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  • Ct Husky Health Inpatient Surgery/procedure Request Form 2016

Get Ct Husky Health Inpatient Surgery/procedure Request Form 2016-2025

11 Fairfield Blvd., Suite 1 Wallingford, CT 06492 1.800.440.5071 www.huskyhealth.com INPATIENT SURGERY/PROCEDURE REQUEST FORM Member s Name .

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There are some benefits available only to HUSKY A, C and D members. These benefits are: Non-emergency transportation to health care appointments. Smoking cessation services: counseling and medications.

HUSKY C—Medicaid for adults 65 and older and adults with disabilities, including long-term services and supports and Medicaid for Employees with Disabilities; HUSKY D—Medicaid for low-income adults without dependent children.

Who is eligible for Connecticut HUSKY Healthcare (SCHIP)? Household Size*Maximum Income Level (Per Year)1$43,7402$59,1603$74,5804$90,0004 more rows

The HUSKY Program is the State of Connecticut's public health coverage program for eligible children, parents, relative caregivers, senior citizens, individuals with disabilities, adults without children, and pregnant women within the income guidelines.

If your HUSKY Health Member ID card has been lost, stolen, or damaged please call Member Engagement Services at 1.800. 859.9889 to ask for a new one. You can also send us a secure member email by clicking here and requesting a new one.

If you are not sure if you should go to an Urgent Care or Walk-in Medical Center, or go to the emergency room, call the HUSKY Health 24/7 Nurse Helpline at 1.800. 859.9889.

In Connecticut, Medicaid is referred to as HUSKY Health and is overseen by the State's Department of Social Services (DSS). Medicaid covers most health care services, including: Home care.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232