Connecticut’s Medicaid program, HUSKY Health, provides low-income residents with access to healthcare, including mental and behavioral services. HUSKY Health includes several plans: HUSKY B (CHIP/SCHIP) and HUSKY A, C, and D, which are Medicaid plans offering coverage based on income, age, family size, and medical needs.
Connecticut’s Behavioral Health Partnership (CT BHP), a collaboration of the Department of Children and Families, the Department of Social Services, and the Department of Mental Health and Addiction Services, works with HUSKY Health to provide mental health services, including therapy, psychiatric care, and substance abuse support.
For Connecticut residents seeking therapy or behavioral health services, understanding how HUSKY Health covers mental health is crucial. This article provides an overview of HUSKY Health’s mental health benefits, eligibility, and service access.
Key takeaways
- To qualify for mental health services under HUSKY Health, you must be a legal resident of Connecticut, meet certain income thresholds, and the service must be deemed “medically necessary.”
- HUSKY Health covers individual psychotherapy, online therapy, family therapy, group therapy, outpatient and inpatient services, therapy for substance use disorders, and higher levels of care.
- Generally, there are no co-pays for therapy or psychiatric services under HUSKY A, C, or D. However, some plans may impose limits on the number of therapy sessions or inpatient days covered.
- HUSKY Health Medicaid offers additional mental health services for specific populations, ensuring that vulnerable groups have access to the care they need. This includes children and adolescents, pregnant women, seniors, people with disabilities, and individuals with both mental illness and substance use disorders.
Who is eligible for therapy under HUSKY Health Medicaid?
To qualify for mental health services under HUSKY Health, individuals must meet specific eligibility criteria based on factors like income, residency, and specific health needs. Here’s a breakdown of the eligibility requirements.
Residency
An individual must be a legal resident of Connecticut to qualify for any HUSKY Health plan. This includes U.S. citizens, naturalized citizens, lawful permanent residents (LPRs), and other people such as refugees, asylum seekers, and valid non-immigrants who meet federal and state residency requirements.
Income thresholds
Eligibility for HUSKY Health is based largely on household income, which is calculated as a percentage of the federal poverty level (FPL) and varies across different HUSKY plans:
HUSKY A: Primarily covers low-income families with children, as well as pregnant women. To qualify, individuals must have a household income at or below a specific percentage of the FPL. The amount changes from year to year, according to federal guidelines. You can find the latest income limits on the HUSKY Health Connecticut website.
HUSKY C: Focuses on low-income seniors and individuals with disabilities. This plan has more specific income and asset limits, often aligned with Supplemental Security Income (SSI) eligibility and Medicare.
HUSKY D: Offers Medicaid coverage for low-income adults aged 19-64 without dependent children. Similar to HUSKY A, individuals must meet certain income requirements to be eligible for this plan.
Determining medical necessity
In order for Medicaid to cover mental health services, the services must meet the “medical necessity” criteria, meaning the therapy or treatment is essential for an individual’s health. Here’s how it works:
- Provider evaluation: A licensed mental health professional, such as a therapist or psychiatrist, evaluates the individual’s symptoms to determine if services are medically necessary, followed by a diagnosis and treatment plan.
- Documentation: The provider documents the need for therapy, explaining how it will reduce symptoms or improve functioning. Medicaid requires this to justify treatment.
- Prior authorization: The mental health provider submits a prior authorization request, including treatment plan details, to Connecticut Behavioral Health Partners. In some cases, this may happen after the first appointment — such as when a therapist has an intake appointment with a client.
- Follow-up assessments: Medical necessity is reviewed regularly, especially for long-term or inpatient care, with follow-up assessments to determine if continued therapy or adjustments are needed.
Services considered medically necessary by a qualified provider are covered under HUSKY Health. This ensures that beneficiaries receive support tailored to their specific mental health needs.
What therapy and behavioral health services are covered by HUSKY Health?
HUSKY Health supports several types of mental health care:
Individual psychotherapy
Individual therapy is an important part of HUSKY Health’s mental health coverage, helping with conditions like anxiety, depression, ADHD, and bipolar disorder. Licensed clinicians, such as licensed clinical social workers (LCSWs) and professional counselors, use approaches like cognitive behavioral therapy (CBT) and psychodynamic therapy in one-on-one sessions.
They aim to develop coping skills, boost self-esteem, and manage mental health challenges. In Connecticut, residents can access individual therapy through in-person therapy or online therapy (also known as telehealth or virtual therapy).
HUSKY Health Medicaid also offers coverage for individuals with more intensive needs. These include trauma-focused cognitive behavioral therapy (TF-CBT), dialectical behavior therapy (DBT), and eye movement desensitization and reprocessing (EMDR).
These therapies are effective for treating PTSD, personality disorders, and other issues arising from trauma or emotional difficulties. They can also assist those dealing with postpartum depression, depressive episodes, and anxiety from life changes.
Online therapy
HUSKY Health Medicaid covers online threrapy, also known as teletherapy or telehealth, in the same way it covers in-person therapy. As long as the provider you want to see offers services online, your same coverage will apply (including medical necessity requirements). This flexibility makes it easier for individuals to access mental health support in a way that best suits their schedules, transportation, and comfort levels.
Family therapy
HUSKY Health offers coverage for family therapy aimed at enhancing communication, resolving conflicts, and strengthening relationships. Several types of mental health care providers, such as licensed marriage and family therapists (LMFTs) licensed clinical counselors (LCSWs) and psychologists work with familes and couples on concerns, including life transitions, substance use disorders, family dynamics, and other relationship challenges. They also support families with adolescent behavior issues, parenting challenges, and conflicts impacting mental health.
These counseling services offer support for adolescents and young adults facing challenges like eating disorders, ADHD, and self-esteem issues, while also providing additional family support. Moreover, they address transitional challenges at various life stages, such as dating, marriage, parenting, and the experience of empty nesting.
Group therapy
Group therapy is a covered service that offers a supportive space to tackle mental health challenges with people who are dealing with similar issues. Licensed psychologists and counselors lead sessions to encourage peer support and teach coping strategies. This environment is especially helpful for building resilience, particularly for those recovering from substance use disorders or managing chronic conditions like obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).
Higher levels of care
When it comes to more chronic mental health conditions like schizophrenia or bipolar disorder, psychiatrists or psychologists may be necessary in addition to an individual’s therapist, since these conditions require both medication and therapy. These specialized programs are vital for vulnerable populations, ensuring they get the holistic care needed to improve their mental health and overall well-being.
Outpatient and inpatient services
HUSKY Health Medicaid covers intensive outpatient programs (IOPs) and inpatient behavioral health services, enabling recipients to receive the appropriate level of care for them. This includes both outpatient, such as weekly psychotherapy, and inpatient services, such as hospitalization.
Inpatient services offer around-the-clock care in hospitals or psychiatric facilities for individuals requiring intensive support, such as those at risk of self-harm or experiencing severe mental health crises. These services are focused on stabilization and treatment, and typically include assessment, medication management, and group therapy. HUSKY also covers IOPs and partial hospitalization for those not requiring full hospitalization, offering an intermediate level of care.
Substance use disorder services
HUSKY Health Medicaid offers mental health and substance use disorder (SUD) support through therapy, counseling, detox, rehab, and medication-assisted treatment. It includes counseling for coping skills, detox and rehab for recovery, and medication-assisted treatment for opioid and alcohol dependencies. The program also provides recovery coaching and peer support, linking clients to in-network resources for continued wellness.
Costs and coverage limits for mental health care with HUSKY Health
HUSKY Health offers mental health services with minimal financial burden. Generally, there are no co-pays for therapy or psychiatric services under HUSKY A, C, or D. However, some plans may impose limits on the number of therapy sessions or inpatient days covered.
For those who exceed these coverage limits, sliding scale fees or additional financial support may be available through other state-funded programs. It’s important to discuss any financial concerns with HUSKY Health during the before beginning treatment.
Step-by-step guide: how to access therapy and mental health services through HUSKY
Navigating HUSKY Health to access therapy and mental health services can be straightforward with the right information. Here’s a step-by-step guide to help beneficiaries get started:
1. Determine if you need a referral
Depending on the type of therapy or mental health service, a referral from a primary care physician (PCP) might be needed. Pre-authorization may also be necessary for specialized treatments or inpatient services, so it’s essential to check the specific requirements with HUSKY health insurance provider.
2. Find a HUSKY Health provider
Use the CT BHP or HUSKY Health website to locate in-network providers who accept Medicaid. These tools help residents find licensed therapists, counselors, or psychiatrists who specialize in various areas of mental health. You can also use Grow Therapy to find a provider who fits your unique needs and accepts your HUSKY Health insurance.
3. Understand the costs
Therapy services under HUSKY Health are typically provided at low or no cost to the patient. However, some services may require a small co-pay, depending on your specific plan and income level. Always verify what services are covered directly with your provider or a HUSKY Health representative to avoid unexpected expenses. In addition, when searching for a therapist, it’s important to ensure the provider is within HUSKY’s network. Out-of-network providers may not be fully covered, leading to higher out-of-pocket expenses.
Coverage for special populations and unique needs
HUSKY Health Medicaid offers additional mental health services for specific populations, ensuring that vulnerable groups have access to the care they need.
Children and adolescents
In July 2023, Connecticut broadened Medicaid coverage to include all children under the age of 15, regardless of residency status. Through HUSKY A and the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, the state ensures regular mental health screenings to evaluate behavioral and emotional health. EPSDT also provides early intervention and field-based support services, where therapists can provide sessions to youth and families in their homes and school settings.
Pregnant women
Pregnant women are prioritized under HUSKY A, with more access to mental health services, due to this population’s susceptibility to perinatal mood and anxiety disorders. HUSKY covers therapy and counseling to help with mental health during and after pregnancy to safeguard the mental health of mothers, and create a healthy environment that promotes bonding.
Seniors and individuals with disabilities
HUSKY C and D provide specialized mental health coverage for individuals with disabilities, including in-home therapy, neuropsychological assessments, and long-term support for cognitive or developmental disorders. HUSKY C also offers geriatric psychiatric care for older adults, focusing on age-related issues and early cognitive decline signs.
Dual diagnosis support
HUSKY provides integrated treatment programs for individuals with both mental illness and substance use disorders, simultaneously addressing both conditions. This holistic approach ensures comprehensive care, improving long-term recovery outcomes.
Finding the mental health care you need with HUSKY Health
Connecticut’s Medicaid program, HUSKY Health, provides strong mental and behavioral health services to those in need. Even though navigating the system or finding the right provider can be challenging, there are many resources like the CT Behavioral Health Partnership and community support available to assist. Start your mental health journey today by finding therapist who accepts HUSKY Health on Grow Therapy.
