Summary
Medicaid’s rules, benefits and name can all vary by state. In Connecticut, Medicaid is also called HUSKY Health. This article focuses on Connecticut Medicaid Long Term Care for seniors, which will pay for care in a nursing home, a beneficiary’s home and other settings through one of three programs – Nursing Home Medicaid, HCBS Waivers and ABD Medicaid. This is different than regular Medicaid, which is for financially limited people of all ages.
Connecticut Nursing Home Medicaid will cover the cost of long-term care in a nursing home for financially limited Connecticut seniors who require a Nursing Facility Level of Care. Coverage includes payment for room and board, as well as all necessary medical and non-medical goods and services, such as:
Items not covered include a private room, specialized food, comfort items not considered routine (tobacco, sweets and cosmetics, for example) and any care services not considered medically necessary.
Connecticut Nursing Home Medicaid beneficiaries are required to give most of their income to the state to help cover care expenses. They are allowed to keep a “personal needs allowance” (PNA) of $75/month, which can be spent on personal items such as clothes, snacks, books, haircuts, flowers, etc. They can also keep enough of their income to make Medicare premium payments if they are “dual eligible,” and enough to make any Medicaid-approved spousal income allowance payments to financially needy spouses who are not Medicaid applicants or recipients.
Connecticut Nursing Home Medicaid is an entitlement. This means all qualified applicants are guaranteed by law, aka “entitled,” to receive benefits without wait. However, not all nursing homes accept Medicaid, and those that do may not have any available spaces when you or your loved one needs care. So, eligible applicants are guaranteed nursing home coverage without wait, but they are not guaranteed coverage in any facility they choose.
A Nursing Home Alternative – Connecticut Nursing Home Medicaid beneficiaries who want to leave their nursing home and return to living “in the community” can receive financial and functional help with that transition through the Money Follows the Person program (MFP). This help can include paying for moving expenses, as well as long-term care services and supports in the new residence. MFP beneficiaries must be moving from a Medicaid-approved facility and into their own home, the home of a relative or a small group home with a maximum of four unrelated residents.
Home and Community Based Services (HCBS) Waivers will pay for long-term care services and supports that help financially limited Connecticut Medicaid recipients who require a Nursing Facility Level of Care remain living in the community instead of residing in a nursing home. The word “waiver” means something like voucher in this instance. Think of it as a voucher that will pay for long-term care services for Connecticut residents who live in their own home, the home of a loved one, their own home, the home of a loved one, adult family living or a managed residential community. While Connecticut HCBS Waivers can pay for some services in those settings, they will not cover room and board costs.
The HCBS Waiver relevant to Connecticut seniors is the Connecticut Home Care Program for Elders.
Connecticut Home Care Program for Elders
The Connecticut Home Care Program for Elders (CHCPE) provides long-term care benefits to Connecticut seniors who live in their own home, the home of a loved one, adult family living (like adult foster care) or a managed residential community (similar to an assisted living residence). While CHCPE will cover some long-term care services in those settings, it will not pay for room and board expenses, like mortgage payments, rent, utility bills or facility fees. CHCPE can also be referred to as the Connecticut Home and Community Based Services Waiver for the Elderly.
CHCPE benefits include adult day care, meal delivery, homemaker services, minor home modifications, non-medical transportation and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting).
Unlike Nursing Home Medicaid, CHCPE is not an entitlement. Instead, it has a limited number of enrollment spots (18,186 per year as of 2023). Once those spots are full, additional eligible applicants will be placed on a waitlist.
Connecticut’s Aged, Blind, and Disabled (ABD) Medicaid, which is also called HUSKY C in Connecticut, provides healthcare coverage and long-term care services and supports to financially limited Connecticut residents who are aged (65 and over), blind or disabled. ABD Medicaid can sometimes be referred to as regular Medicaid for seniors, but it should not be confused with the regular Medicaid that is available for low-income people of all ages.
ABD Medicaid is an entitlement, which means that anyone who meets the requirements is guaranteed by law to receive the benefits without any wait.
HUSKY C beneficiaries who have a medical need for long-term care benefits can receive some of those benefits through the Community First Choice Option.
Community First Choice Option
Connecticut’s Community First Choice (CFC) Option provides long-term care services and supports to HUSKY C beneficiaries who require a Nursing Facility Level of Care but live in their own home or the home of a friend or relative. To be clear, other than rare exceptions, CFC applicants can not live in adult foster care or in an assisted living residence.
CFC benefits include nursing services, meal delivery, home modifications, transportation, therapies (speech, occupational, physical) and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). These benefits can be provided by a licensed caregiver, or the CFC program participant can self-direct some of their benefits and hire a caregiver of their choice, like a friend or a family member, although spouses and legal guardians cannot be hired. A fiscal intermediary handles all financial aspects (payments, tax withholding, etc.) of the employment.
Like HUSKY C itself, CFC is an entitlement program, which means that all eligible applicants are guaranteed to receive benefits. However, the state will conduct a needs assessment for each applicant to determine what benefits they will receive.
To be eligible for Connecticut Medicaid, a person has to meet certain financial and functional (medical) requirements. The financial requirements vary by the applicant’s marital status, if their spouse is also applying for Medicaid, and what program they are applying for – Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers or Aged, Blind, and Disabled (ABD) Medicaid / HUSKY C.
Just For You: The easiest way to find the most current Connecticut Medicaid eligibility criteria for your specific situation is to use our Medicaid Eligibility Requirements Finder tool.
Financial Requirements
Connecticut residents have to meet an asset limit and an income limit in order to be financially eligible for nursing home coverage through the Connecticut Medicaid. The 2024 asset limit for a single applicant is $1,600, which means they must have $1,600 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.
The income of a single applicant can not exceed the cost of the nursing home in the area where they live, which can range from about $7,500-$14,000/month in Connecticut. However, Connecticut Nursing Home Medicaid recipients are required to give most of their income to the state to help cover the cost of care. They are only allowed to keep $75/month of their income as a “personal needs allowance,” plus enough to make Medicare premium payments if they are “dual eligible,” and they can make any allowable spousal income allowance payments to financially needy spouses who are not covered by Medicaid.
For married applicants with both spouses applying for nursing home coverage through the Connecticut Medicaid, the 2024 asset limit is a combined $3,200, and their combined incomes can not exceed the combined cost of nursing home care for the couple, which can range from about $15,000-$28,000/month in Connecticut. But, as mentioned above, Connecticut Medicaid beneficiaries who live in nursing homes are only allowed to keep a small amount of their income and must give the rest to the state to help offset nursing home costs.
For a married applicant with just one spouse applying for Connecticut Nursing Home Medicaid, the 2024 asset limit is $1,600 for the applicant spouse and $154,140 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The income of the non-applicant spouse is not counted and the income of the applicant must not exceed the cost of the nursing home.
Plan Ahead: There are alternative pathways to eligibility for Connecticut Nursing Home Medicaid applicants who don’t meet their financial limits, such as Medicaid Planning. However, applicants are not allowed to simply give away their assets in order to get under the asset limit. To make sure they don’t, Connecticut has a Look-Back Period of five years. This means the state will look back into the previous five years of the Nursing Home Medicaid applicant’s financial records to make sure they have not given away assets.
Functional Requirements
The functional, or medical, criteria for nursing home coverage through Connecticut Medicaid is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that can only be provided in a nursing home. An applicant’s ability to to perform the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning, etc.), is used to determine if a Nursing Facility Level of Care is needed.
Financial Requirements
Connecticut residents have to meet an asset limit and an income limit in order to be financially eligible for Home and Community Based Service (HCBS) Waivers. For a single applicant in 2024, the asset limit for HCBS Waivers in Connecticut is $1,600, which means they must have $1,600 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.
The 2024 income limit for HCBS Waivers in Connecticut for a single applicant is $2,829/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. COVID-19 stimulus checks and Holocaust restitution payments are not considered income.
For married applicants with both spouses applying, the 2023 asset limit for HCBS Waivers in Connecticut is a combined $3,200, and the income limit is a combined $5,658/month. For a married applicant with just one spouse applying, the 2024 asset limit is $1,600 for the applicant spouse and $154,140 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The income limit is $2,829/month for the applicant spouse and the income of the non-applicant spouse is not counted.
Plan Ahead: There are alternative pathways to eligibility for Connecticut HCBS Waiver applicants who don’t meet their financial limits, such as Medicaid Planning. However, applicants are not allowed to simply give away their assets in order to get under the asset limit. To make sure they don’t, Connecticut has a Look-Back Period of five years. This means the state will look back into the previous five years of the applicant’s financial records to make sure they have not given away assets.
Functional Requirements
The functional, or medical, criteria for Home and Community Based Service (HCBS) Waivers in Connecticut is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is normally associated with a nursing home. An applicant’s ability to to perform the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning, etc.), is used to determine if a Nursing Facility Level of Care is needed.
Financial Requirements
Connecticut residents have to meet an asset limit and an income limit in order to be financially eligible for Aged, Blind, and Disabled (ABD) Medicaid, which is also called HUSKY C in Connecticut. The asset limit for a single applicant from July 2023 to June 2024 is $1,600, which means they must have $1,600 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Counts the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.
The income limit for Connecticut ABD Medicaid for a single applicant from July 2024 to June 2025 is $1,234/month. Almost all income is counted (IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc.) other than COVID-19 stimulus checks and Holocaust restitution payments.
For married applicants with both spouses applying, the asset limit for Connecticut’s ABD Medicaid from July 2024 to June 2025 is a combined $2,400, and the income limit is a combined $2,002/month. For a married applicant with just one spouse applying, the asset limit is a combined $2,400 combined and the income limit is $1,491/month for the applicant. The income of the non-applicant spouse is not counted.
Plan Ahead: There are alternative pathways to eligibility for Connecticut ABD Medicaid applicants who are over the asset limit and/or the income limit, such as Medicaid Planning. While Connecticut has a Look-Back Period of five years for Nursing Home Medicaid and Home and Community Based Services Waivers applicants to make sure they don’t give away their assets to get under the limit, there is no Look-Back Period for ABD Medicaid applicants. However, ABD applicants should be cautious about giving away their assets. They might eventually need Nursing Home Medicaid, or an HCBS Waiver, and those programs will deny or penalize the applicant for giving away assets.
Functional Requirements
The only functional requirement to receive basic healthcare coverage through Connecticut ABD Medicaid (HUSKY C) is being aged (65 and over), blind or disabled. For ABD Medicaid applicants and beneficiaries who require long-term care services and supports, the state will administer an assessment of their ability to perform Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and Instrumental Activities of Daily Living (which include shopping, cooking, housekeeping and medication management) to determine the kind of long-term care benefits the state will cover.
One’s home is often their most valuable asset, and if counted toward Medicaid’s asset limit, it would likely cause them to be over the limit. However, in many situations the home is not counted against the asset limit:
These rules apply to all three types of Medicaid, with one important exception – ABD Medicaid applicants can disregard the home equity limit. Value does not matter regarding their home’s exempt status. To learn more about the impact of home ownership on Medicaid eligibility, click here.
Connecticut Medicaid Long Term Care applicants and recipients may also want to consider protecting their home (and other assets) from estate recovery. States are required by law to try and collect reimbursement for long-term care after the death of Medicaid recipients. They do this through their Medicaid Estate Recovery Programs (MERPs). The rules and regulations regarding estate recovery can vary greatly by state, but all states have a MERP. To learn more about the MERP in Connecticut and how you can protect your home from it, click here.
The first step in applying for Connecticut Medicaid Long Term Care coverage is deciding which of the three Medicaid programs discussed above you or your loved one wants to apply for – Nursing Home Medicaid, Home and Community Based Service (HCBS) Waivers or Aged Blind and Disabled (ABD) Medicaid / HUSKY C.
The second step is determining if the applicant meets the financial and functional criteria, also discussed above, for that Long Term Care program. Applying for Connecticut Medicaid coverage when not financially eligible will result in the application, and benefits, being denied.
During the process of determining financial eligibility, it’s important to start gathering documentation that clearly details the financial situation for the Connecticut Medicaid applicant. These documents will be needed for the official Medicaid application. Necessary documents may include tax forms, Social Security benefits letters, deeds to the home, proof of life insurance and quarterly statements for all bank accounts, retirement accounts and investments. For a complete list of documents you might need to submit with your Medicaid Long Term Care application, go to our Medicaid Application Documents Checklist.
After financial eligibility requirements are checked and double checked, documentation is gathered, and functional eligibility is clarified, Connecticut residents can apply online at ConneCT. They can also download an application, complete it and submit it to their local Department of Social Services office.
For step-by-step guides to applying for each of the three types of Medicaid Long Term Care, just click on the name: 1) Nursing Home Medicaid 2) HCBS Waivers 3) ABD Medicaid.
Professional Help: Many seniors need support when it comes to Medicaid Long Term Care’s rules, benefits and application process. These are all complicated, constantly changing and vary by state. The best place to get help with Medicaid Long Term Care is through a professional like a Certified Medicaid Planner or an Elder Law Attorney.
After being approved for nursing home coverage through Connecticut Medicaid, you or your loved one needs to choose which Medicaid-accepting nursing home best meets your needs. Even though Medicaid nursing home coverage is an entitlement, not all nursing homes take Medicaid, and those that do might not have any open spaces. Finding the right nursing home can be time-consuming, especially if you are searching in a specific geographic area.
Connecticut has approximately 200 nursing homes that accept Medicaid, according to the Centers for Medicare & Medicaid Services (CMS). There are about 50 in the southwest corner of the state, which includes New Haven, Bridgeport, Stamford, Norwalk and Danbury. There are roughly 40 in the Hartford area, including the towns of Newington, New Britain and Manchester. And there are about 25 nursing homes in the southeast part of the state in the New London and Norwich areas.
Residents in some Connecticut communities may frequently cross state lines into New York, Rhode Island or Massachusetts for many personal or business reasons, including healthcare. However, Nursing Home Medicaid coverage does not cross state lines. So, a Connecticut resident with Connecticut Nursing Home Medicaid will not be covered in a nursing home in Westerly, Rhode Island, for example, or White Plains, New York, even though those facilities might be closer and more convenient than any in Connecticut.
TOOLS: To find a nursing home that accepts Medicaid near them, Connecticut residents can use use Nursing Home Compare. This is a search tool administered by CMS that has information about more than 15,000 nursing homes across the country.
Once you’ve found nursing homes in your area that accept Medicaid, you can start comparing them, if you have multiple options. The search on Nursing Home Compare can be filtered by overall rating, health inspections, staffing and quality measures, which can be a helpful place to start. The healthcare professionals who work with you can also be a great resource. And you can find more information about Connecticut nursing homes by contacting your local Area Agency on Aging.
After doing your research, you or someone you trust should also visit any nursing homes you’re considering before making a final decision. Call first to make an appointment for the visit, and arrive prepared with a list of questions. Some things you might ask are: Does the residence coordinate social activities? Does it provide transportation? What are the meals like? How will the residence provide access to oral and eye care? Who are the staff doctors? CMS has a comprehensive “Nursing home checklist” you can use to evaluate a nursing home while visiting.
According to CMS data, Connecticut nursing homes averaged 27 health deficiencies that led to citations from 2019-2022, which is slightly above the national average of 25.7 over that same time span. However, Connecticut nursing homes averaged just 8.6 fire safety deficiencies, which is much less than the national average of 13.5.
If you need Medicaid long term care but do not meet the financial eligibility criteria, consider working with a Medicaid Planning professional. These fee-based experts help families structure their finances to become eligible, while streamlining the application process and preserving assets for spouses and family members.
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