Things To Know About Husky And Obamacare
Medicaid, the health care program for people who are poor or have disabilities, plays a key role in expanding coverage as part of the federal health reform law.
The scope of the changes to Connecticuts Medicaid program is likely to be smaller than in many other states, because this state got a head start, expanding Medicaid shortly after the health law passed in 2010. Still, Connecticuts Medicaid program, known as HUSKY, will expand further as of Jan. 1, and existing members will see some changes.
And even people who are seeking private coverage through Access Health CT, the states health insurance exchange, might find that their children could end up in HUSKY.
Here are some key things to know about how the law commonly known as Obamacare affects Medicaid in Connecticut.
1. The four HUSKYs
How Did The Patient Protection And Affordable Care Act Increase Access To Health Insurance
The ACA uses two primary approaches to increase access to health insurance: It expands access to Medicaid, based solely on income, for those with incomes up to 138% of the federal poverty level , and creates eligibility for those with incomes from 139% to 400% FPL to apply for subsidies [in the form of advance.
Medicare Part A Vs Medicare Part B
Original Medicare consists of Medicare Part A and Medicare Part B. Medicare Part A covers hospital stays. It also provides limited nursing home coverage. Medicare Part B covers doctor visits.
Most Medicare beneficiaries have prepaid for Medicare Part A. They paid for this through their payroll taxes.
Medicare Part B currently has a premium of about 121 for most people. If your income is substantially higher than the average, you may pay more. If it is lower, your state may pay for your premium.
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Connecticut A Frontrunner In Medicaid Expansion
Connecticut is one of 38 states and DC that have expanded Medicaid coverage to childless adults through an optional component of the Affordable Care Act. .
Connecticut took a two-step approach to expansion. In 2010, the state launched its HUSKY D program by transitioning very low-income adults from the State Administered General Assistance medical program into Medicaid. In 2014, it further expanded coverage for childless adults by raising the income limit to 138% of FPL, utilizing federal funding from the ACA to increase the eligibility threshold.
In January 2014, the Kaiser Family Foundation estimated that about 286,000 people in Connecticut were uninsured. KFF also estimated that, with Medicaid expansion, about 38% of those 286,000 would qualify for either Medicaid or CHIP. In an October 2014 press release, Access Health CT estimated that 147,000 Connecticut residents were still uninsured.
Medicaid enrollment through Access Health CT was 138,908 during the first open enrollment period, but grew substantially to 277,336 during the second open enrollment period. After that, HHS stopped reporting how many people had enrolled in Medicaid through the exchanges.
But as of May 2021, 951,963 people were covered by HUSKY Health, up from 634,518 total enrollees in 2013. As noted above, this growth was driven primarily by Medicaid expansion coupled with the COVID pandemic.
Husky Health & Medicaid
- Although a HUSKY program, it is not Medicaid. Applicants under the age of 19, uninsured and in higher-income households may be eligible for HUSKY B. Applicants must be able to meet the income guidelines. Family cost-sharing may apply based on specific income level.
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How To Enroll In Medicaid In Connecticut
To apply for HUSKY A, B or D:
- Online at www.accesshealthct.com, under Get Health Coverage
To apply for HUSKY C and Medicaid for Employees with Disabilities:
- Online at www.connect.ct.gov, under Apply for Benefits
- By mail: print an application in English or Spanish and mail it to DSS ConneCT Scanning Center, P.O. Box 1320, Manchester, Connecticut 06045-1320. For help completing the form, call 1-855-626-6632.
- For long-term care benefits, complete an application in English or Spanish and submit it to the Long-Term Care Application Center for your county.
Medicare Part C And Medicare Part C
Medicare Part C can cover Hospital visits, doctors visits and usually prescription drugs. Medicare Part D covers prescription drugs. Both of these programs are private Medicare plans offered by some of the same companies that provide group health insurance through employers. Neither the federal government nor the states offer these programs. There is significant oversight from the centers for Medicare and Medicaid however.
We assist our clients by helping them understand and enroll in Medicare health plans, Medicare supplement plans and prescription drug plans. Call is if you have questions about the difference between Medicare and Medicaid
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Apply For Medicaid In Connecticut
For HUSKY A, B or D: online at accesshealthct.com, under Get Health Coverage by mail by phone at 1-855-805- 4325For HUSKY C and Medicaid for Employees with Disabilities: online at connect.ct.gov, under Apply for Benefits submit application in English or Spanish by mail to address listed below.For long-term care benefits, submit application in English or Spanish to the Long-Term Care Application Center for your county.
Eligibility: HUSKY A: Children ages 0-18 with incomes up to 196% FPL pregnant women with incomes up to 258% FPL parents of dependent children with incomes up to 155% of FPL.HUSKY B: Children up to 318% of FPLHUSKY C/MED-Connect: Aged, blind and disabled beneficiaries who meet income and asset criteriaHUSKY D: Childless adults with incomes up to 138% of FPL
Husky Health The Ct Medicaid Program
The Medicaid program is both federally and state regulated. This means that while the federal program does require certain standards across all 50 states, each state is permitted to add additional benefits and set its own eligibility standards. In Connecticut, the Medicaid program is called Husky Health.
HUSKY A is for parents and caregivers, some kids, and pregnant women. HUSKY B is for children, HUSKY C is for the disabled and elderly, and HUSKY D is for adults without kids.
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Dss: Husky D Coverage Ends 2/28 For Individuals Enrolled In
- Under federal law, HUSKY D provides Medicaid coverage for income-eligible adults without dependent children who are between the ages of 19 and 64 and not enrolled in Medicare. Our records show that you receive Medicare. Ordinarily, we would have stopped your HUSKY D coverage as soon as you became eligible for Medicare.
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Most of the Medicaid changes related to Obamacare involve HUSKY D that is, adults who dont have minor children.
2. More people will be eligible for Medicaid starting in January.
The income limit for Medicaid coverage for adults who dont have minor children will increase Jan. 1 from 56 percent of the poverty level to 138 percent. Thats expected to add 55,000 to 60,000 people to the program.
People can enroll in the expanded Medicaid program through Access Health CT, the states health insurance exchange. Since the exchange opened last week, nearly half the people who have signed up for coverage will be Medicaid clients starting in January.
The income limit for HUSKY D will still be lower than the limit for children, parents and pregnant women to receive public coverage.
3. The application for families in HUSKY will get more complicated.
Right now, most people applying for HUSKY coverage can do so on a 4-page application. The relatively short form was the result of efforts in the 1990s to keep the process of seeking coverage as simple as possible.
But that form is being replaced because, as of Jan. 1, it wont be considered enough to determine eligibility under new federal rules.
Instead, people using a paper application to apply for Medicaid coverage after Jan. 1 will need to use a longer form used to determine eligibility for both HUSKY and private coverage through the exchange. There are separate applications for individuals and families.
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What Is Access Health Ct
Access Health CT is Connecticuts official health insurance marketplace, established to meet the requirements of the Affordable Care Act , increase the number of insured residents in Connecticut, promote positive health outcomes, lower costs, and eliminate health disparities.
At Access Health CT, you can shop, compare and enroll in quality healthcare plans, qualify for financial help to lower your health insurance costs, and if eligible, enroll into free or low-cost coverage through HUSKY Health ) or the Covered Connecticut Program.
All plans offered through Access Health CT include coverage for important Essential Health Benefits such as annual checkups, prescription drugs, lab tests, and several other benefits noted below.
Access Health CT is:
- We are a marketplace that uses a single enrollment application to check your eligibility for: a Qualified Health Plan or free or low-cost coverage through HUSKY Health programs or the Covered Connecticut Program
- We are the only place where you can qualify for financial help to lower your health insurance costs, or if eligible, enroll in free or low-cost coverage through HUSKY Health programs and the Covered Connecticut Program
- We are an option for:
- Individuals or families who need health coverage options
- Individuals or families who need dental insurance coverage options
- Small businesses that need health and dental coverage for their employees
What Access Health CT isnot:
Who Can Enroll Through Access Health CT?
Changes To Connecticut Medicaid Eligibility Guidelines For Parents
In 2014, childless adults became eligible for Medicaid coverage as a result of the ACAs expansion of Medicaid. The federal government initially paid the full cost for this newly-eligible population, although the states began paying a portion of the cost in 2017, and now pay 10% of the cost . This program Medicaid expansion under the ACA is not changing.
But HUSKY A eligibility guidelines have changed for parents with dependent children. In an effort to trim costs, the state reduced the upper income limit for HUSKY A from 201% of the poverty level to 155% of the poverty level . For new enrollees, the change was effective August 1, 2015. For existing enrollees, the change became effective August 31, 2015 if they did not have earned income from a job. For those who did have earned income from a job, the new eligibility guidelines became effective August 1, 2016.
The state noted that parents who were dropped from the HUSKY A rolls had access to subsidized coverage through Access Health CT, but advocates pointed out that there are considerably higher out-of-pocket costs for private plans in the exchange than there are with Medicaid. The Connecticut Mirror reported that as of September 11, 2015, only 140 out of 800 people who had lost coverage at the end of August had enrolled in new coverage through Access Health CT.
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Medical Prior Authorizations Portal
Medical Authorization Portal support resources for providers who submit authorization requests for inpatient or outpatient care are available below.
The portal allows providers to backdate the prior authorization request up to five calendar days to accommodate for member retroactive enrollment and holidays.
To search for a member, you must use the memberâs date of birth and HUSKY Health member ID number. If the member does not display, but the member displayed in AEVS, please fax your authorization request and clinical information to 203.265.3994.
Please note: Behavioral Health inpatient authorizations should continue to be directed to CT Behavioral Health Partnership/Beacon Health Options via phone at . Behavioral Health Home Health authorizations should continue to be directed to CT BHP via ProviderConnect, an online registration application located on the âFor Providersâ homepage at www.ctbhp.com.
How Does Medicaid Provide Financial Assistance To Medicare Beneficiaries In Connecticut
Many Medicare beneficiaries receive Medicaid financial assistance that can help them with Medicare premiums, lower prescription drug costs, and pay for expenses not covered by Medicare including long-term care.
Our guide to financial assistance for Medicare enrollees in Connecticut includes overviews of these programs, including Medicaid long-term care benefits, Extra Help, and eligibility guidelines for assistance.
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Having Both Medicare And Medicaid In Connecticut
If you meet the eligibility requirements for both programs, you can benefit from both Medicare and Medicaid in Connecticut. To qualify for Medicare, you must be either above the age of 65, diagnosed with ALS or ESRD, or a SSDI beneficiary for at least 25 months. If you do qualify for both programs, you can enroll in a Dual-Eligible Special Needs Plan, or DSNP. A DSNP is a form of Medicare Advantage, which means it provides even more benefits than what Original Medicare provides. Your DSNP plan comes with very few out-of-pocket costs. Questions? Send us a message or to get started.
Medicaid Services Waivers & Fees
Some health care services are covered under Medicaid. For a full list of services covered and detailed explanations, consult the HUSKY Health Program Member Handbook. Download and/or print the handbook for your reference. HUSKY Health also includes enhanced services that have additional requirements. These benefits are below.
Community First Choice is a program in Connecticut offered to active Medicaid members. It allows individuals to receive supports and services in their home. These services include, but are not limited to, help to prepare meals and doing household chores, and assistance with activities of daily living . Go here for more information about Community First Choice and start the CFC Application online here.
Home and Community Based Services Medicaid Waivers help people who are financially and functionally eligible receive long-term Services & Supports in their homes.
Money Follows the Person Program is for Medicaid recipients in care facilities such as nursing homes, hospitals and other qualified institutions. The program can help people successfully transition back into the community.
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Important Information For Husky A Medicaid And
- Even though these Medicare beneficiaries are losing the Medicaid Husky A benefit effective August 31, 2015, they will remain on the Low Income Subsidy through December 31, 2016. Despite this coverage, they will be responsible for deductibles and co-pays of Medicare Part A and B if they do not have other coverage.
Does Medicare Pay For Medical Marijuana Or Cbd Oil
The same rules that apply to Medicaids coverage of medicinal marijuana or CBD oil also apply to Medicare. While CBD oil is technically legal at the federal level, it remains unapproved by the FDA. And Medicare and Medicaid will not cover any medications that are not FDA approved. Therefore, CBD oil is not covered by either program.
However, dronabinol and Epidiolex are both covered by Medicare Advantage and Medicare Part D. Medicare Advantage plans and Medicare Part D prescription drug plans are private insurance plans. Most Medicare Advantage plans also cover prescription drugs, and some Part D and Medicare Advantage plans may cover some over-the-counter medicines and supplies.
Find Medicare Advantage Plans In Your Area
While Medicare Advantage plans and Medicare prescription drug plans dont cover medical marijuana, some plans may cover other cannabinoids and similar treatments, depending on the plan.
To compare plans that are available where you live including the drugs that they cover you can view plan details online or call to speak with a licensed insurance agent.
Dss: Husky D Coverage Ends 2/28 For Individuals Enrolled In Medicare And Msp
Text of Letter being sent to affected individuals:
Under federal law, HUSKY D provides Medicaid coverage for income-eligible adults without dependentchildren who are between the ages of 19 and 64 and not enrolled in Medicare. Our records show thatyou receive Medicare. Ordinarily, we would have stopped your HUSKY D coverage as soon as youbecame eligible for Medicare. However, because of the COVID-19 pandemic, a change in federal rulesallowed us to temporarily extend your HUSKY D coverage even after you enrolled in Medicare. Now,following the latest federal rules, we need to end your HUSKY D coverage because you are also enrolledin the Medicare Savings Program . MSP is a Medicaid program that helps you with your Medicarecosts, such as premiums.
Because you are enrolled in both Medicare and MSP, we can no longer extend your HUSKY D coverage.Your HUSKY D coverage will end on February 28, 2022. You will stay enrolled in MSP for as long as youcontinue to qualify. You can read more about MSP at the end of this notice.
Also, because you are enrolled in Medicare, you do not qualify to enroll in and buy a Qualified HealthPlan through Access Health CT.
How did we make this decision?
What should I do if I think you made a mistake?
You can appeal our decisions about your health coverage. For example, you can appeal if you think wemade a mistake about your age or eligibility for Medicare
Medicare Services & Fees
Eligible recipients of Medicare have a choice. They may enroll into either Original Medicare or into a private health plan known as Medicare Advantage . All plans cover the same basic Medicare-covered health services, but there are differences in premiums, deductibles, coinsurance and provider networks. People should carefully consider their own situations before choosing. If their needs change, people may also change plans during the Open Enrollment period each year.
People enrolling in Original Medicare should also consider enrolling in a stand-alone Prescription Drug Plan , also known as Part D, to cover their outpatient prescription drugs. Most Medicare Advantage Plans already cover prescription drugs.
Below is more detail on coverage provided by Medicare parts A, B, C and D:
Original Medicare members can also enroll in Medicare Supplement Insurance, also called Medigap, which fills in the gaps not covered by Original Medicare. Medigap is offered by private, approved insurance companies. These plans pay for costs such as coinsurance, copayments and deductibles.
In Connecticut, a Medigap cannot be used as a stand-alone plan, and is designed to be used in combination with Parts A and B. These plans do not provide prescription drug benefits. The state offers up to 10 standardized policy options, each labeled with a letter. All plans of the same letter offer the same benefits, no matter which insurance company offers the plan.