HUSKY Covered Services and Managed Care Networks in Connecticut: ASOs, Providers, and Benefits (2026)

HUSKY enrollees in Connecticut have access to a comprehensive set of medical, dental, behavioral health, and supportive services that is among the broadest in the country. The state’s unique ASO model means there is no MCO ‘menu’ to navigate — enrollees do not have to choose between competing insurance companies as they would in many other Medicaid states. Instead, a single network of HUSKY-enrolled providers serves all enrollees, administered by specialized ASOs for each service category. This guide explains exactly what HUSKY covers in 2026, how to find providers in each network, and what to do when access to a needed service is denied.

The Connecticut ASO Model: Why It’s Different

Most state Medicaid programs use Managed Care Organizations (MCOs) — competing private insurance companies (Anthem, UnitedHealthcare, Centene, Molina, etc.) that contract with the state to manage Medicaid benefits for assigned populations. The MCO is paid a per-member-per-month capitation by the state and bears the risk of cost overruns; the enrollee chooses which MCO to join (often during a 30-day choice period after eligibility determination); and providers contract separately with each MCO. The model creates competition among MCOs and gives the state predictable per-capita costs but adds complexity for enrollees who must select an MCO and ensure their providers are in that MCO’s network.

Connecticut tried the MCO model from 1995 to 2012 and concluded that it was not delivering the expected savings or quality improvements. In 2012, Connecticut transitioned all HUSKY enrollees to an ASO model under the Connecticut Behavioral Health Partnership (for behavioral health) and the Person-Centered Medical Home initiative (for medical services). Under the ASO model, DSS pays providers directly through fee-for-service claims processing administered by specialized ASOs that manage utilization, prior authorization, provider relations, member services, and quality improvement. The state bears the cost risk; the ASOs are paid administrative fees, not capitation. There is no MCO choice — every HUSKY enrollee uses the same network of enrolled providers.

Sources: CT HUSKY Health, CHNCT

The current ASO administrators in 2026 are: Community Health Network of Connecticut (CHNCT) for medical services and care management; Carelon Behavioral Health (formerly Beacon Health Options, acquired by Elevance/Anthem in 2023) for mental health and substance use disorder services; the Connecticut Dental Health Partnership (CTDHP, administered by BeneCare) for dental services; and Veyo (a Modivcare company) for non-emergency medical transportation. Each ASO operates a member services phone line, a provider directory, and a clinical authorization unit specific to its service category. Enrollees with questions about medical services call CHNCT; questions about behavioral health call Carelon; questions about dental call CTDHP; and transportation arrangements go through Veyo.

Medical Services Covered Under HUSKY

HUSKY A, C, and D medical coverage includes essentially all medically necessary care without categorical exclusions. Specifically covered services include: inpatient hospital care (including labor and delivery, surgical, medical, psychiatric, substance use disorder); outpatient hospital care (including emergency department, observation, surgery, infusion); primary care physician visits; specialist physician visits (cardiology, endocrinology, gastroenterology, neurology, oncology, etc.); preventive care including immunizations, cancer screenings (mammography, colonoscopy, prostate-specific antigen), and the ACA-mandated preventive services without cost-sharing; diagnostic imaging (X-ray, ultrasound, CT, MRI, PET); laboratory testing; durable medical equipment (wheelchairs, walkers, hospital beds, CPAP, glucose monitors); home health care including skilled nursing and home health aide visits; physical therapy, occupational therapy, speech therapy; podiatry; and reproductive health services including all forms of FDA-approved contraception with no cost-sharing.

Several services have specific coverage rules or quantity limits that providers and enrollees should understand. Chiropractic care is covered with a 30-visit annual limit for adults (no limit for children under EPSDT). Adult dental beyond emergency extractions is limited (with full coverage for children — discussed below). Cosmetic procedures and elective procedures without medical necessity are not covered (e.g., elective LASIK, cosmetic dermatology, breast augmentation for cosmetic purposes). Bariatric surgery is covered with extensive prior authorization including a documented 6-month medically supervised weight loss attempt, behavioral health evaluation, nutritional counseling, and BMI thresholds. Fertility services are covered under specific circumstances (artificial insemination is covered; in-vitro fertilization is generally not covered under HUSKY). Plastic surgery and reconstructive surgery are covered when medically necessary (post-mastectomy reconstruction, burn reconstruction, congenital deformity correction).

Sources: CT Medicaid Coverage Policies

HUSKY A and D have no copays or coinsurance for covered services. HUSKY B has limited copays in Bands 2 and 3 (for prescription drugs and a $100 inpatient hospital copay; no copays in Band 1). HUSKY C has no copays for covered services. There are no annual or lifetime benefit caps on most services for HUSKY A, C, and D; HUSKY B has a $5,000 annual durable medical equipment cap. The breadth of coverage and absence of cost-sharing make HUSKY substantially more comprehensive than most commercial health insurance plans, particularly for adults with complex medical needs.

Behavioral Health: Mental Health and Substance Use

HUSKY behavioral health is administered by Carelon Behavioral Health (formerly Beacon Health Options) under the Connecticut Behavioral Health Partnership (CT BHP). Carelon manages the prior authorization, network management, utilization review, and quality oversight for mental health and substance use disorder services. The network includes over 11,000 individual mental health and substance use providers and over 200 community mental health centers, residential programs, intensive outpatient programs, and inpatient psychiatric facilities across Connecticut. The Mental Health Parity and Addiction Equity Act (MHPAEA) applies fully to HUSKY behavioral health, meaning there are no greater limitations on behavioral health services than on medical services.

Sources: CT Behavioral Health Partnership

Covered behavioral health services include: outpatient psychotherapy (individual, family, group); psychiatric medication management; intensive outpatient programs (IOP) for both mental health and substance use disorder; partial hospitalization programs (PHP); inpatient psychiatric care (acute crisis stabilization, longer-term inpatient when medically necessary); residential substance use disorder treatment; medication-assisted treatment (MAT) for opioid use disorder including methadone, buprenorphine/naloxone (Suboxone), and naltrexone (Vivitrol); detoxification (medical detox in a hospital or detox facility); peer support services; case management; and crisis intervention services including mobile crisis response through 988 and the Connecticut crisis services system.

Connecticut’s HUSKY behavioral health benefit is among the most comprehensive in the country, particularly for substance use disorder treatment. The state has expanded medication-assisted treatment availability, eliminated prior authorization for buprenorphine prescribing, and integrated behavioral health into primary care through the Connecticut Behavioral Health Partnership’s Collaborative Care model. The COVID-era expansions of telehealth behavioral health (effective 2020, made permanent in 2024) allow Connecticut residents to access mental health and substance use treatment from home, with no requirement for in-person visits unless clinically necessary. This is particularly valuable for residents in geographic areas with limited behavioral health provider density.

Prescription Drug Coverage

HUSKY prescription drug coverage is administered directly by DSS using the Connecticut Medicaid Preferred Drug List (PDL) — Connecticut does not use a Pharmacy Benefits Manager (PBM) like CVS Caremark, Express Scripts, or OptumRx. Drugs on the PDL are covered without prior authorization; non-preferred drugs require prior authorization (PA) demonstrating medical necessity. The PDL is updated quarterly by the DSS Pharmacy and Therapeutics Committee based on clinical evidence and cost considerations. Approximately 95% of commonly prescribed drugs are on the PDL.

Sources: CT Medicaid PDL

HUSKY A, C, and D have no prescription drug copays. HUSKY B has small copays in Bands 2 and 3 ($1–$3 for generics, $3–$5 for brand-name; capped at 5% of household income annually). Specialty medications (biologics, biosimilars, oncology drugs, hepatitis C cures, HIV antiretrovirals, cystic fibrosis modulators, multiple sclerosis drugs) are covered through the same PDL/PA framework. Specialty drugs are typically dispensed through specialty pharmacies that coordinate with the prescriber for prior authorization, dose preparation, and patient counseling.

Connecticut has implemented several federal and state programs to manage prescription drug costs while maintaining access. The state participates in the federal Medicaid Drug Rebate Program, receiving manufacturer rebates that reduce net drug costs. The state operates the Connecticut Generic Drug Substitution rule requiring generic substitution unless the prescriber writes ‘brand medically necessary’ (the rule has the standard Medicaid one-step approval process). The state participates in the 340B Drug Pricing Program through eligible safety-net providers. And the state administers Connecticut’s portion of the federal Maintenance Drug Co-Pay program for select chronic-condition medications.

Dental Coverage Through CTDHP/BeneCare

Connecticut Dental Health Partnership (CTDHP), administered by BeneCare, provides dental coverage for all HUSKY enrollees. Pediatric dental coverage (under 21) is comprehensive and includes: preventive services (cleanings, exams, fluoride, sealants); restorative services (fillings, crowns); endodontics (root canals); periodontics (gum treatment); oral surgery (extractions including third molars when medically necessary); orthodontics for medically necessary cases (typically severe malocclusion meeting the Salzmann index or similar clinical criteria); and prosthodontics (dentures, partial dentures, when medically necessary).

Sources: CT Dental Health Partnership

Adult dental coverage under HUSKY is more comprehensive than in many state Medicaid programs. Covered services for adults include: preventive services twice per year (cleanings, exams, X-rays); restorative services (fillings, crowns including molar crowns); endodontics (root canals on most teeth); extractions; periodontal scaling and root planing; and dentures and partial dentures including replacement at appropriate intervals. Cosmetic dentistry (whitening, veneers for cosmetic purposes, orthodontics for cosmetic purposes in adults) is not covered. Implants are covered only in specific medical-necessity cases (typically post-trauma or congenital tooth absence).

The HUSKY dental provider network has historically been narrower than the medical network because dental reimbursement rates have not always been competitive with private insurance. Connecticut implemented several dental network improvements in the past five years including reimbursement-rate increases and a dental access initiative through CTDHP/BeneCare. Finding a dentist accepting new HUSKY patients is easier in 2026 than it was in prior years, particularly in urban centers. The CTDHP member services line (1-866-420-2924) can assist with finding network providers and resolving access issues.

Vision, Hearing, and Other Specialty Services

Vision coverage under HUSKY includes annual comprehensive eye exams for children (under 21) with eyeglasses (frames and lenses) covered annually; biennial exams for adults with eyeglasses covered every two years. Contact lenses are covered when medically necessary (for example, post-surgical, keratoconus, or when eyeglasses cannot correct vision adequately). Vision therapy and orthoptic exercises are covered when medically necessary. LASIK and other refractive surgery for cosmetic purposes are not covered. Connecticut has expanded the vision provider network through arrangements with major optometry chains (Walmart Vision Centers, Visionworks, Pearle Vision, LensCrafters) in addition to independent optometrists and ophthalmology offices.

Hearing coverage under HUSKY includes hearing exams and hearing aids for both children and adults with documented hearing loss. The benefit covers one set of hearing aids every five years for adults, with more frequent replacement covered for children under EPSDT or when medically necessary (audiology assessment indicates change in hearing requires new aids). Cochlear implants are covered when medically necessary, including the device, surgery, and habilitation/rehabilitation services post-implant. Connecticut Medicaid hearing aid coverage is more generous than most commercial health insurance plans, which typically exclude hearing aids entirely or cap coverage at $1,000–$2,000 per ear.

Other covered specialty services include podiatry (foot care for diabetics including diabetic shoe inserts and orthotics, routine foot care for individuals with vascular disease, surgery as medically necessary); chiropractic (30 visits/year for adults); acupuncture (covered for chronic pain in specific conditions with prior authorization); nutritional counseling (covered for diabetes, eating disorders, and other medical conditions); diabetes education and management (covered including continuous glucose monitors for type 1 diabetics and type 2 diabetics on insulin); and breast pump rental or purchase for nursing parents.

Non-Emergency Medical Transportation Through Veyo

Non-Emergency Medical Transportation (NEMT) is a federal Medicaid requirement that covers transportation to and from medical appointments for enrollees who cannot transport themselves. Connecticut administers NEMT through Veyo (a Modivcare company). NEMT covers transportation by personal vehicle (with mileage reimbursement to a friend, family member, or volunteer driver), taxi, rideshare (Uber/Lyft via Veyo arrangement), wheelchair-accessible van, and ambulance (for medically necessary non-emergency ambulance transport). The transportation must be to a Medicaid-covered medical service at an in-network or covered provider.

Sources: Veyo CT NEMT

Booking NEMT through Veyo requires advance reservation, typically 48–72 hours before the medical appointment. The Veyo Connect mobile app allows enrollees to book, modify, and track rides; the Veyo member services line (1-855-478-7350) handles bookings for enrollees without smartphone access. Urgent same-day NEMT is available for medically necessary visits when 48-hour advance notice is not possible. Repeated no-shows can result in suspension of NEMT services, though Veyo and CHNCT work with enrollees to address barriers to appointment attendance.

NEMT is one of the most underused HUSKY benefits in Connecticut. Many enrollees do not know the benefit exists and either skip needed appointments due to transportation barriers or rely on family members for rides. The benefit is especially valuable for enrollees in rural Connecticut counties (Litchfield, Windham, parts of Tolland) where public transit is limited and medical specialists may be 30–60 minutes from home. Brokers, navigators, and HUSKY case managers can help enrollees set up NEMT and resolve any access issues.

EPSDT: The Federal Entitlement for Children

Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) is the federal Medicaid entitlement for all enrollees under 21. EPSDT requires Medicaid to cover all medically necessary services for children, regardless of whether those services are included in the state’s Medicaid state plan. The EPSDT mandate is broader than commercial insurance coverage and broader than HUSKY B (CHIP) coverage — for example, EPSDT covers Applied Behavior Analysis (ABA) therapy for autism spectrum disorder without the annual or lifetime caps that commercial plans often apply; EPSDT covers in-home nursing for medically fragile children; EPSDT covers developmental therapy services beyond the standard physical/occupational/speech therapy benefit when medically necessary.

Sources: CMS EPSDT

EPSDT applies to HUSKY A children but not to HUSKY B children (because CHIP is a separate program from Medicaid). This is the practical reason that families with children who have significant medical needs should explore HUSKY A eligibility before defaulting to HUSKY B — the EPSDT benefit can mean the difference between full coverage of ABA therapy or in-home nursing and the cap or denial under HUSKY B.

Accessing EPSDT services often requires advocacy because providers and ASO clinicians may default to the standard state plan benefit limits. The EPSDT advocacy process typically involves a written request for the specific service citing EPSDT entitlement, clinical documentation of medical necessity, and if denied, an appeal through the CHNCT medical necessity review and the DSS Fair Hearing process. Connecticut Legal Services and the Center for Children’s Advocacy (Connecticut nonprofit) provide free assistance to families pursuing EPSDT appeals.

Sources: Center for Children’s Advocacy

Long-Term Services and Supports

HUSKY C LTSS covers a comprehensive set of long-term care services for enrollees meeting both financial eligibility (income, assets — see the HUSKY C Asset Rules article in this series) and clinical eligibility (functional assessment indicating need for nursing-facility-level care). Covered LTSS includes: nursing facility care (private-pay rate approximately $14,500–$17,200/month; Medicaid rate negotiated by the state); assisted living waiver services (Connecticut Home Care Program for Elders); Personal Care Attendant (PCA) waiver services; adult day health programs; home health aide services; meal delivery (Meals on Wheels through area Senior Centers); homemaker services; and durable medical equipment specific to LTSS such as hospital beds, lift chairs, wheelchair ramps for the home, and home modifications for accessibility.

Connecticut has progressively shifted LTSS funding from institutional care (nursing facilities) toward home and community-based services through the Money Follows the Person (MFP) demonstration and the rebalancing effort that began in 2008. As of 2025, approximately 53% of Connecticut LTSS Medicaid funding goes to HCBS and 47% to nursing facility care — a substantial rebalancing from the pre-2008 ratio of approximately 25% HCBS to 75% nursing facility. The rebalancing reflects both consumer preference for aging in place and the lower per-month cost of HCBS compared to nursing facility care.

Sources: Money Follows the Person

The Connecticut Home Care Program for Elders (CHCPE) is the primary HCBS waiver for individuals 65+. CHCPE provides home health aide services, homemaker services, adult day health, personal care, and care management to individuals who would otherwise require nursing facility placement. Enrollment requires both financial eligibility (HUSKY C with income up to 300% SSI FBR) and clinical eligibility (UAS assessment indicating nursing-facility level of care). The PCA waiver provides similar services for adults 18–64 with physical disabilities. Other HUSKY C waivers include the Acquired Brain Injury waiver, the Mental Health waiver, and the Autism waiver, each with population-specific clinical criteria.

Finding HUSKY Providers in Connecticut

The HUSKY provider directory is maintained by CHNCT and accessible online at huskyhealth.com. The directory allows search by provider type (primary care, specialist, hospital), location, and language spoken. The CHNCT member services line (1-800-859-9889) can assist with provider searches and with finding providers accepting new HUSKY patients. For behavioral health providers, the Carelon Behavioral Health directory is accessible at ctbhp.com or by calling 1-877-552-8247. For dental providers, the CTDHP directory is at ctdhp.org or 1-866-420-2924. For vision providers, the directory is integrated with the medical directory.

HUSKY provider access varies by geographic area and specialty. Primary care, behavioral health, and dental access is generally good throughout Connecticut, with the major exceptions being rural areas with limited provider density (parts of Litchfield and Windham counties) and high-demand specialties with limited capacity statewide (developmental pediatrics, child and adolescent psychiatry, geriatric psychiatry, certain orthopedic subspecialties). For high-demand specialties, wait times can extend to 8–16 weeks even for HUSKY-enrolled providers; engaging a HUSKY case manager (through CHNCT) or working with a Federally Qualified Health Center can help shorten the wait by accessing alternative providers or telehealth options.

Federally Qualified Health Centers (FQHCs) are a particularly important resource for HUSKY enrollees. Connecticut has 17 FQHC organizations operating over 250 service sites across the state. FQHCs include Community Health Center Inc. (multiple Connecticut sites), Charter Oak Health Center (Hartford), Cornell Scott Hill Health Center (New Haven), Optimus Health Care (Fairfield County), and Generations Family Health Center (eastern Connecticut). FQHCs provide integrated primary care, behavioral health, dental, and pharmacy services under one roof, with sliding-scale fees for uninsured patients and full HUSKY acceptance. FQHCs also serve as the primary care medical home for many HUSKY enrollees and coordinate referrals to specialists.

Prior Authorization and Coverage Appeals

Prior authorization (PA) is required for higher-cost services and for services with utilization-management criteria. Common services requiring PA include: inpatient hospital admissions (except emergency); high-cost imaging (PET, MRI of certain anatomic regions); non-formulary prescription drugs; specialty drugs (biologics, biosimilars); durable medical equipment over a threshold cost; home health services beyond a defined number of visits; physical/occupational/speech therapy beyond defined visit caps; bariatric surgery; certain orthopedic procedures (spinal fusion, total joint replacement); and out-of-network specialty referrals.

PA requests are submitted by the provider, not the patient. The provider sends clinical documentation to CHNCT (for medical) or Carelon (for behavioral health) and receives a decision within 14 days for standard requests and 72 hours for urgent requests. If approved, the service is covered as billed. If denied, the provider receives a written explanation including the clinical reason for denial and the appeal process. The enrollee receives a copy of the denial notice with appeal rights.

Appeals of PA denials proceed through three levels. First, the provider or enrollee can request a Reconsideration by the ASO clinical reviewer (CHNCT or Carelon), typically completed within 30 days. Second, if the Reconsideration is denied, the enrollee can request a DSS Fair Hearing within 60 days of the Reconsideration decision; the Fair Hearing is conducted by an administrative law judge from the DSS Office of Legal Counsel. Third, after exhausting administrative remedies, the enrollee can file a court action in Connecticut Superior Court. For services that are time-sensitive, the enrollee can request an Expedited Fair Hearing, which is scheduled within 14 days. Continuation of benefits during appeal is available if the appeal is filed within 10 days of the denial — the service continues pending the appeal outcome, with possible recovery if the appeal is ultimately denied.

Sources: DSS Fair Hearings

Frequently Asked Questions