Kentucky Health Insurance

According to the Commonwealth of Kentucky’s Department of Human Services, approximately 654,000 Kentuckians are currently living without health insurance. This statistic continues to rise as the current economy has made it more difficult for businesses to operate profitably in the state.

If you live in Kentucky and are denied by an insurance company, you become eligible for coverage through the Kentucky Comprehensive Health Insurance Association (KCHIA). You can’t be turned down, provided you can produce a “certificate of continuous coverage,” but many of its residents cannot do so because pre-existing health conditions, a lack of full-time employment or employment with businesses that do not offer group health coverage have made them ineligible for coverage under KCHIA.

The Commonwealth also recently introduced an alternate program for Kentuckians who are considered a “high risk” to traditional insurance companies or otherwise cannot provide a certificate of continuous coverage. Kentucky ACCESS, a state authorized health plan, provides limited healthcare benefits through a variety of different medical networks that are typically reserved for private insurance policyholders.

As a general rule, when you seek individual insurance in Kentucky, insurers are allowed to reject your application for coverage based on your health status. However, you may qualify for coverage as a “HIPAA-eligible” individual if you:

• have had ad at least 18 months of continuous creditable coverage, the last day of which was under a group planand
• have exhausted all COBRA continuation coverage which was available to you. People who are HIPAA-eligible are guaranteed the right to buy insurance through the Kentucky  Comprehensive Health Insurance Association

Kentucky Comprehensive Health Insurance Association (ICHIA)

ICHIA offers coverage to individuals who are unable to purchase an individual health insurance policy because they have pre-existing health conditions. You must apply for individual coverage and be rejected by at least one insurer before you become eligible for ICHIA – unless you are a “HIPAA-eligible” individual as described above. All “HIPAA-eligible” individuals, regardless of their health status, are eligible for ICHIA.

The Commonwealth of Kentucky recently launched a new statewide initiative directed at reducing its uninsured residents. The program, Healthy Kentucky, provides a number of coverage alternatives for residents who meet certain income guidelines and insurability criteria. In order to qualify, applicants to the Healthy Kentucky program must earn no more than 200% of the Federal Poverty guideline.

Generally, a single individual who makes no more than $21,000 or a family with dependents who make no more than $44,000 per year will be eligible for a plan under the program.

In 1994, Kentucky legislators passed a “guaranteed issue” mandate designed to protect individuals from rising health insurance premiums and rejections of coverage for individuals living with chronic health conditions typically considered “high risk” by insurers. Within two years of the program’s inception, some 60 nationally-recognized health insurance companies stopped writing new health insurance policies in the state and/or left Kentucky altogether because of its regulatory environment. The state is still suffering the effects of this action and has been trying to lure health insurance companies back.

Kentucky’s Uninsured Children

Some 67,000 children in Kentucky are not covered by health insurance. Unique to the healthcare reform initiatives currently going on throughout the country, the state of Kentucky has also adopted the Kentucky Health Kids program. Families with dependent children qualify for free healthcare coverage so long as their income is less than 150 percent of the Federal Poverty Guideline for their region. Residents who make more than this amount are charged a nominal premium and co-pay for covered children’s medical services, but families who make in excess of 200 percent of the Federal Poverty Guideline for their region do not qualify for the program. The Commonwealth has a current out-of-pocket limit of $450 per family per calendar year.

The federal Healthcare Subsidy Act that Congress introduced in spring of last year was designed to protect unemployed residents in Kentucky and across the country from unaffordable COBRA premiums. The program, in the form of nine-month subsidies, reduces the amount of COBRA insurance for Kentucky unemployment recipients by 35 percent. However, Kentucky was one of the first states in the country to sustain the economic downfall in the form of lost industries and full-time employers who left the state in search of less expensive areas to do business. Farmers, also a major industrial powerhouse for the state have continued to suffer in the current economy. Fewer subsidies are available for them, since less of their goods are being purchased.

The first recipients of the Federal’s COBRA subsidy are about to be notified that their benefits will soon end, meaning that for Kentucky residents who wish to maintain their current level of healthcare benefits will have to pay an additional 35 percent in premium hikes that were previously paid for them. There is not much hope for affordable state-sponsored healthcare on the horizon either. Facing a budget shortfall of approximately $200 million, even more social services in the state will be cut.