Based on a June 29, 2018 legal decision, changes to Medicaid under Kentucky HEALTH did
begin on July 1, 2018 as planned. Please click here for more resources and information about how this impacts Medicaid in Kentucky.
Description: Most beneficiaries of the Kentucky HEALTH program are provided a fully-funded $1,000 Deductible Account, maintained by their Managed Care Organization (MCO). The Deductible Account will help beneficiaries track their healthcare spending and show the cost of healthcare services.
The Deductible Account is fully funded by the Commonwealth of Kentucky. Beneficiaries are not responsible for paying $1,000. Beneficiaries will not receive any bills for services applied to their Deductible Account.
The Deductible Account pays for the first $1,000 of a beneficiary's non-preventive medical and pharmacy services. Preventive services do not count against the Deductible Account, and may allow the beneficiary to earn dollars in their My Rewards Account.
Once a beneficiary's Deductible Account is empty, all eligible claims for covered services continue to be paid by their MCO. If a beneficiary does not use all $1,000 in the year, up to half of the money left in the Deductible Account at the end of the year may be rolled into their My Rewards Account.
Timing: Kentucky HEALTH beneficiaries will receive statements showing the balance in their deductible accounts in when Kentucky HEALTH goes into effect
Beneficiaries will receive a statement every month from their MCO showing the amount of money left in the Deductible Account and all account activity from the previous month. Beneficiaries will receive information on the cost of care and services for different Medicaid providers.
Who is Impacted?
- Medicaid Expansion adults
- Parents/caretaker relatives
- Medically frail individuals
- Former foster youth up to age 26
Who is Not Impacted?
Medicaid beneficiaries not in Kentucky HEALTH (for example, individuals who are disabled or over age 65)