Benefit Grids
This page provides information on HUSKY Health Program benefits and authorization requirements. Benefit information is broken down, by provider type and medical program. The contents provide a general summary of HUSKY Health benefits. For a definitive list of benefits and limitations please see CMAP fee schedules and regulations.
For more detailed information regarding the Prior Authorization process, please see the Provider Manual.
If you have any questions, please contact Provider Engagement Services:
Phone
1.800.440.5071
Monday through Friday
8:00 a.m. – 6:00 p.m.
HUSKY Health Program
Attention: Benefits and Authorizations
P.O. Box 5005
Wallingford, CT 06492
HUSKY Health Program Benefit Grids
- Ambulatory Surgical Clinic Grid - Revised on 6/14/17
- BHP Grid - Revised on 9/2/15
- Chiropractor Grid - Revised on 7/19/17
- Chronic Disease Hospital and Long Term Care Grid - Revised on 6/14/17
- DHP Grid - Revised on 6/20/14
- Dialysis Clinic Grid - Revised on 6/14/17
- DME Grid - Revised on 7/18/17
- Family Planning Clinic Grid - Revised on 7/12/17
- Home Health Grid - Revised on 6/14/17
- Hospice Grid - Revised on 6/20/14
- HUSKY Plus Grid - Posted on 8/8/17
- Inpatient Hospital Grid - Revised on 6/14/17
- Lab Grid - Revised on 6/14/17
- Limited Eligibility Grid - Revised on 1/31/17
- Medical Clinic Grid - Revised on 6/14/17
- Naturopath Grid - Revised on 6/14/17
- Outpatient Hospital Grid - Revised on 7/18/17
- Physician Grid - Revised on 7/12/17
- Podiatry Grid - Revised on6/14/17
- Radiology Grid - Revised on 6/14/17
- Rehab Clinic Grid - Revised on 7/18/17
- Transportation Grid - Revised on 6/14/17
- Therapy Grid - Revised on 7/18/17
- Vision Grid - Revised on 7/18/17
Limited Eligibility Groups
Tuberculosis
- Limited Eligibility Groups Benefit Grid - Revised on 1/31/17
- Provider Bulletin/Policy Transmittal - Revised on 3/20/12
Family Planning
- Limited Eligibility Groups Benefit Grid - Revised on 1/31/17
- Provider Bulletin/Policy Transmittal - Revised on 3/20/12
- Fee Schedules - The following fee schedules include services covered under the Family Planning Limited Eligibility Benefit Group: Ambulatory Surgical Center, Family Planning Clinic, Medical Clinic, Lab, Physician Anesthesia, Physician Office and Outpatient, Physician Radiology and Physician Surgical.
