HealthNet has announced that it will continue to offer a managed care plan for Medicare beneficiaries in 2004. Plans will be available in Fairfield, Hartford, and New Haven counties. However, HealthNet has also announced that the plan offered in Hartford County will have slightly different provisions than the plans offered in New Haven and Fairfield Counties.  

Please note the following important information regarding the Medicare HealthNet plans for 2004:

1. The coinsurance for certain outpatient tests such as x-rays, was 10% in 2003.  For the year 2004, the co-pay will be a flat fee of $20 for x-rays, $100 for CT Scans, $150 for MRA, MRI & PET scans, and $20 for radiation therapy.  

2. Premiums for 2004 will remain at $99/month.

3. Co-payments for an inpatient hospital stay in Hartford County will be $100 per day with a $1,000 annual out-of-pocket maximum.  In New Haven and Fairfield County, there will be a $500 co-pay per admission.  For inpatient mental health stays, the provisions are the same as inpatient hospital stays in each respective county.

4.  Co-payments for skilled nursing facility stays will not change in 2004 from the 2003 rates.  The rates are $0 for the first 1-20 days and $75 for days 21-100.

5.  The co-payment amount for primary care physicians routine physicals will decrease in 2004, from $20 to $15.  However, the co-payment for a specialist will increase, from $20 to $25.

• Individuals formerly enrolled in HealthNet will automatically be enrolled in HealthNet.

• If, after reviewing the changes in HealthNet, an individual decides another choice is preferable for 2004, he or she must take action to disenroll.

For further information and assistance contact the Connecticut CHOICES program. 
A CHOICES staff member can help you think through your options 
and make an informed decision. (800)994-9422.

© Center for Medicare Advocacy, Inc. 01/08/2010