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Kentucky Medicaid

The Kentucky Medical Program is intended to provide medical and health-related assistance to low-income individuals and families who have no medical insurance or have inadequate medical insurance.

Program Name Kentucky Medicaid
Expanded Medicaid Yes
Website chfs.ky.gov
Email CHFS.Listens@ky.gov
Phone 855-306-8959
Apply Online Kentucky Healthy Benefit Exchange
Appeal a Denial Division of Administrative Hearings
Find a Local Office Local Office Search

Eligibility Requirements

To be eligible for Kentucky Medicaid, you must be a resident of the state of Kentucky, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

You must also be one of the following:*

  • Pregnant
  • Be responsible for a child 18 years of age or younger
  • Have a disability or a family member in your household with a disability

* ACA Medicaid expansion covers eligible low-income adults.

Annual Household Income Limits (before taxes)

Household Size* Maximum Income Level (Per Year)
1 $17,131
2 $23,169
3 $29,207
4 $35,245
5 $41,284
6 $47,322
7 $53,360
8 $59,398

*For households with more than eight people, add $6,038 per additional person.

Available Services Include:

Allergy care Maternity services
Ambulance Mental health services
Chiropractic Nursing facility services
Dental Occupational therapy
Diagnostic & radiology services Organ transplants
Durable medical equipment Orthodontics
Emergency room services Pain management services
Family planning services Physical therapy
Hearing aids Physician office services
Home health services Prescription drugs
Hospice Prosthetic devices
Hospital services Urgent care services
Immunizations Vision

Copayments

Generic drug $1
Brand-name drug $1.00 – $4.00
Specialty visits $3
Physical or occupational therapy $3
Office visit $3
Laboratory, diagnostic, or X-ray service $3
Outpatient hospital service $4
Durable medical equipment $4
Outpatient surgery $4
Emergency visit for non-emergency $8
Inpatient services (hospital admission) $50

The following groups do not have a copay:

  • Foster children
  • Children enrolled in Medicaid
  • Pregnant women (includes 60-day period after pregnancy ends)
  • Kentucky Medicaid beneficiaries who have reached their cost sharing limit for the quarter
  • Individuals receiving hospice care
  • The following services are exempt from copays:
  • Emergency services
  • Some family planning services
  • Preventive services

Copay Limits

There is a limit on the total amount of copays you will have to pay. You will not have to pay more than 5% of your family’s income each quarter. Quarters are January-March, April-June, July-September, and October-December.

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