The Kentucky Medical Program is intended to provide medical and health-related assistance to low-income individuals and families who have no medical insurance or have inadequate medical insurance.

Program NameKentucky Medicaid
Expanded MedicaidYes
Websitechfs.ky.gov
Email[email protected]
Phone855-306-8959
Apply OnlineKentucky Healthy Benefit Exchange
Appeal a DenialDivision of Administrative Hearings
Find a Local OfficeLocal Office Search

Eligibility Requirements

To be eligible for Kentucky Medicaid, you must be a resident of the state of Kentucky, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

You must also be one of the following:*

  • Pregnant
  • Be responsible for a child 18 years of age or younger
  • Have a disability or a family member in your household with a disability

* ACA Medicaid expansion covers eligible low-income adults.

Annual Household Income Limits (before taxes)

Household Size*Maximum Income Level (Per Year)
1$17,131
2$23,169
3$29,207
4$35,245
5$41,284
6$47,322
7$53,360
8$59,398

*For households with more than eight people, add $6,038 per additional person.

Available Services Include:

Allergy careMaternity services
AmbulanceMental health services
ChiropracticNursing facility services
DentalOccupational therapy
Diagnostic & radiology servicesOrgan transplants
Durable medical equipmentOrthodontics
Emergency room servicesPain management services
Family planning servicesPhysical therapy
Hearing aidsPhysician office services
Home health servicesPrescription drugs
HospiceProsthetic devices
Hospital servicesUrgent care services
ImmunizationsVision

Copayments

Generic drug$1
Brand-name drug$1.00 - $4.00
Specialty visits$3
Physical or occupational therapy$3
Office visit$3
Laboratory, diagnostic, or X-ray service$3
Outpatient hospital service$4
Durable medical equipment$4
Outpatient surgery$4
Emergency visit for non-emergency$8
Inpatient services (hospital admission)$50

The following groups do not have a copay:

  • Foster children
  • Children enrolled in Medicaid
  • Pregnant women (includes 60-day period after pregnancy ends)
  • Kentucky Medicaid beneficiaries who have reached their cost sharing limit for the quarter
  • Individuals receiving hospice care
  • The following services are exempt from copays:
  • Emergency services
  • Some family planning services
  • Preventive services

Copay Limits

There is a limit on the total amount of copays you will have to pay. You will not have to pay more than 5% of your family’s income each quarter. Quarters are January-March, April-June, July-September, and October-December.