What's the difference between an HMO and a PPO?

An HMO requires you to pick a primary care physician who coordinates your care and provides referrals to specialists. Coverage is generally limited to in-network providers, and premiums are typically lower. A PPO lets you see any doctor or specialist without a referral and offers partial coverage for out-of-network providers, but you pay higher premiums for that flexibility. The right choice depends on whether you value lower cost or wider provider access.

How do deductibles, copays, and coinsurance work together?

Your deductible is the amount you pay out of pocket each year before your insurance starts contributing to most services. A copay is a flat dollar amount you pay at the time of a specific service, like $30 for a primary care visit. Coinsurance is a percentage of the bill you pay after you have met your deductible — for example, 20% of a hospital stay while the insurer pays the other 80%. Your out-of-pocket maximum caps the total you can spend in a year, after which the insurer pays 100% of covered services.

When can I enroll in a health insurance plan?

The annual open enrollment period for individual and family plans through Access Health CT typically runs from November 1 through January 15. Outside that window, you can only enroll if you experience a qualifying life event — losing other coverage, getting married, having a baby, moving, or aging off a parent's plan, among others. Qualifying events open a special enrollment period of 60 days. Employer-sponsored plans have their own annual open enrollment dates set by each employer.

Am I eligible for a subsidy through Access Health CT?

Most Connecticut residents who buy individual coverage through Access Health CT and earn between 100% and 400% of the federal poverty level qualify for premium tax credits, and many earning above that threshold still qualify under expanded rules. Eligibility depends on household size, income, and whether affordable employer coverage is available to you. Our agents can run the numbers with you in minutes and tell you exactly what you would pay after subsidies

Is preventive care really free?

Under federal law, every Affordable Care Act–compliant plan sold in Connecticut must cover a defined list of preventive services at 100% when you use an in-network provider — meaning no copay, no deductible, no coinsurance. That list includes annual physicals, routine immunizations, age-appropriate cancer screenings, well-child visits, and many forms of contraception. The key is staying in-network and confirming the visit is coded as preventive rather than diagnostic.

Health Insurance in Connecticut | United Insurance Since 1973

Health insurance is a contract between you and an insurance company. You pay a monthly premium, and in return, the insurer covers a portion of your medical costs — doctor visits, hospital stays, prescriptions, lab work, and preventive care. Without coverage, a single emergency room visit can run into the thousands, and a serious illness can mean years of medical debt.

For Connecticut residents, health insurance does more than pay claims. It locks in negotiated rates with in-network providers, caps your annual out-of-pocket exposure, and gives you predictable copays in place of full retail pricing. Whether you are between jobs, self-employed, retiring before Medicare, or simply shopping for a better fit, the right plan turns unpredictable medical bills into a manageable monthly cost.

At United Insurance Group, our licensed agents help you compare plans across multiple Connecticut carriers, explain the difference between HMOs, PPOs, and high-deductible plans, and walk you through every deductible, copay, and network detail before you enroll. There is never a charge for the consultation.

A Health Maintenance Organization plan keeps costs low by routing your care through a single primary care physician who coordinates referrals to specialists. Premiums are typically the most affordable of any plan type, and copays for in-network visits are predictable. The trade-off is that care is generally only covered when you stay inside the HMO's network of doctors and hospitals. For Connecticut residents who value lower monthly costs and have an established relationship with a primary care provider, an HMO is often the most cost-effective choice.

A Preferred Provider Organization plan offers the most flexibility. You can see any doctor or specialist without a referral, and you receive partial coverage for out-of-network providers. PPOs are well-suited to families who travel, residents who want access to specialists at multiple Connecticut hospital systems, or anyone managing a condition that requires care outside a single network. Premiums and deductibles run higher than HMOs, but the freedom to choose your providers is often worth the cost for those who use it.

A high-deductible health plan pairs a lower monthly premium with a higher annual deductible and qualifies you to open a Health Savings Account. Contributions to your HSA are tax-deductible, grow tax-free, and can be withdrawn tax-free for qualified medical expenses — a triple tax advantage no other account offers. HDHPs work especially well for healthier Connecticut residents who use few medical services and want to bank pre-tax dollars toward future healthcare costs or retirement medical expenses.

Connecticut consistently ranks among the most expensive states in the country for healthcare. Hospital charges, specialist fees, and prescription costs in the Northeast run well above the national average, which means an uninsured medical event here can be financially devastating in a way it might not be elsewhere.

Health insurance addresses that risk directly. A well-chosen plan caps your annual out-of-pocket maximum, locks in negotiated in-network rates, and turns unpredictable bills into a predictable monthly premium. For most Connecticut families, that protection is worth far more than the cost of coverage.

Connecticut also offers one of the most generous marketplace environments in the country. Through Access Health CT, the state's official health insurance exchange, residents can apply for federal premium tax credits and cost-sharing reductions based on household income. Many Connecticut families qualify for substantial subsidies — and a meaningful number pay little to nothing in monthly premiums after subsidies are applied.

Beyond cost protection, Connecticut law requires every plan sold in the state to cover the ten essential health benefits, including preventive care at no cost, mental health services, prescription drugs, and maternity care. That floor of mandatory coverage means no Connecticut plan can leave you exposed on the basics, regardless of which carrier or tier you choose.

When you shop directly with a single insurance company or through a captive agent, you only see that one carrier's plans. An independent agent like United Insurance Group is not tied to any single insurer. We represent multiple carriers offering health plans in Connecticut, which means we can compare premiums, deductibles, networks, prescription formularies, and out-of-pocket maximums side by side, then recommend the plan that genuinely fits your situation.

Our team includes licensed health insurance agents who specialize in individual, family, Medicare, and small group coverage. We take the time to ask which doctors and hospitals you want to keep, which medications you take, and how often your family actually uses care — and then we match those answers to a plan that makes sense. We also help you determine whether you qualify for Access Health CT subsidies and walk you through the enrollment process from start to finish.

United Insurance Group has been serving Connecticut families and businesses from our Connecticut office since 1973. From 2011 through 2024, members of our team were consistently recognized among Connecticut's top insurance professionals by the Five Star Professional Program, as featured in Forbes and Connecticut Magazine. Our consultations are always free, and there is no obligation to enroll.

What's the difference between an HMO and a PPO?
An HMO requires you to pick a primary care physician who coordinates your care and provides referrals to specialists. Coverage is generally limited to in-network providers, and premiums are typically lower. A PPO lets you see any doctor or specialist without a referral and offers partial coverage for out-of-network providers, but you pay higher premiums for that flexibility. The right choice depends on whether you value lower cost or wider provider access.
How do deductibles, copays, and coinsurance work together?
Your deductible is the amount you pay out of pocket each year before your insurance starts contributing to most services. A copay is a flat dollar amount you pay at the time of a specific service, like $30 for a primary care visit. Coinsurance is a percentage of the bill you pay after you have met your deductible — for example, 20% of a hospital stay while the insurer pays the other 80%. Your out-of-pocket maximum caps the total you can spend in a year, after which the insurer pays 100% of covered services.
When can I enroll in a health insurance plan?
The annual open enrollment period for individual and family plans through Access Health CT typically runs from November 1 through January 15. Outside that window, you can only enroll if you experience a qualifying life event — losing other coverage, getting married, having a baby, moving, or aging off a parent's plan, among others. Qualifying events open a special enrollment period of 60 days. Employer-sponsored plans have their own annual open enrollment dates set by each employer.
Am I eligible for a subsidy through Access Health CT?
Most Connecticut residents who buy individual coverage through Access Health CT and earn between 100% and 400% of the federal poverty level qualify for premium tax credits, and many earning above that threshold still qualify under expanded rules. Eligibility depends on household size, income, and whether affordable employer coverage is available to you. Our agents can run the numbers with you in minutes and tell you exactly what you would pay after subsidies
Is preventive care really free?
Under federal law, every Affordable Care Act–compliant plan sold in Connecticut must cover a defined list of preventive services at 100% when you use an in-network provider — meaning no copay, no deductible, no coinsurance. That list includes annual physicals, routine immunizations, age-appropriate cancer screenings, well-child visits, and many forms of contraception. The key is staying in-network and confirming the visit is coded as preventive rather than diagnostic.

Health Insurance in Connecticut

What Is Health Insurance and How Does It Work?

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Types of Health Insurance Plans Available Through Our Agency

HMO Plans

PPO Plans

High-Deductible Health Plans with HSA

Why Connecticut Residents Need Reliable Health Coverage

Connecticut Marketplace Subsidies

The Independent Agent Advantage for Health Insurance Shopping

Frequently Asked Questions About Health Insurance in Connecticut

What's the difference between an HMO and a PPO?

How do deductibles, copays, and coinsurance work together?

When can I enroll in a health insurance plan?

Am I eligible for a subsidy through Access Health CT?

Is preventive care really free?

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