A Guide to kynect benefits | Kentucky Medicaid

kynect benefits is the official website of the Commonwealth of Kentucky that outlines information about and how to apply for Kentucky Medicaid, which is a health insurance benefits program accessible to low-income Kentuckians.

Kentucky residents who are U.S. citizens, legal aliens, or permanent residents without sufficient health care coverage may apply for Kentucky Medicaid through kynect benefits. According to a publication by wkyt.com, as of 2021 14.6% of Kentuckians live below the poverty line. For this reason, partnering with Insurdinary to explore ways to expand your coverage is the best protection. Insurdinary can optimize your coverage to include a more comprehensive range of benefits and services by way of private health insurance.

    What Is kynect Coverage?

    kynect is the Kentucky government's self-service portal where residents can apply for various state benefits, like Kentucky Medicaid. This comprehensive system encompasses the state's benefits for healthcare, explains what kynect covers, and includes educational resources.

    Kentucky Medicaid is a state and federal government-funded program that gives health coverage to children, low-income adults, pregnant women, elderly people, and people with disabilities.

    The kynect benefits website handles applications and accounts for the Supplemental Nutrition Assistance Program (SNAP), the Kentucky Integrated Health Insurance Premium Payment (KI-HIPP) program, and Kentucky Medicaid.

    kynect is free to use because the federal government pays for most of Kentucky's Medicaid program, which accounts for 72% of the cost to the government to offer kynect benefits to Kentucky residents. Yet, the federal government now pays over 78% due to the increased need for affordable healthcare following the COVID-19 pandemic in 2020. The state also contributes to its Medicaid program through local taxes.

    What Is a MAID Card??

    Kentucky Medicaid

    A MAID card or Medical identification card is what you will receive if you are a Kentucky Medicaid member. On the front of the blue and white card, you'll find your full name and unique Medicaid identification number. This Medicaid number is what doctors use to identify you as a patient receiving care under Medicaid.

    The back of the card outlines the rules for using the card to cover a variety of health needs and services, as well as important contact information relating to your benefits. You can use your MAID card for as long as you remain eligible for Kentucky Medicaid, so keep it in a safe, easily accessible place for your convenience.

    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:

    • Someone 65 or older
    • An adult between the ages of 19 and 65
    • A child up to age 19
    • A pregnant woman
    • A blind or permanently disabled person

    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:

    Size of Household Max Income Eligibility Limit
    1 $19,392
    2 $26,228
    3 $33,064
    4 $39,900
    5 $46,737
    6 $53,573
    7 $60,409
    8 $67,245

    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.

    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 kynect 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.

    Common Procedures and Kentucky Medicaid Eligibility

    Kentucky Medicaid covers many medical services, but there's often confusion surrounding what it does and doesn't cover. Here is a short breakdown of what you can expect to receive when you choose an MCO for Kentucky Medicaid from kynect benefits.

    Dental
    X-Rays Yes
    Exams Yes, bi-annually
    Teeth Cleanings Yes
    Extractions Yes, for wisdom teeth and damaged teeth
    Vision
    Children automatically receive vision coverage under the Kentucky Medicaid program. If you're an adult, you can enroll in a vision insurance policy through kynect from Anthem Vision (Blue View Vision) or Vision Service Plan (VSP).
    Eye Exams Yes
    Glasses Yes
    Laser Eye Surgery No
    Surgery
    Rhinoplasty Yes, if medically necessary.
    Breast Reduction Yes, if medically necessary.
    Hospital
    Hospital stays Yes
    Ambulance transportation Yes
    Urgent care services Yes
    Giving birth Yes
    Therapy and Counselling
    You can use Kentucky Medicaid to cover mental and behavioral health services with your Kentucky Medicaid account. All MCOs offer some form of coverage for mental health services like therapy and counseling. You can also get help for problems with drugs and alcohol abuse.
    Sexual Health
    Gynecologist visits Yes
    Erectile Dysfunction No
    Birth Control Yes, for prescription birth control and IUDs
    Fertility Treatment No
    Specialist Services
    Dermatology Yes
    Physiotherapy Yes
    Massage Therapy Some MCOs like Aetna offer extra benefits under certain circumstances. For instance, Aetna offers a credit of up to $150 to use toward massage therapy for eligible adults.
    Podiatry and Foot Care Yes
    Allergy Testing Yes
    Sleep Physician Services and CPAP Machines Yes

    Extending Kentucky Medicaid Coverage

    Even with all of the coverage you and your family could receive with Kentucky Medicaid through kynect benefits, it may not be enough for your household's needs. No health insurance policy covers everything, so it's often necessary to seek multiple coverage options.

    If you need help finding supplemental insurance for your Kentucky Medicaid, you can simplify your search with the help of Insurdinary. Insurdinary is a top insurance comparison website that will help you determine which insurance plans are most suitable for your needs and easily compare quotes from multiple providers.

    With our seamless processes and team of knowledgeable representatives, Insurdinary makes it easy to compare rates and get the insurance coverage you need. Whether you're interested in travel insurance, life insurance, or additional medical coverage for prescriptions and specialty care outside of kynect benefits and Kentucky Medicaid, we can help.

    FAQ’s

    How long does it take to get approved for Kentucky Medicaid?

    The approval timeline for Kentucky Medicaid can vary depending on various factors, including the completeness of your application and eligibility verification. Typically, it takes about 45 to 90 days to process an application. However, emergency situations can expedite the approval process.

    What are the methods to apply for Kentucky Medicaid?

    You can apply for Kentucky Medicaid through multiple methods, including online applications through the Kentucky Health Benefit Exchange, by phone, by mail, or in person at your local Department for Community Based Services (DCBS) office. The online application is often the quickest and most convenient way to apply.

    Does Kentucky Medicaid cover the expenses of funerals?

    No, Kentucky Medicaid does not cover funeral expenses. It primarily provides healthcare coverage for eligible individuals and families, including services such as doctor visits, hospital stays, and prescription medications.

    Who is eligible for Kentucky Medicaid?

    Eligibility for Kentucky Medicaid is based on income, family size, and other factors. Eligible individuals typically include low-income families, children, pregnant women, individuals with disabilities, and seniors. Eligibility requirements may change, so it's advisable to check with the Kentucky Department for Medicaid Services for the most up-to-date information.

    What is Kentucky Medicaid?

    Kentucky Medicaid is a state and federally funded program that provides healthcare coverage to eligible low-income individuals and families. It aims to ensure that vulnerable populations have access to essential medical services, helping them maintain and improve their health.

    What other types of insurance does Insurdinary offer?

    Insurdinary, and its network of partners offer many different types of insurance. In addition to health, dental, disability, life, funeral and travel insurance as discussed on this page, you may also be interested to explore the following:

    References

    1. https://kypolicy.org/kentucky-medicaid-maintenance-of-effort/#:~:text=Normally%2C%20the%20federal%20government%20pays,%2C%20it%20paid%20over%2078%25.
    2. https://sso.kog.ky.gov/app/kogkygov_yourapplication_1/exk1uyk8okZVYs6Tq4h7/sso/saml?SAMLRequest=fZJha4MwEIb%2fiuS7RqNtbbBCaRkUtjG2Mli%2flBhjG7SJzcWu%2fvtFhcEYFPLljve9u%2bcuGbBL09J1Z8%2fqXVw7AdbbbVdIlj4nJBVxUfrxLEz9JF1yvyjmhV%2bQxSwuw2I%2bZzHyPoUBqdUKkSBE3g6gEzsFlinrUiGJ%2fXDpE7KPZjRxjwRJujggb%2bv6SMXs6Dxb2wLFGEAHtT4FdR%2bc9A2ztsUurHsXHHvdGZdoJB9NxwiLex11fZ3q%2bvD5BfP9NTkvhhJ4IELeRisQwxCdUVQzkEAVuwigltOP9cszdfNSPolop6AVXFZSlMi7XxoFdNzLY3drtNVcNyjPRm4zWR%2bbGIAwAwLKB%2b4JWyorjGJNwM8V%2fPKXFWAnvkkuAFvTgc3w1CjPprO9uvK77Zt2a%2bm9J20u7AFwFERjxp22GqV%2fsddNo783RjArVsh1E8jDeYb%2f%2f4%2f8Bw%3d%3d&RelayState=6fe03c4b-f4ce-4afa-ae09-050a899c341d&rp-realm=https%3a%2f%2fkynect.ky.gov%2fbenefits
    3. https://kynect.ky.gov/benefits/s/auth-reps-assisters?language=en_US
    4. https://www.benefits.gov/benefit/1214
    5. https://www.chfs.ky.gov/agencies/dcbs/dfs/Pages/default.aspx
    6. https://kyoralhealthcoalition.org/op-ed-expanding-medicaid-dental-coverage-means-a-healthier-more-productive-kentucky/#:~:text=On%20January%201%2C%202023%2C%20a,more%20than%20900%2C000%20underserved%20Kentuckians.
    7. https://www.courier-journal.com/story/news/politics/2022/10/20/kentucky-governor-beshear-expand-medicaid-coverage-dental-vision-hearing-care/69577176007/
    8. https://kyportal.magellanmedicaid.com/public/client/static/kentucky/documents/PreferredDrugGuide_full.pdf
    9. https://www.chfs.ky.gov/agencies/dms/Documents/TPLand.pdf
    10. https://www.chfs.ky.gov/agencies/dms/member/Pages/Medical-Transportation.aspx
    11. https://transportation.ky.gov/TransportationDelivery/Pages/default.aspx
    12. https://kynect.ky.gov/healthcoverage/s/vision-care?language=en_US
    13. https://www.anthem.com/individual-and-family/vision-insurance
    14. https://www.vspdirect.com/kentuckyexch/welcome
    15. https://www.chfs.ky.gov/agencies/dms/member/Documents/MCOValueAdded.pdf
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