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HUSKY Health ProgramMember Benefits GridCovered Services for HUSKY A, C, and D
Member Benefits – Covered Services for HUSKY A, C and DAll healthcare you receive through the HUSKY Health program must be from providers who participate in the Connecticut Medical AssistanceProgram (CMAP) network. Providers such as: pharmacies, hospitals, medical equipment companies and home care agencies must also participate inthe CMAP (HUSKY) network. Some non-participating providers can write prescriptions, order tests, or refer HUSKY members for services. However,HUSKY members may be responsible for the cost of visits or other services received from these non-participating providers. If you are unsure if yourprovider participates in HUSKY, need help finding a provider, or need more information on HUSKY benefits or services, call Member EngagementServices at 1.800.859.9889 or send us a secure email anytime.All services must be medically necessary.For information on wellness exams, screenings and vaccines, click here.BenefitLimitations*Is Prior AuthorizationRequired?HUSKY ProvidersWho Offer This CareAcupunctureCovered when medically necessary.NoMedical Doctor or Osteopathwho performs acupunctureAllergy Testing/ShotsCovered when medically necessary.NoPrimary Care Provider or AllergistAmbulance: Emergency ground and rotaryair ambulanceFor emergencies only (Call 911 for emergencyground ambulance).NoAmbulanceAmbulance: Non-emergency air ambulanceTo the closest appropriate provider for anapproved service.YesContact Veyo at 1.855.478.7350for additional informationBehavioral Health(Mental Health and Substance use Treatment)Contact Connecticut Behavioral Health Partnership at www.ctbhp.com or 1.877.552.8247Birth ControlRequires prescription for all methods ofcontraception obtained at a pharmacy. Monthlylimits apply for condoms.The Plan B morning after pill is also covered withprescription.NoAges Birth through 20: Pharmacyor pharmacy that is also aMedical Equipment ProviderAges: 21 : Pharmacy only Methods of birth controlthat are implanted/inserted:Primary Care Provider orOB/GYNCardiac Care(Includes Diagnostic Screening and Testing)Covered when medically necessary.NoCardiologist or Primary CareProviderCardiac Rehabilitation ProgramCovered when medically necessary.NoHospitalContact Member Engagement Services: 1.800.859.9889Monday – Friday 8:00 a.m. – 6:00 p.m.*It is the provider’s responsibility to obtain Prior Authorization1
Member Benefits – Covered Services for HUSKY A, C and DAll healthcare you receive through the HUSKY Health program must be from providers who participate in the Connecticut Medical AssistanceProgram (CMAP) network. Providers such as: pharmacies, hospitals, medical equipment companies and home care agencies must also participate inthe CMAP (HUSKY) network. Some non-participating providers can write prescriptions, order tests, or refer HUSKY members for services. However,HUSKY members may be responsible for the cost of visits or other services received from these non-participating providers. If you are unsure if yourprovider participates in HUSKY, need help finding a provider, or need more information on HUSKY benefits or services, call Member EngagementServices at 1.800.859.9889 or send us a secure email anytime.BenefitChiropracticLimitations*Is Prior AuthorizationRequired?Ages Birth through 20: Limited to certain specificservices provided by an independent chiropractoror within a clinic/health center setting.Ages 21 : Limited to certain specific servicesprovided only at a Federally Qualified HealthCenter.DentalYesHUSKY ProvidersWho Offer This CareChiropractorContact Dental Health Partnership at www.ctdhp.com or 1.855.283.3682.DialysisCovered when medically necessary.NoDialysis site or hospitalDiapers and Adult Incontinence SuppliesAges Birth through 2: Not covered.Ages 3 : Covered if medically necessaryPrescription required.Yes, for ages 3-12Medical Equipment providerDiabetic Supplies such as:blood glucose monitor, alcohol wipes, teststrips (urine, blood or reagent), lancetsAges Birth through 20: Covered under both thePharmacy benefit or under the MedicalEquipment benefit.Ages 21 : Covered under the Medical Equipmentbenefit; specific items covered under thepharmacy benefit.For details see: Content/Publications/CT Diabetic Supply Preferred Product List.pdfInsulin is covered for all ages under the pharmacybenefit.Yes, for some items such asinsulin pumpsAges 21 : Pharmacy for specificitems or pharmacy, MedicalEquipment provider or pharmacythat is also a Medical EquipmentproviderDiabetic Shoes/InsertsAges 21 : 2 pairs are covered per calendar yearwithout prior authorization.If more than 2 pairs per calendaryear are requested, priorauthorization is needed.Medical Equipment providerContact Member Engagement Services: 1.800.859.9889Monday – Friday 8:00 a.m. – 6:00 p.m.*It is the provider’s responsibility to obtain Prior Authorization2
Member Benefits – Covered Services for HUSKY A, C and DAll healthcare you receive through the HUSKY Health program must be from providers who participate in the Connecticut Medical AssistanceProgram (CMAP) network. Providers such as: pharmacies, hospitals, medical equipment companies and home care agencies must also participate inthe CMAP (HUSKY) network. Some non-participating providers can write prescriptions, order tests, or refer HUSKY members for services. However,HUSKY members may be responsible for the cost of visits or other services received from these non-participating providers. If you are unsure if yourprovider participates in HUSKY, need help finding a provider, or need more information on HUSKY benefits or services, call Member EngagementServices at 1.800.859.9889 or send us a secure email anytime.BenefitLimitations*Is Prior AuthorizationRequired?HUSKY ProvidersWho Offer This CareEmergency Services/Urgent CareIn-state: Covered at a Hospital or Urgent CareProvider.Out-of-state: Not covered unless visit is medicallynecessary AND the provider enrolls in HUSKY.Out-of-country: Emergency services are notcovered when received outside of the U.S. or U.S.territories.NoHospital Emergency Departmentor Urgent Care Center within theU.S. and U.S. territoriesEye Care/Glasses(see also Vision Care)Eyeglasses - Ages 21 : Some limits apply on typeof frames and lenses. Limits also apply on howoften you can get glasses. One pair of glasses canbe covered every 24 months unless a new pair ismedically necessaryBirth through 20: Some limits apply on type offrames and lenses. One pair of glasses can becovered every 24 months unless a new pair ismedically necessary or the previous pair was lost,stolen or broken.Contact lenses: Only covered for certaindiagnoses.NoOptometrist or Ophthalmologistfor vision examFamily Planning (For ongoing care)(Includes birth control, exams, testing andtreatment for sexually transmitted diseasesand HIV. Also see Birth Control andMaternity)Covered when medically necessary.NoGenetic TestingCovered when medically necessary.YesSpecialist or Primary CareProviderGynecologyCovered when medically necessary.NoPrimary Care Provider, OB/GYNOptometrist or Optician foreyeglasses or contact lenseswhen coveredPrimary Care Provider orSpecialistPrescription items are obtainedat a pharmacyContact Member Engagement Services: 1.800.859.9889Monday – Friday 8:00 a.m. – 6:00 p.m.*It is the provider’s responsibility to obtain Prior Authorization3
Member Benefits – Covered Services for HUSKY A, C and DAll healthcare you receive through the HUSKY Health program must be from providers who participate in the Connecticut Medical AssistanceProgram (CMAP) network. Providers such as: pharmacies, hospitals, medical equipment companies and home care agencies must also participate inthe CMAP (HUSKY) network. Some non-participating providers can write prescriptions, order tests, or refer HUSKY members for services. However,HUSKY members may be responsible for the cost of visits or other services received from these non-participating providers. If you are unsure if yourprovider participates in HUSKY, need help finding a provider, or need more information on HUSKY benefits or services, call Member EngagementServices at 1.800.859.9889 or send us a secure email anytime.BenefitLimitations*Is Prior AuthorizationRequired?HUSKY ProvidersWho Offer This CareHearing examsCovered when medically necessary.Yes for more than 1 evaluationper calendar year or 2 or morevisits per calendar week.Audiologist or Ear, Nose andThroat doctor (ENT)Hearing AidsHUSKY A, C, D: 1 pair every 3 years.NoAudiologist as a MedicalEquipment provider or a MedicalEquipment provider thatdispenses hearing aidsHearing Aid BatteriesRequires prescription.NoA pharmacy that is also a MedicalEquipment provider Yes for more than 2 nursingvisits per calendar week Yes for greater than 2prenatal visits and/or 2 postnatal visitsYes for more than 14hours/week.Home Health Care Agency PT & ST: Needed for morethan 2 visits per week OT: Needed for more than 1visit per week Certain diagnoses requireprior authorization for morethan 9 visits per calendar yearper providerHome Health Care AgencyHome Health Care: Skilled Nursing Visits at HomeCovered when medically necessary.Maternity Visits: Limited to services for pregnantwomen at high risk. Home Health Aide Visits at HomeMust provide hands-on physical care (for feeding,bathing, toileting, dressing or mobility).Custodial or homemaker/companion services arenot covered. Physical Therapy (PT), OccupationalTherapy (OT), and/or Speech Therapy(ST) Visits at HomeCovered when medically necessary.Contact Member Engagement Services: 1.800.859.9889Monday – Friday 8:00 a.m. – 6:00 p.m.Home Health Care Agency*It is the provider’s responsibility to obtain Prior Authorization4
Member Benefits – Covered Services for HUSKY A, C and DAll healthcare you receive through the HUSKY Health program must be from providers who participate in the Connecticut Medical AssistanceProgram (CMAP) network. Providers such as: pharmacies, hospitals, medical equipment companies and home care agencies must also participate inthe CMAP (HUSKY) network. Some non-participating providers can write prescriptions, order tests, or refer HUSKY members for services. However,HUSKY members may be responsible for the cost of visits or other services received from these non-participating providers. If you are unsure if yourprovider participates in HUSKY, need help finding a provider, or need more information on HUSKY benefits or services, call Member EngagementServices at 1.800.859.9889 or send us a secure email anytime.Benefit Extended Skilled Nursing Visits at Home(nursing shifts) Hospice at HomeHospice care is aimed at comfort careand relieving symptoms of terminalillness. It usually does not includetreatment aimed at cure.For inpatient hospice, see Hospice InpatientCare below Home Infusion Services at Home(Intravenous medicine at home) Nursing Visits at Home for BehavioralHealth ConditionsHospice Inpatient CareHospice care is aimed at comfort care andrelieving symptoms of a terminal illness. Itusually does not include treatment aimed atcure.Limitations*Is Prior AuthorizationRequired?HUSKY ProvidersWho Offer This CareCovered when medically necessary.YesHome Health Care AgencyHospice services are available to members whoare diagnosed with a terminal illness with a lifeexpectancy of 6 months or less.Ages Birth through 20: Members may receivetreatment aimed at cure at the same time theyare receiving hospice care.NoHome Health Care/HomeHospice AgencyAges Birth through 20: Covered when medicallynecessary.Ages 21 : Home Health Agency will teachmembers to administer their own medication.YesHome Health Care Agency/HomeInfusion CompanyContact Connecticut Behavioral Health Partnership at www.ctbhp.com or 1.877.552.8247Inpatient Hospice services are available tomembers who are diagnosed with a terminalillness with a life expectancy of 6 months or less.Yes for inpatient stays that lastlonger than 5 days.Inpatient hospice or hospice unitHospital Care: InpatientInpatient stays and doctor visits while you areinpatient are covered when medically necessary.Yes for all scheduled admissionsexcept for maternity.Hospital OutpatientCovered when medically necessary.Yes, for some surgicalprocedures.Hospital Specialized Long-term Hospital CareCovered when medically necessary.YesHospitalContact Member Engagement Services: 1.800.859.9889Monday – Friday 8:00 a.m. – 6:00 p.m.*It is the provider’s responsibility to obtain Prior Authorization5
Member Benefits – Covered Services for HUSKY A, C and DAll healthcare you receive through the HUSKY Health program must be from providers who participate in the Connecticut Medical AssistanceProgram (CMAP) network. Providers such as: pharmacies, hospitals, medical equipment companies and home care agencies must also participate inthe CMAP (HUSKY) network. Some non-participating providers can write prescriptions, order tests, or refer HUSKY members for services. However,HUSKY members may be responsible for the cost of visits or other services received from these non-participating providers. If you are unsure if yourprovider participates in HUSKY, need help finding a provider, or need more information on HUSKY benefits or services, call Member EngagementServices at 1.800.859.9889 or send us a secure email anytime.BenefitLimitations*Is Prior AuthorizationRequired?HUSKY ProvidersWho Offer This CareLaboratory ServicesCovered when medically necessary.For genetic testing onlyLaboratoryLong Term Care Skilled Nursing FacilityCovered when medically necessary.YesSkilled Nursing FacilityMaternity (prenatal, delivery andpostpartum)Breast pumpsHospital Births: No limitations.Home births: Covered when performed by aCertified Nurse Midwife.Breast pumps: Covered once the baby is born.A prescription in the mother's name is required.Childbirth/Lamaze classes: Not covered.No prior authorization requiredfor prenatal, delivery andpostpartum.Breast pumps: Only hospitalgrade breast pumps require priorauthorization.OB/GYN, Certified Nurse MidwifeMedical Equipment (for use at home)Definition: Reusable equipment that canwithstand repeated use, and is generally usedto serve a medical purpose.Includes items such as Walkers, Wheelchairs,Sleep Apnea Equipment, Breast Pumps, etc.Must be medically necessary and meet thedefinition of Medical Equipment (see Benefit).Yes, for some itemsPrimary Care Provider orSpecialist can write a prescriptionand a Medical Equipmentprovider supplies the itemsMedical SuppliesDisposable i.e. Gauze, Gloves, SyringesPrescription is required.NoPharmacyPrescription is required.Mental HealthContact Connecticut Behavioral Health Partnership at www.ctbhp.com or 1.877.552.8247NaturopathAges Birth through 20: Limited to some specificservices; covered when medically necessary.Ages 21 : Care is covered only when provided ina hospital or outpatient clinic.Yes, for greater than 5 visits perprovider per month.NaturopathNutritional CounselingNutritional counseling is covered when receivedby a physician, APRN or Physician’s Assistant aspart of an office visit or when part of a visit in aclinic or community health center.Nutritional counseling with an independentregistered dietician is not covered.NoPhysician, Advanced PracticeRegistered Nurse (APRN),Physician Assistant (when part ofa visit with a doctor or APRN);can also be provided as part ofclinic visitContact Member Engagement Services: 1.800.859.9889Monday – Friday 8:00 a.m. – 6:00 p.m.*It is the provider’s responsibility to obtain Prior Authorization6
Member Benefits – Covered Services for HUSKY A, C and DAll healthcare you receive through the HUSKY Health program must be from providers who participate in the Connecticut Medical AssistanceProgram (CMAP) network. Providers such as: pharmacies, hospitals, medical equipment companies and home care agencies must also participate inthe CMAP (HUSKY) network. Some non-participating providers can write prescriptions, order tests, or refer HUSKY members for services. However,HUSKY members may be responsible for the cost of visits or other services received from these non-participating providers. If you are unsure if yourprovider participates in HUSKY, need help finding a provider, or need more information on HUSKY benefits or services, call Member EngagementServices at 1.800.859.9889 or send us a secure email anytime.BenefitLimitations*Is Prior AuthorizationRequired?HUSKY ProvidersWho Offer This CareOrthoticsPrescription custom made supportive insertsto address conditions of the feet and anklesCovered when medically necessary.Some orthotics require priorauthorization.Podiatrist, Physical Therapist orOrthopedic DoctorPharmacyPrescription medicineOver-the-Counter medicine, vitamins andsupplementsA prescription is required even forOver-the-Counter (vitamins, medicines andsupplements) that are covered; some limits apply.Some prescriptions require priorauthorization.Call the Pharmacy Benefit Line:1.860.269.2031 for specifics.PharmacyPhysicals(see Wellness Exams)ProstheticsAn artificial device to replace a missing bodypart. The body part may be missing due totrauma, disease or congenital conditionCovered when medically necessary.Some prosthetics require priorauthorization.Contact Member EngagementServicesRehab Services: OutpatientPhysical Therapy, Occupational Therapy,Speech TherapyInpatientPhysical Therapy, Occupational Therapy,Speech Therapy(For services at home see Home Health Care)Covered.YesPhysical Therapists, OccupationalTherapists, Speech TherapistsSurgery: BariatricCovered when medically necessary.YesHospital or Surgical Center CosmeticSurgery considered to be cosmetic is not covered.YesHospital or Surgical Center InpatientCovered when medically necessary.YesHospital or Surgical Center OutpatientCovered when medically necessary.Some procedures require priorauthorization.Hospital or Surgical Center ReconstructiveCovered when medically necessary.YesHospital or Surgical CenterContact Member Engagement Services: 1.800.859.9889Monday – Friday 8:00 a.m. – 6:00 p.m.*It is the provider’s responsibility to obtain Prior Authorization7
Member Benefits – Covered Services for HUSKY A, C and DAll healthcare you receive through the HUSKY Health program must be from providers who participate in the Connecticut Medical AssistanceProgram (CMAP) network. Providers such as: pharmacies, hospitals, medical equipment companies and home care agencies must also participate inthe CMAP (HUSKY) network. Some non-participating providers can write prescriptions, order tests, or refer HUSKY members for services. However,HUSKY members may be responsible for the cost of visits or other services received from these non-participating providers. If you are unsure if yourprovider participates in HUSKY, need help finding a provider, or need more information on HUSKY benefits or services, call Member EngagementServices at 1.800.859.9889 or send us a secure email anytime.BenefitLimitations*Is Prior AuthorizationRequired? Transgender/Reassignment SurgeryTransportation to Medical AppointmentsCovered when medically necessary.Urgent Care/Walk-in (in-state)Covered when medically necessary.NoUrgent Care CentersVision Care, Eyeglasses and Contact Lenses(see also Eye Care/Glasses)Eyeglasses - Ages 21 : Some limits apply on typeof frames and lenses. Limits also apply on howoften you can get glasses. One pair of glasses canbe covered every 24 months unless a new pair ismedically necessaryBirth through 20- Some limits apply on type offrames and lenses. One pair of glasses can becovered every 24 months unless a new pair ismedically necessary or the previous pair was lost,stolen or broken.Contact lenses: Only covered for certaindiagnoses.NoOptometrist or Ophthalmologistfor vision examCovered when medically necessary.NoWellness Exams: ChildrenWellness exams for children can include:A medical history, physical exam, growthscreening, vaccines, oral screening, bloodwork, urine tests, screening fordevelopmental and/or behavioral healthissues, and information about safety.YesHUSKY ProvidersWho Offer This CareMust be transportation to receive a serviceHUSKY covers.Hospital or Surgical CenterContact Veyo at www.ct.ridewithveyo.com or 1.855.478.7350Optometrist or Optician foreyeglasses or contact lenseswhen coveredPrimary Care ProvidersFor more information, click here.Contact Member Engagement Services: 1.800.859.9889Monday – Friday 8:00 a.m. – 6:00 p.m.*It is the provider’s responsibility to obtain Prior Authorization8
Member Benefits – Covered Services for HUSKY A, C and DAll healthcare you receive through the HUSKY Health program must be from providers who participate in the Connecticut Medical AssistanceProgram (CMAP) network. Providers such as: pharmacies, hospitals, medical equipment companies and home care agencies must also participate inthe CMAP (HUSKY) network. Some non-participating providers can write prescriptions, order tests, or refer HUSKY members for services. However,HUSKY members may be responsible for the cost of visits or other services received from these non-participating providers. If you are unsure if yourprovider participates in HUSKY, need help finding a provider, or need more information on HUSKY benefits or services, call Member EngagementServices at 1.800.859.9889 or send us a secure email anytime.BenefitLimitations*Is Prior AuthorizationRequired?Wellness Exams: AdultsWellness exams for adults can include:A medical and family history, physical exam,blood pressure and cholesterol screening,hearing exam, blood work, urine screeningsfor behavioral health issues, alcohol, tobaccoand substance use, personal safety, hearthealth, nutrition and physical activity; andvaccinesCovered when medically necessary.WigsRequires prescriptionHUSKY ProvidersWho Offer This CareNoPrimary Care ProvidersNoContact Member EngagementServices at 1.800.859.9889For more information, click here.Community Health Network of Connecticut, Inc. and the HUSKY Health program comply with applicable Federal civil rights laws and do not discriminate on the basis of race,color, national origin, age, disability or sex. ATTENTION: If you speak a language other than English, language assistance services are available to you, free of charge. Call1.800.859.9889 (TTY: 711) for assistance.Español (Spanish):ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1.800.859.9889 (TTY: 711).Português (Portuguese):ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1.800.859.9889 (TTY: 711).Contact Member Engagement Services: 1.800.859.9889Monday – Friday 8:00 a.m. – 6:00 p.m.*It is the provider’s responsibility to obtain Prior Authorization9
Program (CMAP) network. Providers such as: pharmacies, hospitals, medical equipment companies and home care agencies must also participate in the CMAP (HUSKY) network. Some non-participating providers can write prescriptions, order tests, or refer HUSKY members for services. . Yes for more than 2 nursing visits per calendar week Yes .
