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Kentucky Health Insurance

Kentucky Health Insurance

When researching your health insurance options in the state of Kentucky, there are several things to keep in mind. If your employer does not offer benefits, are you healthy enough to obtain health insurance on the individual market? If so, Health Plan One can be of service to you in quoting plans appropriate for your needs and price range. Are you self-employed, owning your own business and employing between 2-50 employees? Health Plan One can also assist small business owners in obtaining small group coverage. Do you have any pre-existing conditions, disabilities, or are you below an income level which could qualify you for free or low-cost health care programs offered by the government? You may be eligible in Kentucky for Medicaid, KCHIP, or the high risk pool. Eligibility requirements for each of these options are available on this page.

What Every Kentucky Resident Should Know About Health Insurance

The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer, the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not subject to medical underwriting, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.

Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through Health Plan One. Simply visit our Short-Term information page for your free quotes. It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.

What If I'm Between Jobs?

As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs to invest in an individual/family insurance policy through Health Plan One.

With individual coverage you choose the health insurance carrier and benefits you want with the help of Health Plan One. We will quote plans for you and your family from all the different carriers available in Kentucky so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through Health Plan One could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Kentucky each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.

If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the Health Plan One quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.

Small Group Plans

If you are self-employed, you could qualify for a small group plan in Kentucky. You must have 2 or more eligible employees who each work at least 30 hours per week. No minimum amount of time in business is required to apply, but you must be able to provide tax forms and other business documentation requested by the carrier to which you're applying. All carriers in Kentucky do medically underwrite for small group plans. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling. Health Plan One can help you by quoting plans for small groups. Simply call us at (877) 567-5267.

If you're not healthy there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.

Visit our Kentucky Small Business Group page for more information

Medicaid in Kentucky

Medicaid is the state-federal cooperative program available in every state which provides basic health coverage to low-income residents, pregnant women, children under 19, and other groups in need of medical assistance. The program works in practice much like having regular health insurance. Benefits for enrollees include: dental services, family planning, home health services, hospital care, mental health services, and physician visits. For a complete list of covered services, click here: As previously mentioned, there are several different groups who qualify for Medicaid, each with different income requirements. Click here to view the income requirements for eligible applicants and details on how to apply for Medicaid. If you do not meet the maximum income requirements to enroll in Medicaid you may still be eligible for the program's spenddown option. For more information on spenddown, click here: For additional information on the cost of enrollment in Medicaid, click here: To explore more about the program, visit the Medicaid homepage under the Kentucky Cabinet for Health and Family Services at

Medicaid Works is a program under the Medicaid umbrella which provides benefits to working people with disabilities. Under this program, workers with disabilities who earn less than 250% of the federal poverty level can pay a monthly premium in order to buy into the Medicaid program. For full eligibility criteria, click here:

The managed care aspect of the Medicaid program in Kentucky is called the Kentucky Medicaid Health Care Partnership Program. For more on managed care and this program in particular, click here:

For detailed information on the pharmacy options available to Medicaid program enrollees, click here:

Visit for information on Kentucky Medicare.

Kentucky Children's Health Insurance Plan – KCHIP

The KCHIP program provides free or low-cost health insurance to uninsured Kentucky children under age 19 whose parents' income is too high to qualify them for Medicaid but too low to afford coverage on the individual market. Children who qualify for KCHIP have a family income below 200% of the federal poverty level. The program covers doctor visits, dental care, hospitalization, mental health services, vision exams, lab tests and x-rays, immunization and much more. Families with children in KCHIP who make more than 150% of the federal poverty level are charged a relatively low premium. Co-payment is required for all on prescription medicines. To learn more about KCHIP, visit the program's website at

Kentucky Access - High Risk Pool

The insurer of last resort for most Americans is their state's high risk pool. In Kentucky, the pool is called Kentucky Access and is meant for residents who are medically uninsurable on the individual insurance market due to a preexisting medical condition. There are 6 ways one can qualify for the program:

  1. Federally Eligible individual
  2. Insurance rejection
  3. Higher premium rate
  4. High cost condition
  5. Guaranteed Acceptance Program eligible
  6. Spouse or child of an enrollee

Criteria for qualification under one of these categories are available here: Benefits of the program are comparable to other major medical insurance plans. For complete details, visit the program website at