Cost and Coverage of Medicaid in Connecticut

How much is Medicaid in Connecticut? In order to understand Medicaid cost estimates, you must review what services are covered by Medicaid, and which ones are not. The types of Medicaid insurance through HUSKY Health are clear indicators on what is and what is not covered by Medicaid. Since there are four categories of Medicaid coverage in Connecticut (Husky A, Husky B, Husky C and Husky D), there are certain Medicaid services that are always taken care of on the patient’s behalf, and others that will require out-of-pocket payments.

Read more information on the costs and Medicaid coverage in CT through the following topics:

  • What is covered by Medicaid in Connecticut?

  • What does Medicaid not cover in Connecticut?

  • How much does Medicaid cost in Connecticut

What is covered by Medicaid in Connecticut?

Most types of Medicaid insurance cover the same services and equipment. However, because Medicaid varies slightly from state to state, applicants need to review the specifics on what services are covered by Medicaid in order to find out if the state medical assistance program suits their needs. Connecticut Medicaid coverage handles a wide variety of services and equipment on behalf of eligible beneficiaries. This includes:

  • Prescription drugs and lab services.

  • Mental health services, behavioral health treatment and substance abuse disorder services.

  • Hospitalization and emergency services.

  • Outpatient services (ambulatory).

  • Chronic disease management.

  • Durable medical equipment

  • Preventive and wellness services.

  • Maternity care and newborn care.

  • Occupational therapy and physical therapy.

  • Vision care

In addition, Medicaid services related to dental are offered through a state partnership with complying dentists. This includes Medicaid coverage for both children and adults who are eligible for Connecticut Medicaid. These services include: exams, X-rays, dentures (full), root canals for front teeth, fillings, teeth cleanings, treatments with fluoride, crowns that are prefabricated and other dental procedures that are deemed medically necessary for the patient. Note that this program does not include orthodontia and other procedures that are considered cosmetic.

Still, what is covered by Medicaid in CT for elderly and terminally ill patients includes: in-home health aides, hospice services and palliative care services.Children with disabilities may qualify for additional Medicaid services under Connecticut’s state-sponsored medical assistance program. A case worker can help you, and family members, gain access to services to which you are entitled.

Note that if you do not qualify for HUSKY Health, you may qualify for Family Planning Services in Connecticut. This program is of no cost to you, even if you have private health insurance.

What does Medicaid not cover in Connecticut?

Connecticut Medicaid services are expansive, but there are several services and equipment subsets that are not included in CT Medicaid coverage. Those items and services considered what is not covered by Medicaid include experimental treatments, holistic remedies and treatments considered as chiropractic care.

In addition, CT Medicaid coverage does not include cosmetic surgeries, including Botox injections, liposuction and tummy tuck. Furthermore, orthodontics, tooth veneers and teeth whitening treatments are also not considered acceptable Medicaid services. A Medicaid recipient who is interested in such procedures will be expected to pay out of his or her pocket for such procedures. In some cases, cosmetic surgeries will be covered if they are associated with an accident or as a part of a package for those who have lost a great deal of weight through bariatric surgeries. It is important to check with your health care providers regarding your Medicaid coverage level before having any such procedures performed.

What is covered by Medicaid in CT is based on medical necessity. Therefore, any services that are not deemed medically necessary will not be covered by your state-funded Medicaid coverage policy. Note that “medical necessity" may be assessed on a case-by-case basis.Use of out-of-network doctors may also cause you to receive medical bills for part or all of your health care service costs. This can extend to laboratory costs, as well. It is important to check with your doctors prior to appointments to ensure they are still accepting HUSKY Health, and that they use laboratories that also accept your types of Medicaid insurance in CT.

How much does Medicaid cost in Connecticut?

How much is Medicaid, and how do you figure out Medicaid cost estimates in CT? While Connecticut offers an expansive array of services with its HUSKY Health program for both children and adults, there are premiums attached in some cases. Connecticut has the fourth-highest health insurance premiums, per capita, in the country. While many Medicaid recipients will qualify for full Medicaid coverage, and thus will not need to pay any health care premiums, some recipients will not meet the threshold for free Medicaid services, and will need to pay health care premiums to ensure they have health coverage.

How do you estimate Medicaid costs for premiums? Medical policy premiums can range between $14 per month up to $60 per month, depending on individual circumstances. Currently, students at UConn and other state-run universities do not qualify for Medicaid, even if their incomes currently meet threshold requirements. However, students at UConn and other State-run schools may qualify for school-sponsored health care programs that offer lower premiums in comparison to the state’s marketplace policies. Currently, UConn-sponsored insurance programs offered to graduate students cost $1,200 for the year.

While Connecticut Medicaid coverage helps ensure low-income families that are not financially responsible for emergency medical care, you must remember that doctors may require copays at the time of rendering Medicaid services, and that not all doctors accept HUSKY Health as part of their medical insurance coverage.

Further information regarding medical premiums, coverage costs, and copays can be accessed via the designated HUSKY Health hotline number. Additionally, qualified caseworkers, social workers and community partners may be able to answer any pricing questions you may have.



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