Medicaid Expansion: Expanding Medicaid to provide coverage for children aged 14-18 living in families at or below 185% of the federal poverty level (fpl). (Renamed Part A of the state’s HUSKY Program.)

and

New Program: Creating a new program, Part B of the state’s HUSKY Program, to provide coverage for children up to age 18 living in families up to 235% of the fpl.

(With use of income disregards, coverage will be extended to some children up to 300% fpl.)

Children whose mental health needs cannot be accompanied by the basic benefits package may be eligible for HUSKY Plus Behavioral Health Plan. Medically necessity or medical necessary for HUSKY Plus is defined as "necessary to correct/diminish the adverse effects of a medical condition or mental illness." Qualification is based upon DSM-IV, severity of psychiatric and substance abuse symptoms, level of functional impairment, and intensity of needs.

Children with behavior health needs found eligible will receive additional services under HUSKY Plus. As stated in the Title XXI plan, additional services for chronic, long term disorders which, if left untreated, will effect the physical and/or mental health of a child may be addressed under HUSKY Plus.

Children will be dual-eligible for HUSKY B and HUSKY Plus.

Mental Health Benefits

Medicaid (named HUSKY) All benefits provided under the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) requirement in Medicaid, including: screening diagnosis and assessment; testing; psychotherapy; prescription drugs; partial hospitalization; emergency care; consultation and education; day treatment; in-home services; collateral services; therapeutic foster care; early intervention services; crisis programs; and services to youth in certain residential placements.

HUSKY Part B
Inpatient: 60 days annual maximum, with supplemental coverage available through HUSKY Plus for children who meet the criteria for the HUSKY Plus Behavioral Health Plan.

Outpatient: 30 visits annual maximum, with supplemental coverage available through HUSKY Plus for children who meet the criteria for the HUSKY Plus Behavioral Health Plan.

Inpatient and outpatient days are convertible.

Inpatient Substance Abuse: 60 days annual maximum for drug abuse and 45 days annual maximum for alcohol abuse, with supplemental coverage available through HUSKY Plus for children who meet the criteria for the HUSKY Plus Behavioral Health Plan.
Outpatient Substance Abuse: 60 visits annual maximum, with supplemental coverage available through HUSKY Plus for children who meet the criteria for the HUSKY Plus Behavioral Health Plan.
Wrap-around Services: case management, care coordination, enabling services, community based care available through HUSKY Plus for children who meet the criteria for the HUSKY Plus Behavioral Health Plan.

Husky Plus
Children with behavior health needs who qualify will receive additional services under HUSKY Plus Behavioral Health Plan.

Behavioral health needs network will be organized by the Yale Child Study Center and will include most traditional community-based behavioral health providers. The plan will offer case management, care coordination, intensive in-home child and adolescent psychiatric services, and mobile crisis services as a supplement to the behavioral health services included in HUSKY B. However, it will not offer additional inpatient or outpatient days. The duration of treatment provided by a managed care health plan shall be based on the individual needs of the child.
Prescription Drugs: Formularies. $3 copay on generics; $6 copay on brand names