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Kentucky Health Insurance

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  Individual & Family


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Kentucky Health Insurance Companies


Learn more about each health insurance carrier in Kentucky and their respective insurance plans - KentuckyHealth Insurance Plans.

Learn more about each insurance carrier here: Anthem, Anthem, Anthem Blue, Golden Rule, Humana, Humana, Mutual of Omaha, Unicare, Unicare Area A

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Compare health insurance quotes from nearby states:   North Carolina Health Insurance,  Indiana Health Insurance

Kentucky Individual Health Insurance

Today in Kentucky the number of uninsured adults (age 19-24) has reached 18% while in the past six years the cost of health insurance has risen 68.3%. (www.statehealthfacts.org) Statistics like these shows how essential it is to research and find the best health insurance plan available for you. There are many options for individual health insurance in Kentucky and Health Plan One can help find a health care plan that best fits your needs. The state of Kentucky allows medical underwriting which is the process a health insurance company goes through to assess the health status of individuals and use such information to determine if the health insurance company wants to accept an application from a perspective member. There are certain guidelines health insurance companies follow regarding pre existing conditions. In Kentucky, health insurance companies can review a member’s medical history for the last six months before coverage begins. If a pre existing condition does exist, the health insurance coverage can be excluded for up to nine months.  
 
If you do have a pre existing coverage and are denied health insurance coverage, there is a high risk pool available in Kentucky called Kentucky Access. This program allows individual health insurance policies sell to people who may be denied coverage otherwise because of a chronic illness or pre existing condition.   You may be eligible for this program due to your HIPAA group to individual rights. You may also be eligible if you have been a Kentucky resident for at least 12 months and you have been denied insurance coverage, you have been offered coverage at a higher premium rate than Kentucky Access, you have a specified high cost medical condition, you are a participant in the Guaranteed Acceptance Program, or you are a dependent of a Kentucky Access enrollee.  
 
Kentucky Access coverage includes the following:
  • doctor visits
  • prescription drugs
  • outpatient and in-hospital care
  • maternity
  • ambulance
  • labs and x-rays
  • hospice
  • home health visits
  • transplants
  • rehabilitation
  • durable medical equipment
  • mental health and substance abuse
  • physical, and preventive care

Kentucky Group & Small Business (2-50 employees) Health Insurance

Medical underwriting is also allowed within group and small business health insurance in Kentucky.  For group and small businesses, medical underwriting involves the same process as individual health insurance. For members of group and small business health insurance, companies may review their medical history over the past six months prior to coverage and pre-existing conditions can be excluded for a limited time depending upon the type of group plan they are joining.   
 
According to AHIP, The Center for Policy and Research, in Kentucky, the average monthly premium for group and small business health insurance in 2006 was $303 for single coverage and $794 for family coverage. This number can vary greatly depending on the contribution from the employer.
 
As in many other states, there are certain factors that determine eligibility for group and small business health insurance in Kentucky. 
  • Company size 2-50 employees
  • Owner can count as an employee
  • Proprietor-name on license must draw wages

Kentucky COBRA Health Coverage

COBRA, the Consolidate Omnibus Budget Reconciliation Act of 1985, which is offered in the state of Kentucky, provides certain former employees, retirees, spouses, former spouses and dependent children the right to temporary continuation of health insurance coverage at group rates. Coverage is only available when coverage is lost due to specific events, for example, job loss, reduction in hours worked, death or divorce. To be eligible for COBRA coverage you must have been enrolled in your employer’s health plan when you were employed and the health plan must continue to be in effect for active employees.
 

Medicaid in Kentucky

Medicaid is a state/federal program that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents. These individuals must meet certain income and other requirements.
 
Income requirements:
  • Children
    • Ages 1-5: 150% of the Federal Poverty Level
    • Ages 6-19: 150% of the Federal Poverty Level
  • Pregnant Women and Infants
    • Pregnant Women: 185% of the Federal Poverty Level
    • Infants - Ages 0-1: 185% of the Federal Poverty Level
  • Parents
    • Non-Working: 40% of the Federal Poverty Level
    • Working: 70% of the Federal Poverty Level
  • Other populations
    • Medically Needy Individual: 30% of the Federal Poverty Level
    • Medically Needy Couple: 28% of the Federal Poverty Level
    • Supplemental Security Income Recipients: 74% of the Federal Poverty Level

Covered Services

Acute care, ambulatory surgical center services, breast and cervical cancer treatment program, chiropractor, dental, durable medical equipment, early periodic screening, diagnostic, and treatment services, family planning, hearing services, home health services, hospice, hospital, laboratory and x-ray, medical transportation, mental health, nursing facility, organ transplant, pharmacy services, physician services, podiatry, renal dialysis services, rural health clinic services, school-based health services, targeted case management, and vision services.
 
Co-Payments
Co-payments range from $1-2 for prescriptions and other services. There are no co-payments if you are under 18, pregnant, living in a nursing home, or receiving family planning services.
 
You may learn more about Kentucky Medicaid at http://chfs.ky.gov/dms/
 

Other Kentucky Health Insurance Programs

Kentucky offers the program KCHIP to children up to age 19 who are residents of Kentucky, who do not qualify for Medicaid, and whose family income is up to 200% of the Federal Poverty Level. Please visit the KCHIP website for more detailed information at http://chfs.ky.gov/dms/KCHIP.htm
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