Connecticut Health Insurance Consumer Guide

To qualify for Marketplace coverage in Connecticut, you must:³

• Live in Connecticut
• Be a U.S. citizen, national, or lawfully present in the U.S.
• Not be incarcerated
• Not be enrolled in Medicare

Although that makes most people in Connecticut eligible to use the Marketplace, eligibility for financial assistance (premium subsidies and cost-sharing reductions) also depends on income. In addition, to be eligible for financial assistance through Access Health CT, you must:

• Not be eligible for employer-sponsored coverage that’s considered affordable and provides minimum value.
• Not be eligible for HUSKY (Medicaid/CHIP)
• Not be eligible for premium-free Medicare Part A.⁴
• If married, file a joint tax return with your spouse⁵ (with very limited exceptions)⁶
• Not be able to be claimed by someone else as a tax dependent.⁷

Connecticut’s open enrollment period for individual and family health plans runs from November 1 to January 15.⁸

• Enroll by December 15 for coverage to start January 1.
• Enroll between December 16 and January 15 for coverage to begin February 1.
  

Outside of open enrollment, you generally need a qualifying life event, such as losing coverage, getting married, or permanently moving to enroll or make changes. And Connecticut is among a handful of states where pregnancy is considered a qualifying event.⁹

The qualifying event will trigger a special enrollment period (SEP) that will allow you to sign up for coverage or switch to a different plan. 

But some people can sign up without a qualifying life event. For example:

Native Americans can enroll year-round.¹⁰

People eligible for the Covered Connecticut program can enroll anytime.¹¹

Anyone eligible for HUSKY (Medicaid/CHIP) in Connecticut can also enroll year-round.

There are multiple ways to enroll in an ACA Marketplace plan in Connecticut:¹²

• Online: Go to AccessHealthCT.com to create an account and apply. 
• Phone: Contact the Call Center at 855-805-4325. 
• Get help from a navigator, certified application counselor, or agent/broker certified with Access Health CT. These individuals can provide help over the phone, in-person, or online.

You can find affordable individual and family health plans in Connecticut through AccessHealthCT.com, the state’s ACA exchange.

Access Health CT is where you can:

• Shop, compare, and sign up for health and dental plans
• Qualify for financial help to lower your costs
• Enroll in HUSKY (Medicaid/CHIP) or the Covered Connecticut Program if eligible

Eighty-seven percent of Access Health CT enrollees receive subsidies, saving an average of $766 each month on their 2024 premiums.¹³ These subsidies are called Advance Premium Tax Credits (APTC). Subsidy-eligible Connecticut Marketplace enrollees pay an average of $233/month in after-subsidy premiums in 2024.¹³

If your income is no more than 250% of the federal poverty level, you may qualify for cost-sharing reductions (CSR) to lower your deductibles and out-of-pocket costs.¹⁴

If you qualify for Covered Connecticut, the state will cover your portion of the monthly premiums and any expenses related to cost-sharing, such as your deductibles, copays, and co-insurance.

Covered Connecticut is available to enrollees with household income up to 175% of the poverty level (they must also not be eligible for Medicaid, which is available up to 138% of the poverty level).

Under the Covered Connecticut program, eligible enrollees must select a silver plan through Access Health CT and accept all of the federal subsidies available to them. Covered Connecticut then pays any remaining premiums and cost-sharing, resulting in a plan that has a $0 premium and $0 cost-sharing.²

Legislation was considered in 2024 to extend Covered Connecticut to 200% of the poverty level, and also create a second reduced-benefit tier of the program, available to enrollees with income between 200% and 300% of the poverty level. But the bill did not advance.¹⁵

Source: CMS.gov¹⁶

Three insurance companies offer individual/family coverage through the Connecticut exchange:¹⁷ All three will continue to offer plans in 2025.¹

For 2025, the following average rate increases have been approved for the insurers that offer individual/family health coverage via Access Health CT, amounting to an overall average rate increase of 5.9%¹ (this was lower than the average increase of 8.3% that the insurers had proposed).

Source: Connecticut Insurance Department¹

Although the overall average rate increase is 5.9% for 2024, most enrollees — 87% in 2024¹⁸ — get premium subsidies that cover some of their premium costs. These subsidies are designed to keep pace with the cost of the benchmark plan (second-lowest-cost Silver plan), so if the benchmark price increases in 2025, average subsidies will also increase.

For perspective, here’s an overview of how average unsubsidized premiums have changed in Connecticut’s individual/family market over the years:

• 2015: Average decrease of 1%.¹⁹
• 2016: Average increase of 3.5%.²⁰
• 2017: Average increase of 24.8%.²¹
• 2018: Average increase of 28.4%.²²
• 2019: Average insurance of 2.72%.²³
• 2020: Average increase of 3.65%.²⁴
• 2021: Average increase of 0.01%.²⁵
• 2022: Average increase of 5.6%.²⁶
• 2023: Average increase of 12.9%.²⁷
• 2024: Average increase of 9.4%²⁸

A record-high 129,000 people enrolled in private plans through the Connecticut exchange during the open enrollment period for 2024 coverage.²⁹

The enrollment growth was driven in part by the continued subsidy enhancements under the American Rescue Plan and Inflation Reduction Act, as well as the “unwinding” of the pandemic-era Medicaid continuous coverage rule, with some people transitioning from Medicaid to a Marketplace plan. Access Health CT also noted that the enrollment growth was partially due to additional outreach and enrollment efforts by the Marketplace and local brokers.³⁰ 

Source: 2014,³¹ 2015,³² 2016,³³ 2017,³⁴ 2018,³⁵ 2019,³⁶ 2020,³⁷ 2021,³⁸ 2022,³⁹ 2023,⁴⁰ 2024⁴¹

Access Health CT
This website is used by Connecticut residents to sign up for private individual market or small-group coverage and income-based Medicaid/CHIP coverage.

Connecticut CHOICES Program
Offers free enrollment counseling and assistance for older adults, people with disabilities, and their caregivers.

Connecticut Insurance Department
Regulates and licenses the state’s health insurance companies, brokers, and agents. They also address inquiries and complaints from consumers about entities under their regulation.

Husky Healthcare
Provides health coverage for Connecticut residents with lower and moderate incomes.

Medicare Rights Center
This nationwide service offers help and information to Medicare beneficiaries and their caregivers.