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Medicaid Populations Included in
Kentucky HEALTH

Non-Disabled Adults & Children

Traditional Medicaid Adults Eligible Prior to Expansion

  • Pay premiums or copayments*
  • No change to benefits (Dental and vision services covered by health plan. Transportation covered by Commonwealth.)
  • Must meet community engagement (also called PATH) requirement. If primary caretaker of a dependent, participation is optional.***

Pregnant Women & Children (Traditional Medicaid and KCHIP)

  • No out-of-pocket costs (No premiums or copayments)
  • No change to benefits (Dental and vision services covered by health plan. Transportation covered by Commonwealth.)
  • PATH participation is optional for pregnant women.*** 

Medicaid Expansion Adults

  • Pay premiums or copayments*
  • Alternative benefit package (Dental and vision covered through separate account.)
  • Must meet community engagement (also called PATH) requirement. If primary caretaker of a dependent, participation is optional.***                                                                                                        

Medically Frail Adults and Former Foster Youth up to Age 26

  • Optional payment of premiums.**
  • No change to benefits (Dental and vision services covered by health plan. Transportation covered by Commonwealth.)
  • PATH participation is optional.***            

Medicaid Populations Not Included in
Kentucky HEALTH

Traditional Medicaid (Aged, Blind, & Disabled)

Home and Community Based Waiver - 1915(c)

No Change


Michelle P Waiver - 1915(c)

No Change


Acquired Brain Injury - 1915(c)

No Change


Nursing Facility and ICF/MR Residents

No Change


Model Waiver II - 1915(c)

No Change


Supports for Community Living - 1915(c)

No Change


Acquired Brain Injury, Long Term Care - 1915(c)

No Change


Qualified Medicare Beneficiaries

No Change



​*Some Kentucky HEALTH members will contribute to the cost of their healthcare by making once-a-month payments, also known as premiums.  These premiums will cover the cost of all Medicaid-covered visits for the whole month.  If members do not pay their premiums, they may need to pay copayments each time they need a medical service.  Members can move to copayments only if their income is under 100% of the federal poverty level (FPL).  If their income is over 100% FPL, they could lose their benefits for up to 6 months, with the option to get back in sooner if they repay their missed premiums and take a designated re-entry course.

**Monthly premiums are optional for medically frail adults and former foster youth up to age 26, but paying the premium will give members access to the My Rewards Account. This will allow them to earn rewards for healthy activities and use those rewards for services not normally covered by Medicaid.

*** PATH is the community engagement portion of Kentucky HEALTH and stands for “Partnering to Advance Training and Health.”  PATH focuses on helping people get more involved in their communities and gain the skills they need for future success. PATH connects people to opportunities like education, job training, substance use disorder treatment, employment or volunteer activities. People who are enrolled in SNAP or TANF and meeting work requirements already meet the PATH requirement, but may be able to earn My Rewards dollars for completing job enhancement activities.