, doctor, or school record.
•
In the absence of othe aforementioned records, a written statement signed under
penalty of perjury by the parents or guardian stating date and place of birth. An Affidavit
of Identity Form (for each child on the application) - Click here to download an Affidavit of
Identity form for a child, which you can complete on your computer or mobile device.
Affidavits must be signed in the presence of a Notary Public or Commisioner of the
Superior Court.
Affidavit of Identity (Individual/Applicant)
Affidavit of Identity (Individual/Applicant)
Affidavits must be signed in the presence of a Notary Public or Commissioner of the Superior
Court.
Click here to download an Affidavit of Identity form for an individual, which you can complete on
your computer or mobile device.
U.S. Coast Guard Merchant Mariner card
U.S. Coast Guard Merchant Mariner card
Finding of identity from a federal agency or state government
agency
Finding of identity from a federal agency or state government agency
Finding of identity from a federal agency or state government agency including but not limited to
public assistance, law enforcement, internal revenue or tax bureau, or corrections agency, if the
agency has verified and certified your identity.
Driver's License issued by a Canadian government authority
Driver's License issued by a Canadian government authority
Sample Canadian Driver’s License can be viewed here.
Driver’s license issued by a state or territory
Driver’s license issued by a state or territory
Driver’s license issued by a state or territory showing either a photograph of you or other
identifying information such as your name, age, sex, race, height, weight or eye color.
Sample CT Driver License can be viewed here.
All documents that you submit for verification of identity must match your name and birth date
and, if applicable, the name and birth date of each member of your household included on the
application.
U.S. Citizenship or U.S. National Status
To verify your citizenship, send us any of the following documents:
One of these documents:
Plus one of these documents (that has
a photograph or other information such
as a name, race, height, weight eye color
or address)
U.S. Passport or U.S. Passport
Card
U.S. Passport or U.S. Passport Card
U.S. Passport or U.S. Passport Card, current or expired
(issued without limitation).
U.S. Birth Certificate
U.S. Birth Certificate
Sample U.S. Birth Certificate can be viewed here.
Certification of Report of Birth
Certification of Report of Birth
Certificate of U.S. Citizenship
Certificate of U.S. Citizenship
•
Form N-560
•
Form N-561
Certificate of Naturalization
Certificate of Naturalization
•
Forms N-550, N-570
American Indian or Alaska Native
Tribe Documents
American Indian or Alaska Native tribe documents
Documentary evidence issued by a federally recognized
American Indian or Alaska Native tribe. Documents must
identify the individual by name and confirm the individual’s
membership, enrollment, or affiliation with a tribe.
Acceptable documents include but are not limited to:
•
Tribal enrollment card
•
Certificate of Degree of Indian Blood
•
Tribal census document
•
Documents on Tribal letterhead, issued under
the signature of the appropriate Tribal official.
Consular Report or Certificate of
Child Born Abroad
Consular Report or Certificate of Child Born Abroad
•
Department of State Form FS-545
Driver's License
Driver's License
Driver's license issued by a state or
territory or ID card issued by the federal,
state, or local government
School identification
card
School identification card
U.S. military card
U.S. military card
U.S. military card or draft record or
military dependent's identification card
Driver's License
Driver's License
Driver's license issued by a state or
territory or ID card issued by the federal,
state, or local government
U.S. Coast Guard
Merchant Mariner card
U.S. Coast Guard Merchant Mariner card
Voter Registration Card
Voter Registration Card
Medical/Care Document
Medical/Care Document
A clinic, doctor, hospital, or school
record, including preschool or day care
records (for children under 19 years old)
Matching Documents
Matching Documents
2 documents containing consistent
information that proves your identity, like
employer IDs, high school and college
•
Department of State Form FS-240
•
Department of State Form DS-1350
U.S. Citizen Identification Card
U.S. Citizen Identification Card
U.S. Citizen Identification Card (I-197 or the prior version I-
179)
Federal or State census record
showing U.S. citizenship or U.S.
place of birth
Federal or State census record showing U.S. citizenship or
U.S. place of birth
Northern Marianas Identification
Card
Northern Marianas Identification Card.
Adoption Decree
Adoption Decree
•
A final adoption decree showing the child’s
name and U.S. place of birth; or
•
If the adoption is not finalized, a statement
from a state-approved adoption agency that
shows the child’s name, U.S. place of birth,
and birthdate or age (the adoption agency
must state in the certification that the source
of the place of birth information is an original
birth certificate).
Documentation that a child meets
the requirements of section 101 of
the Child Citizenship Act of 2000
Documentation that a child meets the requirements of
section 101 of the Child Citizenship Act of 2000 (8 U.S.C.
1431).
diplomas, marriage certificates, divorce
decrees, property deeds, or titles
U.S. military records showing a
U.S. place of birth
U.S. military records showing a U.S. place of birth.
Evidence of U.S. Civil Service
employment before June 1, 1976
Evidence of U.S. Civil Service employment before June 1,
1976.
All documents that you submit for verification of citizenship must match your name and birth
date and, if applicable, the name and birth date of each member of your household included on
the application.
Lawful Presence/Immigration Status
To verify your lawful presence or immigration status, send us any of the following documents:
Permanent Resident Card ("Green Card", I-551)
Permanent Resident Card ("Green Card", I-551)
Sample Green Card can be viewed here.
Temporary I-551 Stamp (on passport or I-94, I-94A)
Temporary I-551 Stamp (on passport or I-94, I-94A).
Immigrant Visa (with temporary I-551 language)
Immigrant Visa (with temporary I-551 language)
Sample Immigrant Visa with temporary I-551 stamp can be viewed here.
Employment Authorization Card (EAD or I-766)
Employment Authorization Card (EAD or I-766)
Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for applying
for healthcare coverage through the Exchange.
Sample Employment Authorization Card (EAD) can be viewed here.
Arrival/Departure Record (I-94 or I-94A)
Arrival/Departure Record (I-94 or I-94A).
Arrival/Departure Record in foreign passport (I-94)
Arrival/Departure Record in foreign passport (I-94).
Unexpired foreign passport
Unexpired foreign passport.
Country of issuance Reentry Permit (I-327)
Country of issuance Reentry Permit (I-327)
Refugee Travel Document (I-571)
Refugee travel document (I-571).
Certificate of Eligibility for Nonimmigrant (F-1) Student
Status (I-20)
Certificate of Eligibility for Nonimmigrant (F-1) Student Status (I-20).
Certificate of Eligibility for Exchange Visitor (J-1) Status
(DS2019)
Certificate of Eligibility for Exchange Visitor (J-1) Status (DS2019).
Notice of Action (I-797)
Notice of Action (I-797).
In general, all of these documents will follow the same rules for document acceptability used for
verification of the household’s lawful presence. This means a submitted document must have
the following to be accepted:
•
Your full name (first name, last name, and middle name or middle initial if available).
•
An expiration date that has not passed.
•
An alien number that is the same on the application as it is on the provided immigration
document.
Eligibility for Financial Help
To verify your proof of eligibility for financial help, send us any of the following documents:
Proof of Eligibility for Financial Help
Proof of Eligibility for Financial Help
Your eligibility for financial help from Access Health CT might be affected if:
•
your income has changed since you enrolled in your current healthcare coverage
•
you didn’t give consent for us to verify your income with the IRS
•
you didn’t file taxes last year
If any of the above happened, please provide the following documents so we can determine
whether or not you are still eligible for financial help:
1.
Your most recent completed, signed, and filed Federal Tax Return (IRS Form 1040
pages 1 and 2)
2.
IRS Form 8962 (from the same year as your Form 1040)
3.
One of the following to verify that you filed your taxes with the IRS:
a.
copy of certified mail or return receipt
b.
copy of e-mail confirmation of electronic filing
c.
copy of proof of mailing
Sample 1040 can be viewed here.
For information about IRS Form 8962 please visit IRS
website:
For information about IRS Form 8962 please visit IRS website:
https://www.irs.gov/forms-pubs-search?search=8962
Qualifying Life Event for Special Enrollment
To be eligible for a Special Enrollment Period, you must have a Qualifying Life Event. If you
received a letter from us asking you to verify your Qualifying Life Event, please select the
applicable event below for more information on how to confirm your Qualifying Life Event and
complete your Special Enrollment.
Loss of Minimum Essential Health Coverage
Loss of Minimum Essential Health Coverage
Provide a coverage termination letter from employer, HR department, or healthcare coverage
administrator of your terminated coverage. Termination letters must include:
•
Your first and last name
•
An insurance coverage end date that happened or will happen within 60 days of your
Access Health CT application date.
•
The last day of coverage in the termination letter must be the same as the coverage end
date you list on your application.
•
Name of employer or healthcare coverage administrator
•
Name and signature of authorized person issuing the letter
Please note: If your coverage termination letter says that you did not pay your premiums or that
you chose to terminate your coverage, you will not be eligible for Special Enrollment.
A recent move to Connecticut from another state or country
A recent move to Connecticut from another state or country
A piece of mail demonstrating your move to Connecticut:
•
Proof of your address change from another state
•
A recent utility bill from your previous address AND a utility bill from your new
Connecticut residence (2 documents)
•
If moving from another U.S. state, proof of minimum essential coverage for at least one
day during the 60 days before your move is required. This is not required if you are
moving from another country.
Becoming pregnant, giving birth, foster care, or adopting a
baby
Becoming pregnant, giving birth, foster care, or adopting a baby
•
A letter of Certification of Pregnancy
•
A copy of adoption confirmation documents
•
A copy of foster care confirmation documents
No longer eligible for Premium Tax Credits (APTC) or a Cost-
Sharing Reduction (CSR)
No longer eligible for Premium Tax Credits (APTC) or a Cost-Sharing Reduction (CSR)
No documents needed to verify this event.
Gain/change to Health Reimbursement Arrangement (HRA) &
Qualified Small Employer Health Reimbursement
Arrangement (QSEHRA)
Gain of Health Reimbursement Arrangement (HRA) or Qualified Small Employer Health
Reimbursement Arrangement (QSEHRA) or a change in employer contributions to a HRA or
QSEHRA
Provide the letter from your employer, HR department, or healthcare coverage administrator
that explains the gain of Health Reimbursement Arrangement (HRA) or Qualified Small
Employer Health Reimbursement Arrangement (QSEHRA) or a change in employer
contributions to a HRA or QSEHRA.
The letter must include:
•
Your first and last name
•
Name of employer
•
Name and signature of authorized person issuing the letter
•
Date of eligibility or change in contribution
Recently Married
A copy of your marriage license/certificate AND proof of minimum essential coverage for one
day during the 60 days before your marriage (either spouse)
Newly eligible for Premium Tax Credits due to decrease in
household income (Modified Adjusted Gross Income, or
MAGI)
Newly eligible for Premium Tax Credits due to decrease in household income (Modified
Adjusted Gross Income, or MAGI)
•
Letter of attestation of decrease in household income [PDF]
•
Proof of minimum essential coverage that was not obtained through Access Health CT
within 60 days of the decrease in household income.
Gain of Eligible Immigration Status or Citizenship
Gain of Eligible Immigration Status or Citizenship
You may need one or more of these documents, to confirm lawful presence/immigration status:
•
Permanent Resident Card (“Green Card”, I-551)
•
Temporary I-551 Stamp (on passport or I-94, I-94A)
•
Immigrant Visa (with temporary I-551 language)
•
Employment Authorization Card (EAD or I-766)
•
Arrival/Departure Record (I-94 or I-94A)
•
Arrival/Departure Record in foreign passport (I-94)
•
Unexpired foreign passport
•
Country of issuance Reentry Permit (I-327)
•
Refugee travel document (I-571)
•
Certificate of Eligibility for Nonimmigrant (F-1) Student Status (I-20)
•
Certificate of Eligibility for Exchange Visitor (J-1) Status (DS2019)
•
Notice of Action (I-797)
|
What are the key takeaways from this text?
|
Help With Your Verifications
Written by Yessenia Milan | Last published at: January 30, 2025
This article has a list of documents that can be used to verify your eligibility or other
information
|
How can I get the most from my healthcare
coverage?
Written by Yessenia Milan | Last published at: February 19, 2025
•
Schedule your annual in-network checkup
•
Use in-network benefits wherever possible.
•
Find the right primary care doctor for your needs. You can search for a doctor on your
insurance company’s website.
•
Fill prescriptions at in-network pharmacies, and take advantage of generic drugs and
mail order programs, if offered by your insurance company. They are usually the
cheapest options for the prescriptions you may need.
•
Always remember to pay your premiums on time so that you can avoid coverage delays
or lapses in coverage.
•
Call your carrier directly with questions and learn more about their resources.
For more information, click here.
|
What is the main topic of this document?
|
How can I get the most from my healthcare
coverage?
Written by Yessenia Milan | Last published at: February 19, 2025
•
Schedule your annual in-network checkup
•
Use in-network benefits wherever
|
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