Middlesex Health Insurance

Facts and Figures

  • Insurance
    Carriers
    12
  • Number of
    General Doctors
    ???
  • Number of
    Hospitals
    1

Insurance Carriers

State Government Insurance Programs Offered

Health Reinsurance Association(HRA)


HRA: Guaranteed to all Connecticut residents under the age of 65. If HIPAA-eligible then no pre-existing exclusion period. Eligible if previous coverage was terminated for reasons other than non- payment of premium or fraud. HRA: Choose from 2 individual plans: PPO or a Special Health Care Plan (waiting period of 12 months). Choose from 2 conversion plans: PPO and a Special Health Care Plan (no waiting period, if you qualify). All benefits are the same except the Special Plan, which does not cover outpatient prescriptions.

Pre-existing Condition Insurance Plan (PCIP)


Must have been uninsured for at least 6 months prior to applying. Must prove being a U.S. citizen or legal U.S. resident, a Connecticut resident, and having problems getting insurance due to a pre-existing condition. Must have a qualifying pre-existing condition

Medicaid


Must be U.S. citizens and Connecticut residents ages 19–64, not receiving Medicare or Supplemental Security Income (SSI), not be pregnant, live at or below 56% FPL. For those living in Region A (mostly southwestern Connecticut), income limit is 68% FPL. There are no asset requirements

Connecticut Breast and Cervical Cancer early Detection Program(CBCCeDP)


CBCCEDP covers: Office visits, Mammograms, Breast biopsies and ultrasounds, Fine needle aspirations, Pap tests, LEEP, Surgical consultations, Clinical breast exams, and colposcopies and colposcopy-directed biopsies.

Charter Oak Health Plan


Covers Primary care, Specialist office visits, Preventive care, Ambulance, Emergency room visit, Prescription medication, Durable medical equipment, Lab and x-ray, Behavioral health services, Inpatient and outpatient services, Pre- and post-natal care. Lifetime maximum benefit of $1 million, annual maximum benefit of $100,000.

Medicare


Medicare offers Part A, inpatient care in hospitals and rehabilitative centers; Part B, doctor and some preventive services and outpatient care; Part C allows Medicare benefits through private insurance (Medicare Advantage); Part C includes Parts A, B, and C not covered by Medicare. Part D covers prescription drugs.

Heath Care Reform

Through tax credits, small business owners can provide their employees with health insurance coverage without needing to spend so much on their premiums.

Medicare members who fell to the Medicare gap can expect to receive a rebate check of  $250.

Through tax credits, small business owners can provide their employees with health insurance coverage without needing to spend so much on their premiums.

Medicare members who fell to the Medicare gap can expect to receive a rebate check of  $250.

Early retirees who are waiting to be eligible for Medicare can be assured of continued coverage because of a $5 billion support for health plans providing early retirement coverage.

The health care reform gives a $1.5 billion fund for scholarships for health care providers working in areas where there is a scarcity of medical professionals.

Uninsured residents with pre-existing condition can now have coverage through a transitional high-risk pool. This is in preparation for 2014 when the health care reform’s provision that will prohibit insurers from denying coverage to applicants with a pre-existing condition.

Children until the age of 26 can stay on their parent’s policy as dependents regardless if they are still students, working (for as long as their employer doesn’t offer health insurance benefits) or still living with their parents.

No more lifetime limits on health plans. Annual limits will also be strictly regulated.

Patients will have easier access to physicians and emergency care. Women no longer need to get an approval from their primary care physician to see their gynecologist.

"Vista Health Solutions" www.nyhealthinsurer.com Tel (888)215-4045 Email info@nyhealthinsurer.com