Kentucky Health Insurance

In Kentucky, as in many other states, your health insurance options are often dependent on your health status and age. Kentucky State laws protect you in the following ways.

• Coverage under your group health plan (if your employer offers one) cannot be denied or limited, nor can you be required to pay more, because of your health status. This is called nondiscrimination.
  
  
• All health plans in Kentucky must limit exclusion of pre-existing conditions. There are rules about what counts as a pre-existing condition and how long you must wait before a new health plan will begin to pay for care for that condition. Generally, if you join a new health plan, your old coverage will be credited toward the pre-existing condition exclusion period, provided you did not have a long break in coverage.
  
  
• Your health insurance cannot be canceled because you get sick. Most health coverage is guaranteed renewable.
  
  
• If you purchase individual health insurance, there are some limits on how much your premiums can vary due to your health status, age, and other factors.
  
  
• If you leave your job, you may be able to remain in your old group health plan for a period of time. This is called COBRA or state continuation coverage. It can help when you are between jobs, or when you retire early and are not yet eligible for Medicare. There are limits on what you can be charged for this coverage.
  
  
• If you lose your group coverage under a fully insured group health plan and meet other qualifications, you also can buy a conversion policy. There are limits on what you can be charged for a conversion policy, although they tend to be costly.
  
  
• If you lose your group health insurance coverage and meet other qualifications, you will be HIPAA eligible. If so, you can buy individual health insurance from Kentucky Access. All your pre-existing conditions will be covered immediately. Premiums will vary based on your age and gender.
  
  
• You may be eligible to buy health coverage from Kentucky Access if you have had trouble obtaining affordable individual health insurance. In this case you may face a pre-existing condition exclusion period.
  
  
• If you are a small employer buying a small group health plan, you cannot be turned down because of the health status, age, or any factor that might predict the use of health services of those in your group. This is called guaranteed issue.
  
  
• If you are a small employer buying a group health plan, there are limits on what you can be charged because of health status, age, or other characteristics of those in your group.
  
  
• If you have low or modest household income, you may be eligible for free or subsidized health coverage for yourself or members of your family. The Kentucky Medicaid program offers free health coverage for pregnant women, families with children, elderly and disabled individuals with very low incomes.
  
  
• If your children are 18 years old or younger, do not have health insurance, and meet other qualifications, you may be able to buy insurance for them through the Kentucky Children’s Health Insurance Program (KCHIP).
  
  
• If you have lost your health insurance and are receiving benefits from the Trade Adjustment Assistance (TAA) Program then you may be eligible for a federal income tax credit to help pay for new health coverage. This credit is called the Health Coverage Tax Credit (HCTC), and it is equal to 65% of the cost of qualified health coverage, including COBRA and state continuation coverage.
  
  
• If you are a retiree aged 55-65 and receiving pension benefits from Pension Benefit Guarantee Corporation (PBGC), then you may also be eligible for the HCTC.