Kentucky Health Insurance Guide 2025

Everything you need to know about health coverage in the Bluegrass State

Key Facts for Kentucky

Medicaid Expansion Expanded
Marketplace Type State-Based (kynect)
Open Enrollment Nov 1 - Jan 15
Exchange Website kynect.ky.gov

kynect: Kentucky's Health Exchange

Kentucky operates its own state-based health insurance marketplace called kynect. This comprehensive portal allows Kentuckians to apply for Medicaid, shop for private health insurance, and access other state benefit programs all in one place.

One-Stop Shop

kynect makes it easy to find coverage. When you apply, the system automatically determines whether you qualify for Medicaid or marketplace coverage with subsidies, streamlining the enrollment process.

What Can You Do Through kynect?

  • Apply for Kentucky Medicaid
  • Shop for private health insurance plans
  • Access premium tax credits and cost-sharing reductions
  • Apply for other benefit programs (SNAP, KTAP, child care assistance)
  • Report changes to your coverage
  • Renew your coverage annually

Medicaid in Kentucky

Kentucky expanded Medicaid in 2014, becoming one of the first Southern states to do so. This expansion significantly reduced Kentucky's uninsured rate and provided coverage to hundreds of thousands of previously uninsured adults.

Who Qualifies for Kentucky Medicaid?

  • Adults ages 19-64: Up to 138% FPL (about $20,120/year for an individual)
  • Children: Up to 218% FPL through KCHIP (Kentucky Children's Health Insurance Program)
  • Pregnant women: Up to 200% FPL
  • Elderly and disabled: Based on SSI eligibility and income/asset limits
  • Parents/Caretakers: Based on household income up to 138% FPL

Kentucky Medicaid Managed Care

Most Kentucky Medicaid recipients receive coverage through managed care organizations (MCOs). You can choose from several MCOs, each offering:

  • Doctor visits and preventive care
  • Hospital services
  • Prescription drugs
  • Mental health and substance abuse services
  • Dental and vision services
  • Transportation assistance to medical appointments

How to Apply for Kentucky Medicaid

  • Online: Visit kynect.ky.gov
  • Phone: Call 1-855-459-6328 (kynect)
  • In Person: Visit your local Department for Community Based Services (DCBS) office
  • By Mail: Download and mail the paper application

Marketplace Coverage Through kynect

If you don't qualify for Medicaid, kynect offers private health insurance plans from multiple insurers. Many Kentuckians qualify for premium subsidies that make coverage affordable.

2025 Open Enrollment

November 1, 2024 through January 15, 2025. Enroll by December 15 for coverage starting January 1, 2025. Medicaid applications are accepted year-round.

How to Enroll Through kynect

  1. Visit kynect.ky.gov
  2. Create an account or log in
  3. Complete your application with income and household information
  4. kynect will determine your eligibility for Medicaid or marketplace subsidies
  5. If eligible for marketplace coverage, compare plans and select one
  6. Complete enrollment and pay your first premium

Special Enrollment Periods

You can enroll outside of Open Enrollment if you experience a qualifying life event such as losing other coverage, getting married, having a baby, or moving to Kentucky.

Average Costs in Kentucky

Health insurance costs in Kentucky are generally affordable, especially with premium subsidies:

  • Benchmark Silver Plan: Average of $400-500/month before subsidies for a 40-year-old
  • With Premium Tax Credits: Many Kentuckians pay $0-100/month after subsidies
  • Medicaid: Free or very low cost for eligible individuals
  • Bronze Plans: Lower premiums, higher deductibles
  • Gold Plans: Higher premiums, lower out-of-pocket costs
Premium Tax Credits

If your income is between 138% and 400% of the Federal Poverty Level, you likely qualify for premium subsidies. Enhanced subsidies are available through 2025.

Frequently Asked Questions

What is kynect?

kynect is Kentucky's state-based health insurance marketplace and benefits portal. Through kynect, Kentuckians can apply for Medicaid, shop for private health insurance plans, and access other state benefit programs. It serves as a one-stop shop for health coverage and assistance programs.

Has Kentucky expanded Medicaid?

Yes, Kentucky expanded Medicaid in 2014 under the Affordable Care Act. Adults ages 19-64 earning up to 138% of the Federal Poverty Level can qualify for Kentucky Medicaid. This significantly reduced the state's uninsured rate.

When is Open Enrollment for Kentucky health insurance?

Kentucky uses its own state-based exchange, kynect. Open Enrollment for 2025 coverage runs from November 1, 2024 through January 15, 2025. You can apply for Medicaid at any time throughout the year if you qualify.

How do I apply for Kentucky Medicaid?

You can apply through kynect at kynect.ky.gov, by phone at 1-855-459-6328, or in person at your local Department for Community Based Services (DCBS) office.

Need Help Finding Coverage in Kentucky?

Whether you qualify for Medicaid or need marketplace coverage through kynect, our licensed agents can help you find the right plan.

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