Cost and Coverage of Medicaid in Kentucky

If you are wondering, “What services are covered by Medicaid in Kentucky? note that insured services and equipment will vary from state to state. The types of Medicaid insurance services provided by Medicaid will be different from those provided in other parts of the country. Furthermore, the question of, “How much does Medicaid cost?” varies similarly across the nation and within each state. For instance, while Medicaid coverage in KY will come with a monthly premium for some beneficiaries, others will not have to pay anything for medical services. In July of 2016, Kentucky Medicaid covered just over 3 million Kentucky residents. This represents a 17.55 percent increase since the state’s 2013 inaugural Marketplace Open Enrollment Period. If you live in Kentucky, and do not make enough money to afford health care coverage sold on the private market, you may qualify for Kentucky Medicaid.

For more information on Medicaid cost estimates, and for details on what services Medicaid covers and what services it does not, review the sections provided below:

  • What is covered under Medicaid in Kentucky?

  • What does Medicaid not cover in Kentucky?

  • Medicaid costs in Kentucky

What Is Covered Under Medicaid in Kentucky?

You might expect all types of Medicaid insurance to cover the same services and equipment. In fact, the Federal Government requires that every version of Medicaid coverage must envelope cover a set of mandatory services. However, every state has its own version of Medicaid. When you go beyond the mandatory services, each state is free to develop its own mix of covered services. Because the coverage can vary significantly from one state to another, you need to ask the question, “What services are covered by Medicaid in my state of residence?” to find out if the state medical assistance program suits your needs. Kentucky Medicaid coverage pays for a wide variety of services and equipment for eligible beneficiaries.

These services include:

  • Prescription drugs

  • Laboratory, radiology, and diagnostic services

  • Specialized children services

  • Pediatric immunizations

  • Pediatric services such as autism screening

  • Skilled nursing and rehabilitation

  • Durable medical equipment

Other Medicaid services may be covered as well if your physician determines that they are medically necessary. If your Medicaid denies a procedure or piece of equipment, you can always appeal the decision. To learn how to qualify for Medicaid not covered, your appeal rights are spelled out in the paperwork you received when you signed up. The process is pretty much the same in every state.

What are the requirements for Medicaid services that are not covered? If you need a service that is not covered, you will need to file an appeal. You will need a prescription from your doctor; you may need some additional supporting documentation explaining why you need the service, how the service will benefit you, and what, if any alternative treatments are available. Depending on how busy the Medicaid department is, an appeal can take up to six months or longer. It is always good to plan ahead for your medical whenever possible.

Children may be eligible for additional services such as regular exams, teeth cleaning, X-rays or even oral surgery, in extreme cases. Adults do not typically qualify for the Medicaid coverage services.

What does Medicaid not cover in Kentucky?

While Medicaid coverage in Kentucky insures beneficiaries for a number of helpful services, there are certain procedures and pieces of equipment that Kentucky Medicaid will not cover.

The Kentucky Medicaid program establishes covered services based on medical necessity. Therefore, any service that is not medically necessary will not be covered in Kentucky. The following services are not covered:

  • Cosmetic surgery

  • Paternity tests

  • Fertility drugs

  • Hypnosis

  • Massage

  • Dietary Supplements

  • Procedures that are not medically necessary

You can still receive these services, but you will need to pay for them yourself.

Medicaid Costs in Kentucky

For those wondering, “How much is Medicaid in Kentucky?” note that many Medicaid beneficiaries pay nothing at all for their coverage due to the fact that they earn low incomes. Medicaid cost estimates may cover 100 percent of your healthcare costs if your individual income is less than $ 1,366 per month. For a couple, this threshold is $1,842 per month. In every case, your income has to be less than the income limits set by law in Kentucky. In addition, you have to possess Medicaid hospital insurance.

If your income is above this threshold, you may still qualify for Medicaid, but you will have to pay a portion of the cost of your coverage.

The next logical question is, “How much will my coverage cost?” Unfortunately, there is no absolute answer to this question. Medicaid cost estimates can change based on your income, the size of your household and the exact level of coverage you have.

If paying for your Medicaid coverage ever becomes a financial burden, be sure to let your caseworker know right away; you may qualify for additional financial assistance, especially if your income, health or living situation has changed. Even if there are no assistance programs available for you, you may be able to work out an extended payment plan.

If you need medical insurance, but you cannot afford it, Medicaid coverage could be a good option for you. The price you pay for your benefits can vary as well. Many beneficiaries will pay nothing for their coverage. If you cannot pay the cost of healthcare on your own, Medicaid may be the answer you are looking for.



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