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.
High Risk Pool
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
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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.
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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:
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.
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