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Kentucky Health Insurance

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Facts and Figures

  • Place in State
    Health Report Card
    43rd
  • Insured 3,580,416
  • Uninsured 688,000
  • Insurance
    Carriers
    9
  • Number of
    Primary Care Physicians
    7000
  • Number of
    Hospitals
    104
  • Average Cost of
    Health Insurance*
    $377

Breakdown of Insureds

  • Employer-sponsored health insurance 58%
  • Private plans 5%
  • Medicaid 20%
  • Medicare 16%
  • Others 1%

Insurance Carriers

State Health Report Card

While smoking has decreased from 30.5 percent to 24.8 percent of adults in the past ten years, 822,000 people still smoke in Kentucky. Almost 1.1 million adults in Kentucky are obese, 353,000 more individuals than 10 years ago. In the past year, diabetes decreased from 11.5 percent to 10.0 percent of the population. However, there are still 332,000 adults in Kentucky with diabetes. In the past five years, the rate of uninsured population increased from 13.0 percent to 15.4 percent of the population. In the past ten years, the percentage of children in poverty increased from 15.2 percent to 24.7 percent of persons under age 18.

Kentucky Health Insurance Laws and Regulations

According to state law, every Kentucky health insurance plans are guaranteed renewable. This means that insurers cannot deny your application for renewal unless the policyholder was not able to adhere to the policy’s terms. Kentucky state laws require health plans that cover dependents to cover unborn (or adopted) children for up to 31 days. Kentucky health insurance providers implement an exclusion for those with pre-existing condition. This means that if you have been diagnosed with an illness, it will not be covered. The pre-existing condition exclusion period ranges from six months to two years. If you switch to another insurer even after the exclusion period, the new Kentucky health insurance provider may apply their own exclusion period. Small businesses (with 2-50 employees) can join any group health insurance plan being offered to other small businesses. Kentucky health insurance quotes are not closely regulated by Kentucky laws. As with individual plans, insurers have the liberty to set their rates based on some factors such as age, health condition and gender. Group plans may be terminated if conditions were violated.       

Kentucky state laws require health plans that cover dependents to cover unborn (or adopted) children for up to 31 days.

Insurers in Kentucky implement an exclusion for those with pre-existing condition. This means that if you have been diagnosed with an illness, it will not be covered. The pre-existing condition exclusion period ranges from six months to two years. If you switch to another insurer even after the exclusion period, the new insurer may apply their own exclusion period.

Small businesses (with 2-50 employees) can join any group health insurance plan being offered to other small businesses. Rates for these plans are not closely regulated by Kentucky laws. As with individual plans, insurers have the liberty to set their rates based on some factors such as age, health condition and gender. Group plans may be terminated if conditions were violated.

Heath Care Reform

Young adults in Kentucky can now stay under their parent’s policy. The new health law mandates health insurance companies to allow parents to keep their children in their policy until age 26. 35,610 young adults in Kentucky have benefited from this  plan (as of June 2011).

Because of the new law, Medicare members no longer need to worry about their extra  prescription cost. Once they reach the donut hole in 2010, they are sent a check for a $250 rebate. 69,438 seniors in Kentucky have received the rebate to offset the cost of their prescription drugs. A 50 percent discount was also given for brand name drugs once they’ve hit the donut hole. This resulted to an average savings of $40,147,823  for Kentucky Medicare members. The Affordable Care Act aims to close the donut hole by 2020.

One of the provisions of the health care reform is to provide preventive care services free of charge for Medicare members and free from cost-sharing for those enrolled under private plans. In 2011, 538,544 Medicare members and 732,000 private plan members in Kentucky have received free preventive care services like colonoscopies and mammograms.

The new health law protects consumers’ money through the medical loss ratio which mandates insurers to spend 80 percent of their Kentucky health insurance dollars on medical care and only 20 percent on administrative costs. 981,000
Kentucky residents are now able to maximize their premium.

Insurers are no longer allowed to impose a lifetime limit on their members’ benefits. 1,414,000 Kentucky residents are now free from having lifetime limits on their coverage. Patients with chronic diseases don’t have to worry about maximizing their limit because of their accumulating medical costs.

Through the Pre-Existing Condition Insurance Plan, Kentucky residents who have pre-existing condition can now have affordable Kentucky health insurance quotes. As of 2011, 435 residents now have a Kentucky health insurance. Without this provision, they would still remain uninsured.

Kentucky has received a $5 million  grant to develop more health programs and policies. They have also received $42.1 
million to create more health centers and to improve existing centers and the quality of health care delivered.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Because of the new law, Medicare members no longer need to worry about their extra prescription cost. Once they reach the donut hole in 2010, they are sent a check for a $250 rebate. 69,438 seniors in Kentucky have received the rebate to offset the cost of their prescription drugs. A 50 percent discount was also given for brand name drugs once they’ve hit the donut hole. This resulted to an average savings of $40,147,823 for Kentucky Medicare members. The Affordable Care Act aims to close the donut hole by 2020.

One of the provisions of the health care reform is to provide preventive care services free of charge for Medicare members and free from cost-sharing for those enrolled under private plans. In 2011, 538,544 Medicare members and 732,000 private plan members in Kentucky have received free preventive care services like colonoscopies and mammograms.

The new health law protects consumers’ money through the medical loss ratio which mandates insurers to spend 80 percent of their premium dollars on medical care and only 20 percent on administrative costs. 981,000 Kentucky residents are now able to maximize their premium.

Insurers are no longer allowed to impose a lifetime limit on their members’ benefits. 1,414,000 Kentucky residents are now free from having lifetime limits on their coverage. Patients with chronic diseases don’t have to worry about maximizing their limit because of their accumulating medical costs.

Through the Pre-Existing Condition Insurance Plan, Kentucky residents who have pre-existing condition can now have affordable coverage. As of 2011, 435 residents now have a Kentucky health insurance. Without this provision, they would still remain uninsured.

Kentucky has received a $5 million grant to develop more health programs and policies. They have also received $42.1 million to create more health centers and to improve existing centers and the quality of health care delivered.

 

State Government Insurance Programs Offered

Kentucky Access

866-405-6145

Having a pre-existing condition usually hinders people from acquiring coverage. Kentucky Access is a state health insurance program designed to give residents with pre-existing condition access to be enrolled in Kentucky health insurance plans. Kentucky Access is also open to HIPAA eligible. Coverage includes hospital care, surgery, preventive care, doctor visits, maternity care and home health care.

Medicaid

800-635-2570 502-564-4321

Some of services include Hospital care (inpatient and outpatient), Nursing home care, Physician services, Laboratory and x-ray services, Immunizations and other early and periodic screening, Diagnostic and treatment (EPSDT) services for children, Health center (FQHC) and Rural health clinic (RHC) services, Nurse midwife and nurse practitioner services. Benefits also include Chiropractor, Dental, Durable medical equipment (DME), Family planning, Hearing, Hospice, Medical transportation, Organ transplant, Pharmacy, Podiatry, Renal dialysis and Vision.

Children’s Health Insurance Program (KCHIP)

877-524-4718 877-524-4719 TTY

KCHIP: Covers Doctor visits, Dental care, Hospitalization, Outpatient hospital services, Psychiatrists, Laboratory tests and x-rays, Vision exams, Hearing services, Mental health services, Prescription drugs, Glasses, Immunizations, Well- child checkups, Physical therapy, Speech therapy, and many other services.

Kentucky Women’s Cancer Screening Program

502-564-3236

chfs.ky.gov (Search: Cancer Screening) – If screened and diagnosed for breast or cervical cancer, may be eligible for complete health coverage through Medicaid, including dental, prescriptions etc.

Medicare

800-633-4227

Medicare offers Part A, inpatient care in hospitals and rehabilitative centers; Part B, doctor and some preventive services and outpatient care; Part C allows Medicare benefits through private insurance (Medicare Advantage); Part C includes Parts A, B, and C not covered by Medicare. Part D covers prescription drugs.

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