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    A) Questions about the March 27, 2019 Legal Decision

  • When will Kentucky HEALTH begin in Kentucky?

    ​As of March 27, 2019, the Kentucky HEALTH program is not live and does not have an anticipated start date. Any updates to the implementation timeline of Kentucky HEALTH will be made available at

  • What does the legal decision mean for beneficiaries?

    ​Medicaid beneficiaries will not see changes in their coverage and benefits due to the delay of Kentucky HEALTH.  For the most up-to-date information about your coverage and benefits, beneficiaries can contact your Managed Care Organization (MCO).

    The contact information for each MCO is:

    • Anthem - 855-690-7784 
    • Aetna Better Health of KY (formerly CoventryCares of KY) - 855-300-5528 
    • Humana CareSource - 855-852-7005 
    • Passport Health Plan - 800-578-0603 
    • WellCare of Kentucky - 877-389-9457
    If someone does not know the name of their Managed Care Organization, they can reach out to the Department for Community Based Services (DCBS) at 1-855-306-8959 or a local DCBS office. They can also can access information about their Managed Care Organization and benefits at
  • Are beneficiaries responsible for copays for prescriptions and doctors’ visits?

    ​Because Kentucky HEALTH did not start, the Medicaid copay policy still applies. This means that some Medicaid beneficiaries are required to pay copays for some services. For more information about the copay policy, please visit the Department for Medicaid Services (DMS) website at and click "Members." 

  • Should providers continue to submit Medically Frail Attestation Forms on behalf of beneficiaries?

    ​No. At this time, Managed Care Organizations will not be accepting Medically Frail Attestation Forms. More information will be provided in the future.  

  • Since Kentucky HEALTH did not begin on April 1, what happens with the money in a My Rewards Account? Can beneficiaries still accrue My Rewards?

    A beneficiary's My Rewards Account balance is not affected. They may continue to accrue My Rewards dollars. Should Kentucky HEALTH take effect in the future, they may be able to use My Rewards dollars.

    Beneficiaries may continue to accrue My Rewards dollars by doing many qualifying activities, including:

    • Taking online courses at
    • Getting preventive care
    • Participating in education and training activities
    • … and more!

    Check out the Qualifying Activities to Accrue My Rewards Dollars for a full list of qualifying activities.

  • B) Kentucky HEALTH Overview

  • What is Kentucky HEALTH?

    Kentucky HEALTH is the Commonwealth’s new health and well-being program for certain low-income adults and their families. The program gets its name from its mission. The word HEALTH stands for “Helping to Engage and Achieve Long Term Health.”

    The goal of the program is to offer each beneficiary the ability to customize a path based on individual needs that will lead to better health, engagement in their communities, improved employability, and success through long-term independence.

  • Why Kentucky HEALTH?

    The current system has not improved health outcomes and is not sustainable. The Medicaid expansion as enacted has not moved the needle on these metrics, and the Commonwealth cannot continue a program that does not propel participants toward better health and economic security.

    Instead, the Commonwealth needs a program that empowers and supports the well-being of individuals, families, and communities in Kentucky.

    Kentucky HEALTH will:

    • Address the needs of the whole person to help improve beneficiary health and well-being.

    • Help beneficiaries be more active and informed about healthcare and how to use it.

    • Connect beneficiaries to employment and training services using programs, resources, and tools that are already available in our communities.

    • Be more cost-effective and accountable.

    • Provide beneficiaries new skills to transition them successfully to commercial health insurance.

    • Save an initial estimated $2 billion in state and federal taxpayer dollars over the demonstration, according to initial estimates.

    • Help make the Medicaid program affordable for the Commonwealth to maintain, even with the economic issues facing Kentucky.

  • How will Kentucky HEALTH affect beneficiaries?

    Kentucky HEALTH is designed for working age adults and their families.  Kentucky HEALTH benefits will be available to all non-disabled Medicaid beneficiaries, low-income parents, family caregivers, pregnant women, Former Foster Youth up to age 26, and children. Kentucky HEALTH is not for people who are on Medicare (over age 65) or those who are on Medicaid due to age or disability.

  • How can beneficiaries get information about their Kentucky HEALTH benefits?

    Beneficiaries will have many different ways to get information about their benefits.  Some examples of information about beneficiary benefits include:

    • Notices from Kentucky HEALTH

    • Notices from the Managed Care Organizations ((MCOs)

    • Comprehensive beneficiary handbook MCOs

    • The call center

    • Kentucky HEALTH website, including key resources such as the Kentucky HEALTH Getting Started Guide, a comprehensive overview for beneficiaries

  • How do beneficiaries apply for Kentucky HEALTH?

    Beneficiaries may use benefind to see if they qualify for Medicaid coverage.  Benefind is the state website to apply for Medicaid, Kentucky Child Health Insurance Program (KCHIP), Supplemental Nutrition Assistance Program (SNAP - formerly called Food Stamps), Kentucky Transitional Assistance Program (KTAP), Kentucky’s Temporary Assistance for Needy Families (TANF cash assistance program) and other benefit programs.  Please go to to apply for benefits without having to visit a local DCBS office. To contact an assister, call 1-855-459-6328. Beneficiaries can also click here to find an assister in their area

  • Can application assisters still help beneficiaries?

    Yes, in-person assisters will be trained on Kentucky HEALTH and able to help beneficiaries apply. Beneficiaries may call 1-855-459-6328 or  use this search tool to find an assister in their area

  • Are there any added costs to implementing Kentucky HEALTH?

    While there are some new development administrative costs to implement the program, initial estimates suggest that Kentucky HEALTH could save an initial estimated $2 billion in state and federal funds over the course of the demonstration.

  • C) Eligible and Non-eligible Populations

  • Who is eligible for Kentucky HEALTH?

    Working-age adults and their families may be eligible for Kentucky HEALTH.  This includes Medicaid beneficiaries, such as:

    • Low-income parents and caretakers (including Medicaid expansion adults)

    • Pregnant women

    • Children

    • Former Foster Youth up to age 26

    Individuals can use the Kentucky HEALTH Eligibility Finder to get a prediction of if they may be eligible for Kentucky HEALTH, and if so, what their eligibility category is likely to be. Individuals can officially apply for Kentucky HEALTH at 
  • Who is NOT affected by Kentucky HEALTH?

    Individuals who are over 65, blind, and/or disabled will not be affected by Kentucky HEALTH. Examples of people who will not see any changes to their Medicaid include: 

    • Individuals on certain waivers:

      • Home and Community Based Waiver

      • Michelle P. Waiver

      • Acquired Brain Injury (ABI) and ABI Long-term Care Waiver

      • Model Waiver II

      • Supports for Community Living

    • Individuals determined eligible for Supplemental Security Income

    • Individuals in the Medicaid buy-in program for working disabled adults

    • Individuals covered by a Home and Community Based Waiver or residing in a Long Term Care Facility

    • Individuals on Medicare

    • Children in foster care or receiving subsidized adoption

    • Individuals participating in the Breast and Cervical Cancer Treatment Program

  • Will individuals lose benefits under Kentucky HEALTH?

    When Kentucky HEALTH goes live, individuals will not lose medical benefits.

    Most individuals will keep the same benefits.  Pregnant women, children, individuals who qualify as Medically Frail, Former Foster Youth up to age 26, and groups covered by Medicaid before the expansion will have all the same benefits they do now, including vision, dental, and access to non-emergency medical transportation. 

    Non-disabled adults—those who became eligible for Medicaid when it was expanded—will also be able to get the same medical benefits, but they will get some of them in a different way.  These individuals will still have access to preventive and specialty medical services through their managed care organization (MCO) plan; however, non-medical vision and dental services will be available through their My Rewards Account—a special health savings account where participants can earn dollars by doing certain healthy activities. Click here for more information about the activities that qualify for My Rewards dollars!

  • How will beneficiaries know what to do when Kentucky HEALTH begins?

    We will keep people informed in many different ways. Beneficiaries will hear directly from the Commonwealth and from their health plan (Managed Care Organization), social media, community outreach, direct mail and more. 

  • What can beneficiaries do now to get ready for Kentucky HEALTH?

    If beneficiaries have recently moved, they should log in to or call 1-855-306-8959 to update their mailing address and sign up for email updates so they do not miss any important information.

    Starting on January 1, 2018, all adults eligible for Kentucky HEALTH began earning My Rewards dollars. When beneficiaries go to the dentist for a cleaning, take their dependent child in for a check-up, get a health screening, or complete other types of preventive services, they automatically earn dollars in their My Rewards Account. Beneficiaries may also take online courses at to earn dollars for their My Rewards Accounts. The My Rewards Accounts will become active when Kentucky HEALTH begins. Click here for more information about the activities that qualify for My Rewards dollars!

  • Do Survivors of Domestic Violence and beneficiaries experiencing homelessness need to answer "No" to the question asking "Are you in Good Health?" on the Medicaid application to qualify as Medically Frail?
    There are specific questions within the Medicaid application for beneficiaries to indicate if they are experiencing homelessness. However, the process for Survivors of Domestic Violence will vary, based on how the application is completed:
    1. When completing an application with a Department of Community Based Services (DCBS) caseworker, applicants will be asked if they are a Survivor of Domestic Violence
    2. Applicants utilizing the self-service portal at will be directed to call DCBS

  • How will Domestic Violence be reported? How long will the Survivor of Domestic Violence designation last?

    ​Beneficiaries self-report their status as a Survivor of Domestic Violence. After reporting their status, the beneficiary will be considered a Survivor of Domestic Violence for 12 months. If someone is already a Medicaid beneficiary, the person can report a change to reflect the domestic violence information. Beneficiaries can report a change by:

    1. Calling the Department for Community Based Services at 1-855-306-8959
    2. Visiting a local Department for Community Based Services office to speak with a case worked 

  • D) Medically Frail Designation

  • What does “medically frail” mean?

    Beneficiaries may be considered medically frail for many different reasons.  Some of those reasons include:

    • Disabling mental health diagnosis

    • Chronic substance use disorder

    • Serious and complex medical condition

    • Significant impairment in ability to perform activities of daily living

    • Diagnosed with HIV/AIDs

    • Eligible for Social Security Disability Insurance (SSDI)

    • Chronic homelessness

    • Survivors of Domestic Violence

  • How will someone know if he or she is medically frail?

    Kentucky HEALTH will be able to identify people who are medically frail using four key methods:

    1. The State Systems identify individuals who receive Ryan White programs (HIV/AIDS), and Retirement Survivors and Disability Insurance (RSDI) due to disability
    2. Managed Care Organizations (MCOs) may be able to look at a beneficiary's past medical services to screen for Medically Frail status
    3. Providers can report that their patient may be Medically Frail to the patient's MCO. The provider may be asked to fill out the Kentucky HEALTH Medically Frail Provider Attestation form
    4. The beneficiary can self-report that they may qualify as Medically Frail by completing the health screening questions at

  • How does being medically frail change the benefits someone gets on Kentucky HEALTH?

    Someone who is considered medically frail will get all the same medical benefits he or she gets now, including:

    • Preventive care services

    • Specialty services

    • Non-emergency medical transportation

    • Vision services

    • Dental services​

  • Will someone who is medically frail have to do anything different?

    People who are Medically Frail will have access to new resources. 

    1. They will have an option to pay a monthly premium.  If they do pay, they will have access to a My Rewards Account.

    2. They will have an option to participate in the PATH program.  It stands for “Partnering to Advance Training and Health,” and will provide lots of great job and community engagement resources, free of charge. 

    Managed care organizations will periodically need to verify that beneficiaries are still medically frail, and beneficiaries may be asked to provide information as a part of that process. 

  • Will beneficiaries be covered by their MCO while waiting to be determined Medically Frail?

    Medically Frail determinations do not impact eligibility or enrollment. The individuals will have a cost share requirement and PATH Community Engagement requirement (unless otherwise exempt or otherwise meeting) while waiting to be determined Medically Frail.

  • How long will a beneficiary be considered Medically Frail? Does it have to be renewed? What is the process the renew Medically Frail status?
    A Medically Frail designation is generally valid for 12 months. After the 9th month, the Managed Care Organization (MCO) will begin the process to determine if the beneficiary still qualifies as Medically Frail. There are two ways to confirm if the person still qualifies as Medically Frail:
    1. The MCO reviews medical information to see if the individual still has a Medically Frail condition
    2. Providers complete the Provider Attestation form to verify if the beneficiary still has a condition that meetings the definition of Medically Frail

    Beneficiaries can complete the health screening questions at for more information about what qualifies as Medically Frail. They can contact their MCO for more information. 

  • What is the timeline for a beneficiary to change their eligibility category to Medically Frail?

    If a beneficiary thinks they may be Medically Frail, they should contact their Managed Care Organization (MCO) as soon as possible. MCOs will have 14 days to decide on whether a beneficiary qualifies as Medically Frail. The MCO will give the beneficiary guidance on next steps, which may include reaching to a provider. Once the MCO determines if the beneficiary is Medically Frail, the beneficiary will receive a Medically Frail approval or denial letter from their MCO. 

  • Do all MCOs use the same criteria to determine Medically Frail status>

    Yes, all MCOs use the same tool to determine if a beneficiary qualifies as Medically Frail. 

  • How does the point system help determine if a beneficiary with a Substance Use Disorder qualifies as Medically Frail?
    There are two Substance Use Disorder-related situation that automatically qualify someone as Medically Frail based on provider attestation:
    1. First, a beneficiary has had at least one inpatient or residential Substance Use Disorder (SUD) treatment episode, at least one Intensive Outpatient Program (IOP) service, or a partial hospitalization service for SUD treatment within the last 6 months
    2. Second, a beneficiary has had at least one drug overdose requiring medical care within the last 6 months 
    The Commonwealth has also developed a tool to determine if someone in Kentucky HEALTH may qualify as Medically Frail. The tool assigns point values to certain qualifying situations or conditions. For example, participating in a voluntary Substance Use Disorder recovery program within the last 6 months counts as three points. To qualify as Medically Frail due to a Substance Use Disorder, beneficiaries must have five points based on qualifying situations or conditions.  

    For now, if the beneficiary qualifies as Medically Frail, the beneficiary will be considered Medically Frail for 12 months, starting when the Kentucky HEALTH program begins. 

  • E) Cost Sharing

  • What are the differences between the Premium Plan and the Copay Plan?
    Individuals who are required to make premium payments begin on the Premium Plan. If the individual does not pay the premium each month to his or her Managed Care Organization, then he or she will have a penalty that varies based on household income:
    1. If household income is at or below 100% of the Federal Poverty Level, the individual will be moved into the Copay Plan. This means that the individual will have to pay a copayment to the provider each time he or she gets a medical service. The individual's My Rewards Account will also go inactive.
    2. If household income is above 100% of the Federal Poverty Level, the individual is suspended from Medicaid benefits for a six-month suspension period. The individual may end the suspension period early by completing certain re-entry activities. 

  • How much will Kentucky HEALTH beneficiaries pay in monthly premiums?

    Monthly premium payments will be on a sliding scale based on the beneficiary's household income.  Premiums will range from $1.00 to $15.00 per month.

    Premium Amount Based on Household Income

    Household income under 25% Federal Poverty Level (FPL)

    $1.00 per month​

    Household income between 25-50% Federal Poverty Level (FPL)

    $4.00 per month​

    Household income between 51-100% Federal Poverty Level (FPL​)

    $8.00 per month​

    Household income  between 101-138% Federal Poverty Level (FPL​)

    $15.00 per month​

    • Pregnant women and children on Kentucky HEALTH will not have a premium payment.

    • People who are medically frail or former foster youth up to age 26 can choose to pay the monthly premium to get access to a My Rewards Account.

    • All other adults in Kentucky HEALTH will be required to pay monthly premiums.

  • How much will beneficiaries pay if they have copayments?

    Beneficiaries who are paying their monthly premiums will not have copayments. However, beneficiaries with a household income below 100% of the Federal Poverty Level (FPL) who do not pay their premium will have to pay copayments. Copayment amounts may vary based on the type of service, and range from $3.00 for an office visit to $50.00 for a hospital visit. Copayments can be more expensive than the monthly family premiums.

  • How will cost share optional beneficiaries opt-in or opt-out of cost sharing?

    Cost share optional individuals​ receive an initial premium invoice and can opt in by paying the first premium and continuing to pay premiums.  If a beneficiary begins to pay premiums and then stops, however, they will have a $25 deduction from their My Rewards Account.

    If they don't pay the initial payment, they are moved to the no cost share plan and do not receive a penalty. The MCOs will stop sending invoices at that point. 

  • How does the new copayment policy going into effect on January 1, 2019, interact with Kentucky HEALTH?
    Starting January 1, 2019, Medicaid beneficiaries in Kentucky will start paying copays for some services. Some services and individuals will be exempt from copayments:
    1. Services exempt from copays: Emergency services, some family planning services, and preventative services (including screenings, check-ups, and patient counseling to prevent illnesses, disease and other health problems)
    2. Individuals exempt from copays: Children (including foster children), pregnant women (includes 60-day period after pregnancy ends), individuals on hospice care 
    When Kentucky HEALTH begins, some beneficiaries will have a monthly premium requirement instead of copayments. The penalty for not paying a premium may depend on a beneficiary's household income:
    1. Household income that is at or less than 100% of the Federal Poverty Level (FPL): They may be subject to the copay requirement
    2. Household income that is above 100% of the Federal Poverty Level (FPL): Their medical benefits may be suspended

    Some beneficiaries on Kentucky HEALTH will be exempt from copayments, regardless of their income when Kentucky HEALTH begins. For example, individuals who qualify as Medically Frail or are Former Foster Youth up to age 26 may have an optional premium that will not have copayments if they fail to pay the premium. If a beneficiary has a cost sharing requirement from Kentucky HEALTH, it will begin when Kentucky HEALTH begins. Non-Kentucky HEALTH Medicaid beneficiaries will still have copayments once Kentucky HEALTH begins. 

  • Will copays be charged per service or per visit?
    Copays are paid per visit. A visit is defined as an encounter or series of encounters that are performed on the same date of service at the same physical location (including telehealth services). 

  • For people transitioning into Kentucky HEALTH, how long will they pay copayments before being moved to premiums?
    These individuals will be placed on the copayment plan and given 60-days to pay a premium. If a premium is submitted within the 60-day period, they will switch to the premium plan.

  • If individuals within the same household are on the same MCO but have different lengths of duration in Kentucky HEALTH, which premium amount should be paid?
    The premium will be calculated based on the cost share requirement or optional member with the longest duration of enrollment in Kentucky HEALTH.

  • How does Fast Track assist beneficiaries with their premium payments?

    Fast Track can help some new Kentucky HEALTH beneficiaries access their benefits sooner. Like commercial insurance, some people on Kentucky HEALTH will need to pay a premium before their benefits will start. To speed up access to coverage, new applicants can pay a premium when they apply, instead of waiting for a bill (invoice) from their Managed Care Organization (MCO).


    Individuals may select the Fast Track option when they complete a Medicaid application with a DCBS Caseworker or on They can indicate that they want to Fast Track their coverage by choosing an MCO on the Fast Track MCO Selection screen. They will be enrolled with that MCO for the rest of the benefit year, which means they will only be able to change MCO for good cause reasons. Once the individual chooses an MCO and completes the application, the individual pays the MCO right away. This will complete the Fast Track process.


    The Fast Track amount may be different from the amount the person owes as a monthly premium. If the person paid more than the ongoing monthly premium, the overpayment will be applied to future premium invoices. If the person did not pay enough, he or she will get a bill from the MCO for the remaining amount.

  • Who is not impacted by Fast Track?

    ​Fast Track will not impact everyone. For example, it will not impact:

      1. People who are on Medicaid now and transition to Kentucky HEALTH when it begins. Those individuals will get an invoice from their Managed Care Organization (MCO) as a part of their transition. 
      2. Newly applying pregnant women, Former Foster Youth up to age 26, and children. They may be eligible for coverage immediately and up to 90 days before their application date.
      3. Newly applying refugees. They do not have a cost sharing requirement, so their benefits may start on the first day of the month they apply.
      4. Newly applying people who qualify as Medically Frail or are Survivors of Domestic Violence. They have an optional premium, but they will not have to pay before their benefits start. Their benefits may start on the first day of the month they apply.

  • What happens if beneficiaries do not pay their premiums?

    Beneficiaries who do not pay their premiums will have different penalties, based on their income and health status.

    • Pregnant women and children will not have a premium, so nothing will change.

    • Medically Frail and Former Foster Youth up to age 26 will keep their benefits, but their My Rewards Account will go inactive.  This means they will not be able to use the My Rewards Account to access extra benefits.

    • Other beneficiaries with household income under 100% FPL will have to pay copayments for each visit, and their My Rewards Account will go inactive. This means they will not be able to use the My Rewards Account to access extra benefits.

    • Other beneficiaries with household income over 100% FPL will lose access to their medical benefits, including their My Rewards Account, for up to six months unless they meet requirements for early re-entry.

    Beneficiaries will have opportunities to prevent a penalty; and if they lose their benefits, they will have opportunities to take steps to get them back before the end of the six-month lockout period.  Those steps include repaying missed premiums and taking a re-entry course. 

  • Can a beneficiary re-enroll after they have been locked out for not paying premiums?

    Yes, a beneficiary can re-enroll in Kentucky HEALTH.

    The beneficiary will need to complete the re-entry course and repay missed premiums, up to three months.

  • F) My Rewards Account

  • What is a My Rewards Account?

    A My Rewards Account is an account for most adults eligible for Kentucky HEALTH.  It works like a Health Spending Account.  Beneficiaries can accrue dollars into their account by completing certain activities.

  • What will the My Rewards Account cover?

    The My Rewards Account can be used to pay for services not covered by a beneficiary's managed care organization (MCO). For example, beneficiaries on the Alternative Benefit Plan may use My Rewards dollars to pay for non-medical dental and vision services. For all Kentucky HEALTH beneficiaries, medically necessary dental and vision services are still covered by the beneficiary’s MCO.

    MCOs will continue to cover non-medical dental and vision services for traditional Medicaid adults, pregnant women, children, individuals who qualify as Medically Frail, and Former Foster Youth up to age 26. These individuals will not use My Rewards Accounts for non-medical dental and vision services.

  • Who does not have a My Rewards Account?

    Children and non-Kentucky HEALTH Medicaid beneficiaries will not have My Rewards Accounts.

  • Why would eligibility groups with optional premiums decide to pay premiums to access their My Rewards Account and complete My Rewards activities if their dental and vision services are covered by their health plan?

    Eligibility groups with optional premiums (Former Foster Youth up to age 26, Survivors of Domestic Violence, and Medically Frail) are encouraged to earn My Rewards dollars so that if or when they transition to other categories of eligibility, they already have dollars in their My Rewards Account to pay for services not covered by their health plan. For example, someone in the Former Foster Youth up to age 26 category will transition to a new category of eligibility when they turn 26 years old. At that time, they may need to use My Rewards dollars to pay for some services that are not covered by their health plan.


    The My Rewards Account component of the Kentucky HEALTH program was designed to include additional benefits beyond dental and vision services, such as some fitness activities or over-the-counter medications. These additional benefits are not yet available.

  • What happens to a woman's My Rewards Account when she is pregnant?
    While a woman is pregnant, and for 60-days after the pregnancy ends (post-partum period), the woman is marked as "pregnant" in the eligibility system. While in the pregnancy category, beneficiaries do not have a cost sharing requirement and are a part of the State Plan. This means they do not need a My Rewards Account to access vision or dental services. A woman may be able to earn My Rewards Account dollars while she is pregnant and during the post-partum period if:
    1. New Beneficiary: If a woman enters Medicaid while she is pregnant, and she is eligible for Kentucky HEALTH, her benefits will include and active My Rewards Account
    2. Existing Beneficiary: If she was an existing Kentucky HEALTH member before she became pregnant and she had an active My Rewards Account when she became pregnant, her My Rewards Account will remain active
    3. Existing Beneficiary (Penalty): If the woman's My Rewards Account was inactive because she did not pay a required premium, her account will remain inactive during her pregnancy

  • Will it be difficult for beneficiaries to earn My Rewards dollars?

    No. Beneficiaries can earn My Rewards dollars for activities they already do. For example, beneficiaries can get rewards for things like getting yearly physicals, taking their dependent children to the doctor for well-child visits, and taking a health risk assessment with their managed care organization.

    Beneficiaries can get My Rewards dollars for these types of services without having to take any extra steps – the credit is applied automatically to their account. 

  • How else can beneficiaries earn “dollars” into their My Rewards Account?

    Beneficiaries can do healthy activities or extra community engagement activities to earn dollars for their My Rewards Account.  Click here for the list of qualifying My Rewards activities, which includes the examples listed below, and many more. 

    Health and well-being

    • Complete health risk assessment with the managed care organization

    • Complete diabetes, cardiovascular, weight management, or other chronic disease management course

    • Complete child preventive medical or dental exam

    • Avoid inappropriate emergency room visits

    • Follow-up with primary care doctor after ER visit

    Community Engagement

    • Register with career center and complete goals/needs assessment

    • Complete employment-related education or GED prep classes

    Beneficiaries will also have a Deductible Account to pay for some of their initial healthcare services.  If they do not use all of the money in that account, they may be able to roll half of the unused funds into the My Rewards Account at the end of the year.

  • Will My Rewards dollars earned now be available to use when Kentucky HEALTH begins?
    Yes, beneficiaries are encouraged to complete free online courses at, get preventative services done, and complete and report qualifying healthy activities at Everyone is encouraged to begin accruing rewards now.

  • Can an individual earn My Rewards dollars for completing their PATH Community Engagement requirement?

    While some activities can be used for both PATH Community Engagement requirements and to accrue My Rewards dollars, activity hours cannot be counted for both. An individual can only earn My Rewards dollars for community engagement activities if they have already completed their monthly PATH Community Engagement requirement.

  • Do dollars that have been accrued in a My Rewards Account expire?

    There is no expiration date for My Rewards dollars that have been accrued by beneficiaries. There is also no cap to the amount a beneficiary can accrue. Individuals who leave Kentucky HEALTH and are commercially insured without Kentucky Medicaid ​may apply to receive a cash payout of up to $500 from the remaining balance of their My Rewards Account. 

  • Is there a cap on how many My Rewards dollars that can be accrued?

    No, there is not a cap to how much money a beneficiary can accrue in their My Rewards Account. ​

  • Will the parent designated as primary caregiver get the My Rewards Dollars for a child's preventative care?

    If a specific eligible adult has not already been selected to receive My Rewards dollars for child preventative services, then the primary caregiver will receive the My Rewards dollars.

  • Can My Rewards dollars be used for copayments and premiums?

    No, My Rewards dollars can only be used for preventive and routine vision and dental services. There are a variety of ways to remain in Kentucky HEALTH for beneficiaries who have missed their premium payments or who are struggling. There are some ways to help people who may have trouble paying premiums or copayments:

    • Third parties can pay premiums on behalf of members. Friends, family, community organizations, providers and others can help pay a member's premium to help the member avoid penalties
    • Providers cannot turn away certain individuals for their inability to pay. Members with a household income at or below 100% FPL cannot be denied access to services if they cannot afford to pay a copayment. ​
  • What if a beneficiary does not receive enough My Rewards dollars to pay for treatment?

    Major medical services like preventive and specialty services will be covered for all Kentucky HEALTH beneficiaries. No one on Kentucky HEALTH should be missing yearly exams, cancer screenings, health screenings or checkups because of their My Rewards Account. In fact, these types of services will give beneficiaries funds to use on other services.

    If Medicaid expansion adults want non-medical vision and dental services, they can get them through their My Rewards Account. They can earn the dollars they need for those services by getting the types of health services recommended for them. They can also earn dollars by taking their dependent children in for their recommended health visits, by taking online health courses, or even by volunteering. 

    It may take some planning ahead, but Kentucky HEALTH offers many options for beneficiaries to earn the funds to access their vision and dental benefits.

  • When can beneficiaries start earning My Rewards Dollars?

    If beneficiaries are on Medicaid now and are eligible for Kentucky HEALTH, they will be able to earn My Rewards dollars before Kentucky HEALTH begins.

    • January 1, 2018: Starting in January 2018, all adults eligible for Kentucky HEALTH may begin earning My Rewards dollars. When beneficiaries go to the dentist for a cleaning, take their dependent child in for a check-up, get a health screening, or complete other types of preventive services, they will automatically earn dollars in their My Rewards Account 

    • April 1, 2018: Beneficiaries have the opportunity to continue earning dollars by participating in My Rewards education and training activities

    Beneficiaries may use My Rewards dollars when Kentucky HEALTH begins.

  • How many My Rewards dollars will be required for dental and vision services?

    ​The My Rewards Account is the way for some Kentucky HEALTH beneficiaries to pay for some vision and dental services. On average, it costs between $46 and $52 My Rewards dollars to pay for a General Eye Examination. It costs $127.50 My Rewards dollars to pay for a Comprehensive Oral Examination, Routine Dental Cleaning, and Panoramic X-Ray.

    A full list of the vision and dental services covered by the My Rewards Account can be found here.

  • G) PATH Community Engagement

  • What is the PATH Community Engagement requirement?

    PATH stands for “Partnering to Advance Training and Health” and refers to the community engagement requirement of Kentucky HEALTH. Some Kentucky HEALTH beneficiaries will need to participate in 80 hours each month of PATH Community Engagement activities to stay eligible for Medicaid benefits through Kentucky HEALTH. 

    Though the PATH Community Engagement requirement will only apply to some Kentucky HEALTH beneficiaries, Kentucky HEALTH is offering ALL beneficiaries access to many community engagement and employment resources through the PATH Community Engagement program. Beneficiaries can use the program to access job opportunities, job training, volunteer opportunities, and much more – all free of charge.

  • How can a beneficiary report PATH Community Engagement hours?
    There are multiple ways a beneficiary may report their PATH Community Engagement hours each month:
    1. Online at
    2. Calling a Kentucky Career Center
    3. Visiting a Kentucky Career Center (KCC Office Search:
    4. Calling the Department for Community Based Services at 1-855-306-8959 to request a paper form be mailed to the beneficiary. The beneficiary fills out the paper form and mails it to the address listed on the form

  • Who is required to participate in PATH Community Engagement?

    Many adult Kentucky HEALTH beneficiaries will be required to complete 80 hours of PATH-approved activities each month to stay eligible for their Kentucky HEALTH benefits.

    Pregnant women, children, individuals who qualify as Medically Frail, primary caregivers, full-time students, and Former Foster Youth up to age 26 will be considered exempt from the PATH requirement.

    Some beneficiaries are already meeting the PATH Community Engagement requirements; 

    •  Beneficiaries who are enrolled in the Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance for Needy Families (TANF) and meeting work requirements for one of these programs
    • Beneficiaries who have a full-time job (work 30 hours or more per week) and have reported it to DCBS or on benefind
    • Beneficiaries who are enrolled in Kentucky Integrated- Health Insurance Premium Payment (KI-HIPP) program

    Beneficiaries who are already meeting their PATH Community Engagement requirement  may be able to earn My Rewards dollars for some community engagement activities.

  • Are full-time students exempt from PATH Community Engagement during school breaks?

    A full-time student is exempt from a PATH Community Engagement requirement as long as they can verify that they are enrolled in a educational program full time. For many students, this may mean during the summer, they are not exempt from PATH Community Engagement. 

  • What can a beneficiary who lost their job do to maintain their benefits?

    If a beneficiary reports the loss of full time employment, they will also lose their PATH Community Engagement exemption. This means that they will need to complete their  PATH Community Engagement ​requirement beginning the next month. 

  • If someone is receiving unemployment, does this impact their PATH Community Engagement Requirement?

    No, unemployment insurance benefits have no impact on Kentucky HEALTH. A beneficiary who receives unemployment insurance benefits is still required to complete and report PATH Community Engagement hours if they are not otherwise exempt or meeting a satisfactory condition.​

  • When will beneficiaries who are conditionally eligible receive their PATH Community Engagement notice?

    The PATH Community Engagement Notice will be sent to beneficiaries no less than ​30 days prior to their requirement beginning. This will be sent once a beneficiary is fully enrolled and no longer conditionally eligible. 

  • What does “primary caregiver” mean?

    The primary caregiver is an adult member of a household who provides full-time care for another tax-dependent member of the household.  In general, only one adult member in the household can claim to be the primary caregiver. An individual must report their status as a primary caregiver to the Department for Community Based Services (DCBS) to be exempt from the PATH Community Engagement requirement.

    Example: A stay-at-home parent taking care of his or her child.

    Primary caregiver status will not change the benefits a person receives through Kentucky HEALTH. In addition, primary caregiver status will not affect whether or not the person needs to pay a premium. 

  • Is there a plan being developed to provide more and better-paying jobs?

    There are many high-demand, good-paying jobs in Kentucky now.  Over the next several years, there will be thousands of job openings, especially in 5 key areas:

    1. Advanced manufacturing

    2. Business and information technology

    3. Construction trades

    4. Healthcare

    5. Transportation and logistics

    While many jobs in these and other in-demand fields do not need a college degree, some do need a high school diploma or GED and some skills training. Participating in education and training courses will count towards the PATH Community Engagement requirement. Kentucky Career Center (KCC) coaches, may even be able to help beneficiaries find scholarships to participate in training opportunities

  • Will there be a PATH Community Engagement exemption for those who do not have reliable transportation, are living in an area without available work or volunteer opportunities, have been convicted of a felony or are facing other hardships?

    Kentucky HEALTH is partnering with local workforce development boards to identify resources that will help beneficiaries meet program requirements, gain practical skills, and obtain necessary training to successfully navigate the program.

    However, Kentucky HEALTH will consider exceptional circumstances that prevent beneficiaries from being able to meet their PATH requirements. Beneficiaries may qualify for temporary exemptions from the PATH Community Engagement requirements, based on their situation.

  • What happens if someone doesn’t meet the PATH requirement?

    Beneficiaries who do not meet their PATH (Partnering to Advance Training and Health) requirement will lose access to their medical benefits until they make up or meet the required hours or take a re-entry course. ​

  • If someone has had trouble finding a job in the past, what should they do in order find a job?

    They should visit a career coach at a Kentucky Career Center to discuss what may be holding them back. Career coaches are trained to look at the education and experience people have and identify if they need some additional training. They will also tell people about the in-demand jobs in their region, and will assist them with job applications and making a resume.

  • If someone can’t make it to a career center, how can they learn more about high demand jobs and what it takes to get them?

    ​There are many high-demand, good-paying jobs in Kentucky that do not need a college degree, but do need a high school diploma or GED and some skills training. Visit to learn about short-term certification programs at community and technical colleges nearby that can help people qualify for these jobs. People can earn the certificate they need in 16-80 weeks.

  • If someone did not graduate from high school, but would like to get certified for a high-demand job, what are their options?

    Schools in the Kentucky Community and Technical College System offer a program called Accelerating Opportunity. This program helps people earn their GED and a job certification at the same time. 

  • What can beneficiaries do to prepare for the Kentucky HEALTH program and the PATH Community Engagement requirement?

    ​1. Log in to or call 1-855-306-8959 to update their mailing address and email address so they do not miss any important information.

    2. Visit's  PATH Community Engagement page to see if they will need to complete the PATH Community Engagement requirement when Kentucky HEALTH starts. Beneficiaries who must complete a PATH Community Engagement requirement will receive important information in the mail before the requirement starts in their county.

    3. Think about how they want to complete the PATH Community Engagement requirement. Options include:

    • Job skills training
    • Searching for a job & education for a job
    • GED classes or community college
    • Employment
    • Community work experience
    • Volunteering
    • Taking care of a relative or other person with a disabling health condition

    4. Visit a Kentucky Career Center to learn more about how to find education opportunities, job training, and available jobs in their area.

    • Learn about high-demand jobs and the path to get those jobs at
    • Look for a job using the FOCUS tool:
    • Schedule an appointment with a Career Coach at a Kentucky Career center:

    5. Explore volunteer opportunities near them on these websites, as some volunteer roles will help fulfill the PATH Community Engagement Requirement:

  • H) Deductible Account

  • What is the Deductible Account and what can it be used for?

    The Deductible Account acts like a health savings account.  The state will pay $1,000 into the account at the beginning of the year.  During the year, the money in the account pays for the first $1,000 of non-preventive medical expenses. After the account is depleted, all medical services will continue to be covered by the beneficiary’s managed care plan.

    If the beneficiary has funds left in the account at the end of the year, a portion of those funds may roll over into the beneficiary’s My Rewards Account. 

    Click here for more information about the Deductible Account

  • Will the $1,000 state-funded Deductible Account come with a debit card or will it be managed through the claim submission process?
    Beneficiaries will receive a regular statement in the mail with their Deductible Account balance and a list of the health services they received. The statement will show the balance of the Deductible Account until the $1,000 is fully used. If they beneficiary's health services uses all $1,000 in the account, additional health services that are covered by Medicaid will still be covered by the beneficiary's MCO. If they beneficiary has a balance in the account at the end of the year, up to half of those funds could be rolled into the individual's My Rewards Account, to be used on services that are not covered by the beneficiary's MCO. 

  • I) Employer Sponsored Insurance

  • Is there a way for the Commonwealth to help beneficiaries buy insurance through their employer?

    Yes. If beneficiaries are eligible for Medicaid and have access to health insurance through their employer, beneficiaries may be eligible for the Kentucky Integrated Health Insurance Premium Payment (KI-HIPP) program, when it begins.  With this program, the Commonwealth will pay for  beneficiaries and their families to enroll in the beneficiary’s employer plan for only $1-$15 per month.

  • Who can get help paying for employer-sponsored insurance?

    People who are eligible for Kentucky HEALTH and have a job that offers health insurance may be eligible for help paying the premium for their employer-sponsored insurance through the KI-HIPP program.

    Not all plans will be eligible for the KI-HIPP program. The plan will be evaluated to make sure it is cost-effective for the state.

  • Do beneficiaries have to enroll in employer-sponsored insurance through KI-HIPP if it is available?

    Some beneficiaries may have to enroll in employer-sponsored insurance if it is available; but if they are required to do so, they will be getting financial help through the KI-HIPP program so that their monthly premiums are the same as the monthly Kentucky HEALTH premiums. 

    Participating in KI-HIPP will be optional for the first year a beneficiary is in Kentucky HEALTH.  After that, the beneficiary may need to provide information about his or her employer health plan, and the state will decide if the plan is cost-effective.  If it is, the beneficiary will need to enroll in the plan, and will get checks from the state to help pay most of the cost of the premium.  If the plan is not cost-effective, the beneficiary will continue receiving benefits through Kentucky HEALTH.

  • Will the medical benefits be the same for beneficiaries who are part of the KI-HIPP program?

     The KI-HIPP program will give beneficiaries access to all the benefits of their employer plan PLUS all the benefits of Medicaid--including benefits and providers.

    Beneficiaries who are part of the KI-HIPP program will need to pay the same premium they would pay for regular Kentucky HEALTH coverage, and will keep access to their My Rewards Account.

  • J) Penalties, Re-enrollment and Reporting Changes

  • What is the difference between a penalty, suspension period, and a lockout?
    A penalty is a general term that refers to when a beneficiary does not comply with the requirements of the program, and could face a negative consequence as a result. Not all penalties result in a loss of benefits. Some examples of penalties may include using the emergency room for a non-emergency service or failing to pay required premiums (when the household's income is at or below 100% FPL).

    A suspension period means that a Kentucky HEALTH beneficiary is still eligible, but benefits are suspended until the person take a corrective action. The individual may have a suspension period if he or she fails to pay required premiums (and has household income over 100% FPL) or fails to meet PATH Community Engagement requirements. He or she can complete certain requirements to re-enter Kentucky HEALTH and get his or her Medicaid benefits before the end of the suspension period.

    A lock-out means that a Kentucky HEALTH beneficiary is not eligible and has lost benefits. The person cannot regain eligibility and benefits until corrective action is taken or the lockout period expires. An individual may be locked out if he or she does not report a change in his or her situation that makes him or her ineligible for Medicaid benefits, if the person voluntarily withdraws from Medicaid, or if he or she fails to complete the redetermination process in a timely manner 

  • How do penalties affect newborns and children?

    ​Children are not subject to penalties and/or suspensions. If a recertification is completed, children will receive a new certification period; however, the adult who had the suspension will not. If a recertification is not completed, the case will be denied due to failure to recertify; the exemption is for deemed eligible newborns and pregnant women who will have their certification pushed back

  • If a beneficiary loses access to Kentucky HEALTH for any reason, can they still be billed as Medicaid beneficiaries?

    ​If a beneficiary's enrollment with a Managed Care Organization (MCO) is suspended because of a Kentucky HEALTH penalty, that person cannot be billed as a Medicaid beneficiary. If a beneficiary has appealed the penalty within the designated time, they may be eligible to maintain their coverage while the appeal is processed. However, if they have debt, he or she may be billed directly. The person may be eligible for Medicaid coverage outside of Kentucky HEALTH. Before removing a beneficiary from Medicaid, the system will check to see if they meet any of the following categories of eligibility:

    1. Elderly (age 65 or older), blind and/or disabled
    2. Residents of nursing facilities or Intermediate Care Facilities for individuals with developmental disabilities 
    3. Children in foster care or receiving subsidized adoption
    4. Women in the Breast and Cervical Cancer Treatment Program
    5. Supplemental Security Income recipients
    6. Working disabled adults in the Medicaid buy-in program
    7. Recipients of Home and Community Based Services Waivers
      1. Home and Community Based Waived – 1915 (c) 
      2. Michelle P Waiver – 1915 (c)
      3. Acquired Brain Injury – 1915 (c)
      4. Acquired Brain Injury, Long Term Care – 1915 (c)
      5. Model Waiver II – 1915 (c)
      6. Supports for Community Living – 1915 (c)

  • Do beneficiaries need to reapply to Kentucky HEALTH every year?

    Beneficiaries will need to update or verify their information every year during their annual redetermination period.

    Beneficiaries must respond to any Kentucky HEALTH requests for information during this period or they may have a six-month lockout from accessing benefits.

  • What happens if someone does not respond during the redetermination period?

    Beneficiaries will have an additional three months after their redetermination date to submit their paperwork and become re-enrolled in Kentucky HEALTH.

    If the beneficiaries has not responded within the three months after their redetermination date, they will need to wait for six months before they can re-enroll in Kentucky HEALTH.  This does not apply to pregnant women, children, or people determined medically frail.

  • How long do beneficiaries have to report a life change, such as in family composition, income, or employment?

    Beneficiaries will have 30 days to report a change, but it is recommended that they report a change as soon as possible. ​

    Beneficiaries can report these changes by contacting the Department for Community Based Services or logging on to

    Beneficiaries must report changes in circumstances such as:

    • Changes to household composition
    • Changes to household income
    • Changes to employment status
    However, beneficiaries do not need to report short-term changes, such as:
    • Changes in work hours that will not exceed 30 days
    • A fifth or periodic paycheck
    • Holidays, vacation days, or sick leave that is shorter than 30 days
  • What can beneficiaries do if they believe they have been wrongly disenrolled?

    Kentucky HEALTH beneficiaries will be able to appeal all eligibility determinations through the same channels and processes they use for appealing eligibility determination today. ​

  • Is there a limit to the number of times someone can be disenrolled from the program and re-enroll?

    There is no limit to how many times someone can re-enroll. However, there are limits to the number of times someone can take the re-entry courses for penalties and suspensions. Each re-entry course can be taken once per year, to clear each suspension reason. ​

  • Will retroactive eligibility be available?

    The Commonwealth will continue to provide retroactive coverage to pregnant women and children. For other Kentucky HEALTH beneficiaries, medical benefits will start the same month the beneficiary makes his or her first premium payment. For example, if the beneficiary makes the first premium payment on the 5th of the month, his or her coverage will go back to the 1st of that month.  ​

  • When do beneficiaries get coverage after a suspension?

    Beneficiary coverage starts the first of the month after they complete all re-entry requirements. ​

  • K) Businesses and Non-Profits

  • What role do businesses and Community Based Organizations (CBOs) play in verifying participant hours?

    It is the individual's responsibility to manage their PATH Community Engagement hours. 

    • For employment verification, individuals need to attest to their number of hours worked, the name of the employer, and the location. Recommended documentation for employment would be a pay stub. 
    • ​For volunteer activities, individuals are required to attest to the number of volunteer hours, the name of the sponsoring organization, and description of the volunteer activity.
    • These activities may be verified by the program coordinator via email, letter QR code, etc. Selections for verification options can be made in Business Connect when posting opportunities. 
  • Are there additional costs or requirements for businesses and CBOs to be involved with PATH Community Engagement participants?

    ​Businesses and organizations will continue filling opportunities using their current processes. PATH Community Engagement increases the number of individuals seeking opportunities but there are no costs of fees. 

  • How do businesses and CBOs reach PATH participants?

    ​Kentucky HEALTH is partnering with Kentucky Career Centers, and directing individuals to seek help through the career center staff or in the Focus online portal. For jobs to appear on the site, businesses must post job opportunities by visiting For volunteer opportunities to appear, organizations must post opportunities in Business Connect (more information to come).

  • Are current volunteers and employees affected by this?

    ​Businesses and CBOs may have current employees or volunteers who are Kentucky HEALTH recipients with a PATH Community Engagement requirement. It is important to remember that in compliance with employer discrimination laws, you may not ask an individual about their Medicaid status during the application process. CBOs may receive requests for additional documentation of volunteer hours from individuals who have a PATH requirement. 

  • What if a Kentucky HEALTH recipient lives far from a Career Center or Adult Education location and therefore can’t access those resources?

    ​Kentucky Career Center Services and resources are available to recipients via the phone and online. In addition, there will be maps developed that highlight areas with high demand for services. These areas will be visited by career centers representatives to share resources and set up local appointments at designated community partner locations (such as libraries).

  • Will there be online courses available?

    ​Online courses will be available. However, many courses are shorter than one hour, and may be limited. The Kentucky Career Centers can assist with education opportunities that have online options that count toward PATH Community Engagement hours.

  • Are PATH Community Engagement participants only available to work 20 hours per week?

    ​No. Kentucky HEALTH recipients who have a PATH Community Engagement requirement must complete a minimum of 20 hours of engagement per week, but that is not a limit to the hours they may work.

  • How will this new talent pool be supported to enter and succeed in the workforce?

    ​The PATH Community Engagement requirement incentivizes recipients to engage in their communities and gain and maintain employment. To support their efforts, Kentucky HEALTH is partnering with Kentucky Career Centers and Adult Education to provide career coaches, conduct career assessments, provide life skills trainings and connect people to additional resources to improve their overall well-being and employability.

  • What is Focus Talent?

    ​Focus Talent is where businesses can post job opportunities. To post these opportunities, businesses need to set up an account at

  • What if businesses already post opportunities elsewhere (such as their organization’s website)?

    ​Job seekers will continue to use various sources for their job search but posting opportunities directly in Focus is the recommended way to most effectively reach this broader audience and meet hiring needs. Focus does pull positions from thousands of public websites to gather jobs posted on those websites and receive feeds of job listings from Direct Employers Association (DE) and Americas Job Exchange (AJE). To access Focus Talent, visit

  • For businesses that work with external recruiters, what instructions should we give staffing agencies to recruit from the Kentucky HEALTH population?

    ​Staffing companies may post open positions in Focus Talent and may see an increase in volume of job seekers in the areas they serve.

  • Are businesses responsible for conducting pre-employment assessments, such as background checks, drug tests, or skills tests?

    ​Businesses are responsible for their own hiring practices and requirements. Kentucky Career Centers do provide assessments to help direct people to education and/or training resources to make them more competitive in the workforce or to aid in their job search. In addition, there may be new training program opportunities created within identified areas.

  • What types of activities can CBOs provide that count towards PATH Community Engagement hours?

    ​Community Engagement is one way to meet the Kentucky HEALTH objective of promoting improvements in health, social, financial literacy, education, or further promote well-being. Opportunities may include, volunteer, work, and programs that are offered by Community Based Organizations such as support group meetings (such as Alcoholics Anonymous). To see a full list of qualifying activities please visit

  • Do organizations need to create special programs for Kentucky HEALTH recipients?

    ​Organizations do not need to create new or special programs, but understand that there may be an increase in the number of people looking for volunteer opportunities to satisfy their requirement. We urge Community Based Organizations to support the efforts of this population.

  • What is Business Connect and how do CBOs post opportunities?

    Business Connect is the online platform that Community Based Organizations use to post opportunities for Kentucky HEALTH recipients to fulfill their PATH Community Engagement requirements. Posting Opportunities in Business Connect allows qualifying Kentuckians to register in Citizen Connect and search opportunities to help fulfill their PATH Community Engagement. More information to come about how to start using Business Connect.

  • How can CBOs partner with other local organizations?

    ​Networking with other organizations is a great way to realize local level solutions. Kentucky HEALTH will host Partnership Summits in each workforce area. Organizations are also encouraged to connect with their local Kentucky Career Centers and participate in community meetings.

  • ​Do non-profits need to track and certify volunteer service?
    Non-profits do not need to change what they do now to manage their volunteers. There is no requirement to verify hours for non-profits. However, non-profits may provide individuals with some documentation to verify the hours of volunteer services. Individuals are required to track any volunteer hours they complete. The individual needs to meet any application or background screenings the non-profit requires. When using the Commonwealth's system to post opportunities, organizations can create accounts in Business Connect to log in and upload volunteer opportunities. There are also options within Business Connect an organization can select to assist in verifying an individual's participation.
  • Will employers have to submit verification for PATH Community Engagement hours?
    No, beneficiaries may upload pay stubs to verify PATH Community Engagement hours that they complete by working. 

  • L) Emergency Transportation and Emergency Room Use

  • Will beneficiaries still have transportation in case of an emergency? Are Kentucky HEALTH beneficiaries losing transportation to their medical appointments?

    Kentucky HEALTH beneficiaries will still have access to emergency transportation when they need it.

    However, when Kentucky HEALTH begins, some beneficiaries will no longer have transportation to their regular, non-emergency medical services.  Pregnant women, children, medically frail individuals, and former foster youth up to age 26 will still have this non-emergency medical transportation, but other non-disabled adults on the program will not.

  • Will beneficiaries be penalized for inappropriate emergency room visits?

    Yes, funds will be taken from a beneficiary’s My Rewards Account for each confirmed inappropriate emergency room visit.

    However, beneficiaries can call their managed care organization’s nurse advice line before they go to the emergency room.  If the nurse advice line recommends the beneficiary go to the emergency room, that person will not have funds taken out the My Rewards Account, even if the visit did not end up being an emergency.

  • M) Other

  • When will people who are formerly incarcerated need to complete PATH Community Engagement requirement?
    Individuals leaving incarceration and applying for Kentucky HEALTH coverage may have different requirements based on their situation. Some individuals may be eligible for an exemption and may not need to complete the PATH Community Engagement requirement. If individuals are required to complete the PATH Community Engagement requirement, they will have up to 90 days before the PATH Community Engagement requirement begins. Kentucky HEALTH beneficiaries will get a notice telling them if they have a PATH Community Engagement requirement, and when that requirement will begin. 

  • If incarcerated individuals believe that they should qualify as Medically Frail, can they use jail healthcare records as proof?
    An individual may trigger the Medically Frail assessment process before or after leaving jail or prison. The individual's healthcare provider may complete the Clinician Attestation Form and submit it to the individual's Managed Care Organization (MCO), even if the individual is still in jail or prison. The individual can request that his or her provider begin this process. Once the MCO receives the form, the MCO will use the information to verify if the individual meets the criteria to qualify as Medically Frail. 

  • Are notices sent in other languages?

    Yes, we have Spanish versions of the notices. If an applicant selects a language other than English or Spanish, they will receive additional information with their notices. 

  • How will beneficiaries set up a Kentucky Online Gateway (KOG) account if they do not have an email account?

    A beneficiary must have an email account to create a Kentucky Online Gateway (KOG) account. Many different sites offer free email accounts. Some common places to set up an email account include GMAIL, AOL​, Outlook, and Yahoo! Mail; but there are other options available online.

  • What can participants do on Citizen Connect?
    • Request  appointments with a Career Coach at a Kentucky Career Centers (KCC)
    • Take free courses online
    • Search and sign up for community engagement activities
    • View and manage benefits
    Visit to get started today!