Dual Eligibility in Connecticut: Key Facts
| Dual Eligible Population | Approximately 10% of Connecticut Medicare beneficiaries |
|---|---|
| QMB Income Limit (Individual) | $1,255/month (100% FPL) |
| SLMB Income Limit (Individual) | $1,694/month (120% FPL) |
| Connecticut Medicaid Agency | Connecticut Department of Social Services |
| Phone | 860-424-5008 |
What Is Dual Eligibility?
Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Connecticut, approximately 10% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.
Medicare Savings Programs in Connecticut
Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Connecticut that helps pay your Medicare costs. There are four MSP levels:
| Program | Individual Income Limit | What It Pays |
|---|---|---|
| Qualified Medicare Beneficiary (QMB) | $1,255/month | Part A and B premiums, deductibles, and copayments |
| Specified Low-Income Medicare Beneficiary (SLMB) | $1,694/month | Part B premium only |
| Qualifying Individual (QI) | ~$1,800/month | Part B premium only (limited slots) |
| Qualified Disabled Working Individual (QDWI) | ~$4,615/month | Part A premium only |
Benefits of Full Dual Eligibility in Connecticut
Full dual eligible beneficiaries in Connecticut receive:
- $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
- $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
- Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
- Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
- Additional services — Dental, vision, hearing, and transportation (varies by Connecticut Medicaid program)
How to Apply for Dual Eligibility in Connecticut
To apply for Medicaid in Connecticut and potentially qualify for dual eligibility, contact the Connecticut Department of Social Services at 860-424-5008. You can also apply online through Connecticut’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.
D-SNPs: Dual Eligible Special Needs Plans in Connecticut
Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Connecticut, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.
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