Medicare

Medicare, a federally-funded health insurance program, is the nation’s largest health insurance program, covering nearly 40 million people.

Medicare is not part of insurance plans offered on AccessHealthCT.com, Connecticut’s health insurance marketplace. If you are covered under Medicare, whether through Original Medicare or a Medicare Advantage Plan, you will still have the same benefits.

The Affordable Care Act does impact Medicare by (1) expanding existing coverage for seniors, including preventive care and wellness visits without charging for the Part B co-insurance or deductible, and (2) helping seniors in the Medicare Part D “donut hole” by providing a discount when buying Part D-covered brand-name prescription drugs and a discount on generic drugs covered by Part D.  By 2020, the donut hole will be eliminated completely.

Preventive & screening services

Medicare Part B (Medical Insurance) covers:

• Abdominal aortic aneurysm screening
• Alcohol misuse screenings & counseling
• Bone mass measurements (bone density)
• Cardiovascular disease screenings
• Cardiovascular disease (behavioral therapy)
• Cervical & vaginal cancer screening
• Colorectal cancer screenings
• Depression screenings
• Diabetes screenings
• Diabetes self-management training
• Glaucoma tests
• HIV screening
• Mammograms (screening)
• Nutrition therapy services
• Obesity screenings & counseling
• One-time “Welcome to Medicare” preventive visit
• Prostate cancer screenings
• Sexually transmitted infections screening & counseling
• Shots:
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
• Tobacco use cessation counseling
• Yearly “Wellness” visit

Medicare Advantage

Medicare Advantage, or Medicare Part C, is a health plan that offers Medicare Part A, B and typically D benefits through a private insurance company.  The Affordable Care Act makes a number of changes to Medicare Advantage, but most of these changes will not impact individuals with Medicare Advantage plans.  One major change is a requirement that Medicare Advantage plans cannot charge enrollees more than traditional Medicare for chemotherapy administration, skilled nursing home care and other specialized services.