| NAME OF INSURANCE |
ELIGIBILITY
|
DESCRIPTION
|
ADVOCACY
|
| HUSKY A
|
Children 18 and under with household income at or below 185% of Federal Poverty Level (FPL) No asset test.
|
A federal and state funded Medicaid managed care health plan administered by the Conn. Dept. of Social Services. Participants pay nothing for premiums or for health care services. Also, children on HUSKY A are eligible for EPSDT (Early, Periodic Screening, Diagnosis and Treatment) which expands the level of services covered by Medicaid.
|
Husky website
http://www.huskyhealth.com/
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HUSKY A
|
| HUSKY B HUSKY PLUS
|
Children 18 and under with household income between 186-235% of FPL for Tier 1, 236-300% of FPL for Tier 2, and above 300% FPL for Tier 3 No asset test.
|
A federal and state funded managed care health plan administered by the Conn. Dept. of Social Services; participants of Tier 1 pay no premium, but have co-pays for health care; participants of Tier 2 pay $30/month for one child with a maximum of $50/month for two or more children; participants of Tier 3 pay full cost of premium plus co-pays
|
Husky website
http://www.huskyhealth.com/
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HUSKY B |
| HEALTHY START
|
Pregnant women with household income at or below 185% of the Federal Poverty Level. No asset test.
|
Healthy Start is an expanded Medicaid program, which provides prenatal and all other medical services for pregnant women who are over income for "straight Medicaid" but whose income is at or below 185% of the FPL. |
CT Dept. of Social Services
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Healthy Start |
| HUSKY A FOR CAREGIVER RELATIVES
|
Parents or caretaker relatives who have a child/children on HUSKY A and whose income is at or below 185% Federal Poverty Level are eligible for health coverage under HUSKY A
No asset test.
|
A federal and state funded Medicaid managed care health plan administered by the Conn. Dept. of Social Services. Free health care for parents who live with child or relative care giver.
|
Husky website
http://www.huskyhealth.com/
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HUSKY A for families/Caretaker Relative |
| MEDICAID AND MEDICAID WAIVER PROGRAMS
|
| MEDICAID (also known as Title 19) |
Coverage groups: *Low income families with dependent children (TFA); *Low income elderly or disabled individuals; *Low income individuals without dependent children (SAGA/GA); *Refugees
|
Medicaid health insurance administered by the CT Dept. of Social Services. Also pays for home health care, nursing home care, and prescription medicines.
|
CT Dept. of Social Services; Statewide Legal Services
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Medicaid |
| MEDICAL SPENDDOWN PROGRAM |
No restriction except total medical bills must bring person's income down to the "medically needy income limit" set by DSS. Income/medical expenses are reviewed every six months |
Medicaid health insurance administered by the CT Dept. of Social Services. Also pays for home health care, nursing home care, and prescription medicines.
|
CT Dept. of Social Services; Statewide Legal Services
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Medical Expense Spend Down Policy |
| DEEMING WAIVER/ KATIE BECKETT WAIVER/ 2176 MODEL WAIVER
|
Waiver program enables severely disabled individuals to be cared for at home and be eligible for Medicaid based on the individual's income alone. Without the waiver, the income of legally liable relatives is counted when the individual is cared for at home.
|
There is a long waiting list for this program; however, families of severely disabled individuals who want to care for their family member at home are encouraged to add their name to the waiting list.
|
CT Dept. of Social Services Medical Utilization Review Unit
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Deeming Waiver or Katie Beckett Waiver or 2176 Model Waiver
|
| MEDICAID FOR THE WORKING DISABLED
|
People who are disabled and who are employed and paying Social Security taxes (or who have wage stubs proving earnings if not paying Social Security taxes) can earn up to $75,000 per year AND BE ELIGIBLE FOR MEDICAID. Spousal income is not counted. Single person asset limit is $10,000; Married persons limit is $15,000
|
People who are eligible under this Medicaid coverage group may be charged a premium. Maximum premium is 10% of income in excess of 200% of the Federal Poverty Level. In addition to all regular Medicaid services, people eligible for this program who are in need of personal care assistance will also receive services under the PCA Waiver Program. |
CT Dept. of Social Services; Independent Living Centers; Protection and Advocacy for Persons with Disabilities
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Medicaid for the Employed Disabled |
| BREAST AND CERVICAL CANCER COVERAGE GROUP
|
Women diagnosed with cancer or pre-cancerous conditions through the free breast and cervical cancer screening program can receive free treatment for the cancer or pre-cancer condition through a special Medicaid coverage group. No income or asset restrictions.
|
A woman qualifying under this Medicaid group is eligible for full Medicaid benefits, not only those relating to the diagnosed cancer or pre-cancer condition.
|
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Breast and Cervical Cancer Early Detection Program
|
| MEDICARE RELATED:
|
| MEDICARE
|
People aged 65 and older, and disabled individuals under age 65, and people with End-Stage Renal Disease (permanent kidney failure)
|
Federal program administered by the U.S. Dept. of Health and Human Services pays for acute care; hospital care (Part A); medical insurance (Part B); and prescription drugs (Part D). Deductibles and co-payments apply to some of the benefits. Some medical expenses, such as prescription drugs, dental care, and routine physicals, are not covered at all.
|
Center for Medicare Advocacy
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Medicare |
| MEDIGAP INSURANCE
|
Anyone who has Medicare.
|
Privately puchased insurance policies to supplement benefits available through Medicare Parts A and B . There are 12 standard Medigap plans, designated by letters A through L; Plan A is the basic benefit package and each of the other 11 plans include the basic package with a different combination of additional benefits
|
Center for Medicare Advocacy
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Medigap |
| MEDICARE MANAGED CARE
|
People who are on Medicare and sign up for a Medicare managed care plan.
|
Medicare Managed Care plans use a network of health care providers and facilities and a system of prior approval from a primary care physician, a gatekeeper, to achieve these goals. In Connecticut, most plans now require a monthly premium, especially if there is a prescription drug benefit associated with the plan. Each plan requires co-payments for doctor’s visits and other services. There is still a premium for Part B, but no deductible or coinsurance as there was with original Medicare coverage. |
Center for Medicare Advocacy; CHOICES Program
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Benefits Assistance * Medicare Beneficiaries
or search by program name:
Choices Program |
| OTHER:
|
| CADAP - CONNECTICUT AIDS DRUG ASSISTANCE PROGRAM
|
Person with HIV or AIDS; Net countable income must be at or below 400% Federal Poverty Level; No asset limit; Must first apply for Medicaid and SAGA Medical
|
Prescription drug program helps people living with HIV/AIDS pay for federally approved HIV antiretroviral drugs and drugs which prevent opportunistic infections associated with HIV/AIDS.
|
CT Dept of Social Services
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CADAP |
| CONNPACE - CONNECTICUT PHARMACEUTICAL ASSISTANCE CONTRACT TO THE ELDERLY AND DISABLED
|
Age 65+ or disabled age 18+; Income restrictions; Asset restrictions; Must be a resident of Conn. for 6 months prior to date of application. People who have health insurance are eligible for ConnPACE when their prescription benefit has been exhausted for the year.
|
Prescription drug program helps elderly or disabled people pay for prescriptions. ConnPACE "wraps around" Medicare Rx, and ConnPACE recipients must enroll in a Medicare Prescription Drug Plan. ConnPACE pays Medicare Rx premiums, and covers prescriptions through deductibles and coverage gaps. ConnPACE also pays for drugs not on a Medicare plan's formulary and all excluded drugs. |
CT Dept of Social Services
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Connpace
|
| PRIVATE INSURANCE/ MANAGED CARE PLANS/ FEE-FOR-SERVICE PLANS/ INDEMNITY PLANS |
No restriction
|
Health insurance purchased privately or through one's employer.
|
Office of Healthcare Advocate
website: www.ct.gov/oha/site/default.asp
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Office of the Healthcare Advocate |
