A Guide to kynect benefits | Kentucky Medicaid

Applying for Kentucky Medicaid

If you need affordable healthcare and are wondering how to apply for kynect, you have several ways to apply for assistance.

The easiest way is by applying for Kentucky Medicaid through the kynect benefits self-service portal. When you arrive at the application page, you must create a Kentucky Online Gateway account with your email and password. Once you log in, you can complete the application using a computer, tablet, or smartphone at your convenience.

Information you'll need to provide to complete your application includes:

• Your social security number
• Your state I.D. card or driver's license to prove your identity
• Your birth certificate as proof of citizenship
• Proof of health insurance, if you have insufficient third-party coverage and plan to use Kentucky Medicaid as supplemental coverage
• Proof of income like a checking or savings account statement, pay stubs, life insurance policies, etc.
• A physician statement verifying your pregnancy and estimated delivery date, if applicable

If you need additional assistance with your application, you can reach out to a kynector. A kynector is a trained professional with the tools and expertise to help Kentuckians apply for healthcare coverage through Kentucky Medicaid. You can also speak with a caseworker by calling 1 (855) 306-8959.

You can also apply for kynect with a physical application and deliver it in person to a local Department for Community-Based Services (DCBS) office. You can also mail your completed application to the Office of the Kentucky Health Benefit Exchange at 12 Mill Creek Park, Frankfort, KY, 40601, or fax it to (502) 573-2005.

Eligibility Requirements

Any legal resident of Kentucky can apply for kynect. To qualify for Kentucky Medicaid, you must be a low-income individual or family and meet one of these eligibility criteria:

Because income plays a major role in getting free health care through Kentucky Medicaid, your household must meet certain income requirements to be eligible for benefits. According to the number of people in your household, you must earn less than these annual income amounts before taxes:

Getting a Kentucky Medicaid Card

As a kynect benefits member, you can easily access and download your MAID card. To do so, visit your dashboard and click on the "I want to..." button. Once the dropdown menu pops up, click on "View/Download Medicaid Card." You can also access that link from the Medicaid section on the Benefits screen.

After clicking the link, you'll see a copy of your MAID card as a PDF on a new internet browser tab. To download a copy of the card, click the download icon on the top right of the PDF screen.

Renewing or Replacing Your Kentucky Medicaid Card

As a kynect benefits member, you can request a new physical Kentucky Medicaid card electronically if you prefer not to download a digital copy. Request your MAID card electronically by visiting the same "I want to..." dropdown link on your dashboard. Then click "Request a Medicaid Card."

Pick your name or whoever's name in your household that needs a Medicaid card from the "Who needs a new Medicaid card" tab. You'll also need to answer the "Why are you replacing your Medicaid card" question and complete any additional information on the screen. You can either choose to get the new MAID card in the mail at your home address or pick it up from a DCBS office.

Whether you're requesting a new physical MAID card electronically or replacing your original card that is no longer in your possession, you'll follow the same steps.

Though your MAID card will be valid for as long as you are eligible for Kentucky Medicaid through kynect benefits, you must renew your benefits every 12 months. Otherwise, you risk losing your health care coverage. Before it's time to renew your benefits, your local DCBS office will send a form to your home address explaining your renewal timeline and options.

The most convenient way to renew your Medicaid and keep your MAID card active is by renewing it on the kynect benefits self-service portal. You can also complete the Renewal Form for Medical Coverage that the DCBS office sends you and mail it to DCBS Family Support, P.O. Box 2104, Frankfort, KY, 40602. Document drop offs at a DCBS office are also acceptable.

Kentucky Medicaid Coverage

kynect benefits offer Kentuckians the opportunity to select their preferred MCO to provide their health care coverage. An MCO or Managed Care12 Organization is an insurance company that is under contract with the Kentucky Department for Medicaid Services to provide Medicaid-approved health care services to eligible Kentucky residents.

When you qualify for kynect benefits and Kentucky Medicaid, you can select your MCO from the Enrollment Manager screen. On that screen, you'll see a list of current MCOs with a summary of their plans. You can choose the best option matching your or your family's eligibility, which will also appear on the Enrollment Manager screen.

Many people in Kentucky know their Medicaid coverage according to their MCO. An example of an MCO is Humana. Every MCO maintains a network like other health coverage agencies to ensure they provide comprehensive services to their members. Coverage options may vary, and you can learn more about the general Kentucky Medicaid coverage and what treatments and services the program does not cover.

Dental

For adults and children with Kentucky Medicaid through kynect benefits, covered dental care includes:

• Annual oral exams
• Emergency dental visits
• X-rays
• Tooth extractions
• Dental fillings

Thanks to a provision due to Governor Andy Beshear's expansion of the Kentucky Medicaid program active as of January 1, 2023, adult Medicaid participants will receive more comprehensive dental coverage. As a result of this provision, more low-income adults and individuals with disabilities will receive better reimbursement rates for their dental services. Even if you need a treatment that Kentucky Medicaid doesn't cover, you will pay less out of pocket, which makes dental care more accessible.

kynect benefits' Kentucky Medicaid for adults will now provide many more dental services to improve oral health and well-being. You can now receive Medicaid coverage for dental implants, dentures, two annual teeth cleanings, root canals, dental restorations, and periodontics. The new provision doesn't apply to children because they already receive comprehensive dental care. If you are traveling outside of Kentucky for leisure, invest in proper travelers insurance.

Prescription Drugs

When you choose your Kentucky Medicaid MCO through kynect benefits, your plan covers some prescription drugs. The state has a comprehensive preferred drug list to cover a myriad of health problems.

These are some of the basic guidelines for Kentucky Medicaid prescription drugs:

• All covered drugs must be medically necessary and have FDA approval.
• Covered diabetic supplies include sterile needles, lancets, reagent strips, and home blood glucose monitors.
• Medical professionals may prescribe over-the-counter drugs from a list of eligible drugs for reimbursement from the pharmacy.

Though Kentucky Medicaid covers many medications and medical supplies through pharmacies, it won't cover everything or reimburse you for the drugs you take. For example, if you want to take medication to gain or lose weight, encourage fertility, or promote hair growth, you'll have to pay for it out-of-pocket. You also can't use Medicaid to pay for vitamins other than prenatal vitamins.

Extended Health Care

Extended health care is an additional health insurance policy that takes care of medical expenses that a primary insurance policy doesn't cover. Unfortunately, Kentucky Medicaid may not cover your health care needs entirely, though it does offer a substantial amount of help to disabled and low-income residents.

Extended health care is sometimes necessary. Though buying a private insurance plan will cost more than free Kentucky Medicaid, the premiums will be substantially less than paying out-of-pocket for medical procedures, medications, and medical supplies. In Canada, many people rely on extended health care plans to make up for the shortcomings of their free government-funded care.

While kynect benefits isn't currently offering extended health care in the traditional sense, you can purchase a private insurance policy to fill in the gaps Kentucky Medicaid leaves open. Examples of private insurance coverage to consider are:

• Critical illness insurance: This policy offers coverage if you are likely to develop a debilitating illness.
• Disability insurance: You can purchase disability insurance to shield your household against sudden income loss due to health-related problems.
• Orthodontic insurance: Though you and your children can get dental insurance through Kentucky Medicaid, you may need more help paying for expensive orthodontic procedures like braces.

If you have both Kentucky Medicaid through kynect benefits and a private insurance policy, your Medicaid coverage will be your supplemental insurance. In other words, your private health insurance plan must cover all eligible expenses before Medicaid takes care of what's left. You must also notify Kentucky Medicaid about your private coverage to avoid third-party liability.

Travel and Out-of-State Coverage

Unfortunately, you can't use your Kentucky Medicaid benefits if you travel out of the state. Though Medicaid is a federally funded program with several mandated services that each state must follow, states also have the right to create their own eligibility requirements. As such, you cannot transfer or use your MAID card anywhere but in Kentucky.

If you are going on vacation and wish to purchase travel insurance to cover unexpected medical costs on your trip, you will need to purchase a separate plan from a private insurer. If you are traveling outside of Kentucky for leisure, invest in proper travelers insurance.

Still, as a Kentucky resident, you can use Medicaid to cover medically necessary transportation needs if you're seeking a health-related service that Medicaid covers. If you have a severe illness or injury that requires emergency medical attention, Kentucky Medicaid will cover your emergency ambulance to a hospital if no other means of transportation is available.

Sometimes non-emergency ambulance transportation is necessary, especially for people with disabilities or who cannot leave their beds. If there is no free transportation option available that will meet your medical needs en route to a Medicaid-covered service, Medicaid may cover the transportation.

Medical transportation for specialty care is also acceptable by Medicaid. However, a referral from the Medicaid member's primary care physician may be necessary.

To book the service, you'll need to partner with the Human Service Transportation Delivery (HSTD) program. As Kentucky's brokerage system for medical transportation, the HSTD may provide medical transportation assistance by bus, taxi, van, or public transport, depending on the needs of the Medicaid recipient. They also provide wheelchair service and accessible transportation.

Students & Seniors

Kentucky offers two school-based Medicaid programs for students. The School-Based Health Services (SBHS) program allows local education agencies to become Medicaid Health service providers for eligible children. The other option is the School-Based Administrative Claiming (SBAC) program, which reimburses Kentucky school district employees for the time they spend identifying and enrolling students and their families into Medicaid.

Kentucky also offers specific coverage for seniors who are Medicaid members. Low-income seniors over 65 can receive coverage for medical and non-medical services and support through one of three long-term care programs:

• Nursing Home Medicaid: If you are an eligible member, you'll receive this benefit at a nursing home facility.
• Home and Community-Based Services: This program offers Medicaid waivers to provide at-home services and support to delay nursing home admissions. However, home and community-based services usually have waiting lists and aren't available to everyone.
• Regular Medicaid: If you are a senior, blind, or disabled, you can receive long-term care services like adult day care if available.

What Kentucky Medicaid Does Not Cover

At first glance, it might seem like Kentucky Medicaid through kynect benefits covers almost everything. While you can enjoy many benefits with this program, Medicaid won't cover:

• Private nursing
• Elective cosmetic surgery
• Elective cosmetic dental procedures
• Hair removal or replacement
• Glasses not covered by Medicaid
• Contact lenses
• Liposuction
• Tattoo removal

It is also important to note that kynect does not cover the cost of funerals. While the state offers basic resources and very limited monetary benefits towards burial costs, what is available will most definitely not cover burial costs and services. It is always wise to ensure that in the event of your passing, your family is secured with comprehensive funeral insurance.

If you are looking for even more insurance coverage beyond what Denali Care provides, such as life insurance, consider exploring your options. Visit our life insurance quote page to get personalized quotes and find a policy that suits your needs.