What Does Access Health Insurance CT Cover?

July 8, 2014
what does affordable care act cover

Connecticut’s official health insurance marketplace, Access Health CT, offers state residents and small business owners a range of health care coverage options from public health care programs and health insurance carriers. It's also the only place where qualified families, individuals, and employers can get financial assistance with their health care costs.
Essential Health Benefits
Established to fulfill the requirements of the Affordable Care Act, Access Health CT provides coverage for a wide array of treatments, tests, and services, including the following essential health benefits:

  • Ambulatory services and outpatient care
  • Hospitalization (surgery, etc.)
  • Emergency services
  • Maternity care
  • Newborn care
  • Pediatric care
  • Prescription medications
  • Laboratory work
  • Wellness and preventive services
  • Chronic disease management
  • Habilitative and rehabilitative devices and services related to disabilities, injuries or chronic conditions
  • Substance use disorders and mental health services including psychotherapy, counseling, and other behavioral health treatments

Additional Coverage
In addition to the above minimum services, some plans offer additional benefits or reduced cost sharing for certain services. Access Health CT allows applicants to choose a Gold, Silver, or Bronze plan based on their individual needs and capabilities. Each of these plans provides different levels of benefits under differing terms. Plans may vary based on the specific carrier; however, in accordance with the Affordable Care Act's requirements, all plans must provide coverage for minimum or essential health benefits, regardless of the specific carrier or policyholder.
Dental Coverage
All Access Health CT health plans offer some coverage for pediatric dental needs, and certain preventive pediatric dental services are free from cost sharing. Applicants can also purchase stand-alone dental coverage in addition to their existing health insurance plans. Although pediatric dental coverage is considered an essential health benefit, insurers are not required to offer adult dental coverage.
Catastrophic Coverage
Connecticut residents under the age of 30 can also attain “catastrophic” health plans via Anthem, ConnectiCare, and Healthy CT. These plans protect patients from exceedingly high medical costs related to unanticipated events. They also include coverage for yearly visits to a primary care physician and preventive benefits. Catastrophic plans offer lower premiums when compared to traditional health insurance plans; however, they provide fewer benefits and require higher cost sharing. Catastrophic plan policyholders are ineligible for the tax credits that policy holders of traditional coverage health plans may use to lower premium costs.
When Can I Enroll?
Because open enrollment for 2014 ended March 31, applicants will have to wait for the next enrollment period between November 15, 2014 and February 15, 2015. Connecticut residents can either apply through a certified insurance broker or in person at a local Enrollment Center or at one of the Enrollment Fairs held throughout the state. Connecticut residents can also use www.accesshealthct.com to compare plans, apply for financial assistance, and enroll in health care coverage starting on November 15, 2014.

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