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As with other kinds of insurance, there are several types of health insurance available in Connecticut.

Major medical plans typically cover a comprehensive array of healthcare needs, including doctors’ visits, drugs and hospital care. These benefits can be delivered in several different ways:

  • Indemnity plans - These major medical plans typically have a deductible – the amount you pay before the insurance company begins paying benefits. After your covered expenses exceed the deductible amount, benefits usually are paid as a percentage of reasonable and customary expenses, often 80 percent. These plans usually provide the most flexibility in choosing where to receive care.

  • Preferred Provider Organization (PPO) plans – In these major medical plans, the insurance company enters into contracts with selected hospitals and doctors to furnish services at a discounted rate. As a member of a PPO, you may be able to seek care from a doctor or hospital that is not a preferred provider, but you will probably have to pay a higher deductible or co-payment.

  • Health Maintenance Organization (HMO) plans – These major medical plans usually make you choose a primary care physician (PCP) from a list of network providers. Your PCP is responsible for managing all of your healthcare. If you need care from any network provider other than your PCP, you may have to get a referral from your PCP to see that provider. You must receive care from a network provider in order to have your claim paid through the HMO. Treatment received outside the network is usually not covered, or covered at a significantly reduced level.

  • Point of Service (POS) plans – These comprehensive plans are a hybrid of the PPO and HMO models. They are more flexible than HMOs, but do require you to select a primary care physician (PCP). Like a PPO, you can go to an out-of-network provider and pay more of the cost.


Limited benefit plans provide coverage for a particular healthcare setting, ailment or disease. Here are some of the options that may be available to you:
  • Basic Hospital Expense Coverage – Covers a period of usually not less than 31 days of continuous in-hospital care and certain hospital outpatient services.

  • Basic Medical-Surgical Expense Coverage – Covers costs associated with a necessary surgery, including a certain number of days of in-hospital care.

  • Hospital Confinement Indemnity Coverage – Covers a fixed amount for each day that you are in a hospital.

  • Major Medical Expense Coverage - Covers hospital, medical and surgical expenses.


  • Accident Only Coverage – Covers death, dismemberment, disability or hospital and medical care caused by an accident.


  • Specified Disease Coverage – Covers diagnosis and treatment of a specifically named disease or diseases – such as cancer.

  • Other Limited Coverage – You may purchase insurance covering only dental or vision or other specified care.
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