Medicaid in Connecticut

To learn more about Medicaid in Connecticut, check out the statistics below.

Enrollment

  • In the 2011 fiscal year, the distribution of Medicaid enrollees by group was approximately as follows: the aged (14%), the disabled (10%), adults (35%) and children (40%).

CHIP

  • In October 2014, child enrollment in Medicaid/CHIP was 320,127, which amounted to 41.7% of total Medicaid/CHIP enrollment.

Costs Covered

  • In the 2012 fiscal year, the distribution of spending by type of medical service was approximately: acute care (50.5%), long-term care (42.4%) and disproportionate share hospital payments (7.1%).
  • In the 2012 fiscal year, the federal government and Connecticut shared the cost of Medicaid 50-50.
  • In the 2011 fiscal year, the percentage of Medicaid spending by enrollment group was approximately: the aged (27%), the disabled (34%), adults (21%) and children (17%).

Medicaid Expansion

  • The state of Connecticut was one of 27 states, along with D.C., to have elected Medicaid expansion in 2014.
  • The augmentation of Connecticut’s Medicaid program has given an estimated 80,000 residents access to medical assistance.
  • Connecticut’s post-Affordable Care Act monthly Medicaid enrollment was 767,157 in October 2014.

1) What is Medicaid?

Providing millions of people all across the United States with low-cost or free health insurance, Medicaid is one of the most important programs in the country, and the types of people that are covered vary greatly:

  • Pregnant women
  • The disabled
  • The elderly
  • Families that have children

Citizens within every county of Connecticut can be eligible for Medicaid and non-citizens as well. It is important to note that immigrants who meet the qualifications put forth by the CT Medicaid program are eligible to apply for Medicaid too. They must be able to meet the income requirements that go with their household size. The way that Medicaid functions, families with larger households are allowed to earn more income and still receive the benefits of the federal and state program.

A number of the services included in the Connecticut Medicaid program are:

  • Dental care (for children under 21)
  • Vision care (for children under 21)
  • Primary care physician visits.
  • Hospital visits.
  • Immunizations.
  • Screenings.
  • Treatment.
  • Preventive care.

If you are deemed eligible to receive the medical benefits of the state program, then you will meet the health insurance requirement of the Affordable Care Act’s individual mandate. If you do not have coverage at the moment and do not want to incur any fines, begin the Medicaid application process by applying here.

2) How do I apply for Medicaid in Connecticut?

For anyone that believes they may qualify for medical assistance, it is crucial that they learn how to apply for Medicaid. In the state of Connecticut, where the state program for assistance is HUSKY Health, there are plenty of ways that you can go through the CT Medicaid application, and these methods vary depending on your reason for applying.

For instance, pregnant women must go through a different application process than an applicant who is blind, disabled or elderly. This is because of the three different kinds of HUSKY Health that are offered. There is A & B for pregnant women and children, C for the disabled, the age and the blind and D for very low-income Americans.

If you are applying for HUSKY A & B, then you have the option to apply online or by phone. The Connecticut Medicaid phone number to apply is 1-855-805-HEALTH (4325), which can also be used to apply for HUSKY D. The same website can be used to apply for either of these kinds of Medicaid. To begin the process, apply here. However, HUSKY C has its own website for individuals to apply on. For those who do not want to file their application online, they also have the choice of downloading, filling out and submitting their forms in person at a DSS office or by mail to DSS ConneCT Scanning Center, P.O. Box 1320, Manchester, Connecticut 06045-1320.

3) What does CT Medicaid cover?

The Connecticut Medicaid program, or HUSKY Health, provides a number of benefits to its beneficiaries. The comprehensive health plan features a wide variety services that comprise what the state considers basic benefits:

  • Preventive services
  • Visits to the primary care physician
  • Stays in the hospital
  • Family planning services
  • Health care specifically for women
  • Maternity care services
  • Physical, occupational and speech therapy treatments
  • Physical rehabilitation
  • Audiology services
  • DME or Durable Medical Equipment
  • Hearing aids
  • Labs and X-rays
  • Care for your vision
  • Outpatient care
  • Emergency care
  • Prescription medications
  • Behavioral health (which is offered through the Connecticut Behavioral Health Partnership)
  • Dental care (which is offered through the Connecticut Dental Health Partnership)
  • Dialysis
  • Services for home health
  • Hospice
  • Orthotic as well as prosthetic devices
  • Ambulatory surgery

Before you apply for Medicaid in CT with the belief that you will receive all of the above benefits, you should note that there are certain services that are only available to HUSKY A, C and D members. The special services limited to these groups are:

  • Counseling and medication for patients undergoing smoking cessation.
  • Non-emergency transport to care appointments.
  • EPSDT or Early and Periodic Screening, Diagnosis & Treatment for children under the age of 21, even if they are not covered.

4) Who is eligible for Connecticut Medicaid?

The Connecticut Medicaid program, known as HUSKY Health, is divided into three different categories: HUSKY A & B, HUSKY C AND HUSKY D. The groups of people that make up these categories are as follows:

  • HUSKY A & B: A is for children and their parents or relative caregivers as well as pregnant women who meet the income requirements. B is for children under the age of 19 who do not have health insurance but are in households with higher incomes.
  • HUSKY C: The groups of people that may qualify for Medicaid under C include residents who are at least 65 years old and blind and disabled individuals between the ages of 18 and 65.
  • HUSKY D: This type of Medicaid is for residents of Connecticut who are between 19 and 65 who are not pregnant, do not receive any benefits from Medicare and who do not qualify for HUSKY A.

Review the 2015 Connecticut Medicaid income requirements below:

  • 1 person = $11,770
  • 2 family members = $15,930
  • 3 family members = $20,090
  • 4 family members = $24,250
  • 5 family members = $28,410
  • 6 family members = $32,570
  • 7 family members = $36,730
  • 8 family members = $40,890
  • Add $4,160 for each additional person for families with more than eight family members.

In addition to falling into the above groups, individuals and families must meet income requirements, and occasionally, medical and age requirements. Furthermore, there are two factors that cannot be overlooked when it comes to determining eligibility. Everyone who wants to apply for Medicaid in CT must be:

  • A U.S. citizen or legal resident of the country.
  • A resident of Connecticut.

5) What is the Medicaid expansion, and did Connecticut accept the Medicaid expansion in 2014?

Connecticut was one of 28 states (including the District of Columbia) to elect Medicaid expansion after the implementation of the Affordable Care Act. The augmentation of their medical assistance program has allowed the government of Connecticut to disperse medical care to more residents (immigrants and citizens) than ever before. This was done by expanding the access of the program.

After the ACA, Connecticut residents who were under 65 and made up to 133 percent of the federal poverty level became eligible to receive Medicaid benefits. The children of families who met this requirement also received medical assistance. Nevertheless, even with the Medicaid expansion, residents are still required to meet a number of eligibility requirements before they are accepted as beneficiaries. Income qualifications must be met, and in some cases, age and medical requirements must be satisfied in order for someone to receive the benefits of Connecticut Medicaid, which is also known as HUSKY Health.

Individuals and families who do not meet the criteria for assistance from the federal and state program will have to look elsewhere for the coverage that they are required to have under the individual mandate. If you are not sure about your eligibility, contact a Medicaid office and provide them with the details of your situation.

6) How do I contact Connecticut Medicaid?

If you would like to learn more about Connecticut’s medical assistance program, HUSKY Health, then it is recommended that you call the CT Medicaid phone number: 1-877-CT-HUSKY (1-877-284-8759). A representative will be able to help you with whatever questions you may have regarding the state’s Medicaid program. Those individuals with hearing impediments or auxiliary audio devices are asked to call this number instead: 1-866-492-5276. Another convenient option you have when it comes to learning more about Connecticut’s medical program is to email a HUSKY Health representative directly, where you will be connected to the CT Department of Social Services.

If you would rather not email or call to find out your answer, another option you have is to mail in your inquiry to the Medicaid office. Any questions that you have for the Department of Social Services should be addressed to:

HUSKY Health Program
c/o Department of Social Services
55 Farmington Avenue
Hartford, CT 06105.

Additionally, there are a number of DSS offices located throughout the state of Connecticut, which you are free to visit for any questions you have. Common reasons to contact the Connecticut Medicaid office include if you are having problems with your Medicaid application, if you do not know how to apply and if you are unsure of your eligibility.

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