What Does HUSKY C Cover? Medical, Dental, and Long-Term Care

HUSKY C, Connecticut’s Medicaid program for residents 65 and older and for adults 18 to 64 who are blind or have a disability, covers a wide slate of medical, behavioral, dental, vision, hearing, pharmacy, and transportation services at no cost to enrollees, and it is the only HUSKY program that pays for long-term care in a nursing home or at home.¹ Services must be medically necessary and delivered by a provider enrolled in the Connecticut Medical Assistance Program.²

Medical, Pharmacy, and Behavioral Health Benefits

The covered-services list for HUSKY C is the same one used for HUSKY A and HUSKY D.² On the medical side it pays for:

Primary and specialist office visits, preventive screenings, allergy testing, gynecology, cardiac diagnostics, nutritional counseling, and naturopathic care.
Inpatient and outpatient hospital care, emergency room visits, and urgent care.
Surgery, including bariatric, reconstructive, and gender-affirming procedures.
Outpatient physical, occupational, and speech therapy.
Dialysis at centers or hospitals.
Maternity care, including prenatal visits, delivery, postpartum care, and breast pumps.
Hospice for patients with a terminal illness and a life expectancy of six months or less.
Acupuncture in office and outpatient settings, and chiropractic spinal manipulation (with some limits for adults over 21).
Telehealth, both audio-visual and in some cases audio-only, for codes on the state’s approved telehealth table.³

Prescription drugs and selected over-the-counter products are covered at no cost. Doctors must prescribe generics where one exists; brand-name or non-preferred drugs need prior authorization. Drugs for cosmetic conditions, sexual dysfunction, fertility, obesity, and experimental uses are excluded.⁴

Mental health and substance use treatment is handled through the Connecticut Behavioral Health Partnership. No referral is required, and clinical care managers are available around the clock.⁵

Dental Coverage

Dental benefits are administered separately through the Connecticut Dental Health Partnership and cost nothing when a member sees a participating dentist. Adults 21 and older are covered for one cleaning and one set of bitewing X-rays per year, fillings once every two years per tooth surface, crowns once every five years with prior authorization, and root canals once per tooth per lifetime.⁶⁷

Vision, Hearing, and Medical Equipment

Eye exams are covered along with one pair of glasses every 24 months. Contact lenses are only available for specific diagnoses, and for adults 21 and up, lost or broken glasses are not replaced until the 24-month period resets. Hearing aids are covered at one pair every three years, with batteries available by prescription.²

Durable medical equipment is covered with a prescription. That includes wheelchairs, walkers, and sleep apnea machines; some items require prior authorization. The program also pays for prosthetics, orthotics, diabetic supplies such as monitors, test strips, lancets, and insulin, and two pairs of diabetic shoes per year for adults.²

Rides to Medical Appointments

Members without another way to reach medical appointments can use non-emergency medical transportation, arranged through Medical Transportation Management. Rides generally need to be booked at least 48 business hours ahead, though same-day and next-day service is available for urgent situations and hospital discharges. Emergency ground and air ambulance are fully covered, and non-emergency facility-to-facility ambulance transfers do not need prior authorization when billed with the right modifiers. Rides to pharmacies or to pick up equipment that does not require a fitting are not covered.⁸

Long-Term Care at Home or in a Facility

Long-term care is where HUSKY C does the most that the other HUSKY programs cannot. Members who qualify can enter a nursing home or stay at home through several home and community-based services programs. Nursing home residents contribute most of their monthly income toward the cost of care, keeping a $60 personal needs allowance; Medicaid pays the rest.⁹

Community First Choice

Community First Choice is an entitlement, so eligible people are guaranteed services with no waiting list. It funds personal attendant care at home for members who meet a nursing-facility level of care, including help with bathing, dressing, eating, toileting, meal preparation, and chores, plus accompaniment on errands and to doctor’s appointments.¹⁰ Participants choose and hire their own staff, including friends and certain family members, set schedules, and direct how care is given. DSS must give at least 10 days’ written notice before cutting or ending services.¹¹

Connecticut Home Care Program for Elders

CHCPE is a Medicaid waiver for residents 65 and older who are at risk of nursing home placement. It pays for personal care attendants, homemaker and companion services, home-delivered meals, adult day health, assistive technology, minor home modifications, respite care, and care management.¹² Enrollment is capped, so applicants may be waitlisted. The program currently serves more than 3,000 people.¹³

Personal Care Assistance Waiver

The PCA waiver serves adults 18 to 64 with chronic, severe, and permanent physical disabilities who need hands-on help with at least two activities of daily living. Participants act as the employer, recruiting, hiring, training, and supervising attendants while a fiscal agency handles payroll and taxes.¹⁴ Covered tasks include bathing, dressing, eating, toileting, errands, light meals, and bill paying. Medical tasks such as administering medication are not included, and the waiver has a waiting list.¹⁵

Acquired Brain Injury Waivers

Two waivers serve adults 18 to 64 with an acquired brain injury who would otherwise need institutional care. ABI Waiver I and ABI Waiver II fund group day habilitation, community living support, cognitive-behavioral services, companion and chore services, environmental home modifications, care management, and respite. ABI Waiver II adds adult day health, recovery assistant services, and consultation services not available under the first waiver.¹⁶ Neither is an entitlement, so waiting lists apply.¹⁷

Money Follows the Person

Connecticut’s Money Follows the Person demonstration helps Medicaid recipients leave nursing homes and other institutions and return to the community. It funds supplemental supports, such as housing coordinators, that go beyond standard Medicaid services to make the move possible.⁹

What Enrollees Pay

Standard HUSKY C has no premiums and no copays. The one exception is MED-Connect, the sub-program for employed adults with disabilities, where higher-income participants may owe a monthly premium.¹⁸ Members who also have Medicare get coordinated benefits: DSS pays the Medicare Part B premium and picks up coinsurance and deductibles where they apply.¹⁹

1
CT.gov. Healthcare Coverage – HUSKY C
2
HUSKY Health CT. HUSKY A, C, D Covered Services Benefit Grid
3
CT DSS MAP. Telehealth Information
4
CT.gov. HUSKY – Pharmacy
5
CT BHP. CT BHP Member Handbook
6
CT Dental Health Partnership. Benefits for Adults
7
CT Dental Health Partnership. Your Benefits
8
HUSKY Health CT. Transportation Benefits Grid
9
CT General Assembly. Connecticut’s Medicaid Home and Community-Based Services
10
CT.gov. CFC More Information
11
Disability Rights Connecticut. Community First Choice
12
CT.gov. Connecticut Home Care Program for Elders
13
Area Agency on Aging of South Central Connecticut. Department of Social Services Partnerships
14
CT.gov. The Personal Care Attendant Program
15
My Place CT. Personal Care Attendant Waiver
16
CT DSS MAP. ABI Waiver Covered Services
17
211 Connecticut. Traumatic Brain Injury Waiver
18
CT.gov. HUSKY Health – How to Qualify
19
CT DSS MAP. Eligibility Response Reference Guide