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What It Is

​Medicaid is a program for families and individuals who have income and resources within the established guidelines. Resources only apply to the aged, blind or disabled population within the established guidelines.


Nursing Facility (NF) services include room, dietary services, nutritional supplements, social services, activities, respiratory therapy and supplies, nursing services, the use of equipment and facilities, medical and surgical supplies, (prosthetic devices are included only if ordered by a physician), laundry services, drugs ordered by the physician and personal items routinely provided by the facility.

Also included, if ordered by the physician, are X-rays, physical therapy, speech therapy, occupational therapy, podiatry services, laboratory services and oxygen, and related oxygen supplies, and ventilator use.

For more information see Nursing Facilities.

If you are elderly or disabled, Medicaid Waiver programs can provide Medicaid coverage for many different services that help you stay in your home.

Waiver services include personal care assistance, program coordination, homemaker services, respite care and case management.

For more information see Medicaid Waiver Services.

The Kentucky Medicaid program provides medical assistance to individuals meeting income, resource, and technical eligibility requirements. The income limit is $217 and resource limit is 2,000 for an individual. If an individual's income exceeds $217, spenddown eligibility may exist.

The spenddown program provides time-limited medical assistance to individuals by using medical expenses to meet excess income amounts. Eligibility is determined on a quarterly basis using the month of application and two subsequent months or the three months prior to the application month. Medical expenses that are incurred during the quarter or are owed from any prior period may be used in the spenddown program.

The Affordable Care Act of 2010 created a new national Medicaid minimum eligibility level that covers most Americans with household income up to 133 percent of the federal poverty level.This new eligibility requirements is effective Jan. 1, 2014.
Effective Jan. 1, 2014, in compliance with the Affordable Care Act, eligibility for Medicaid and KCHIP will be based on Modified Adjusted Gross Income (MAGI). This includes most categories that previously were included in the Family Medicaid Assistance program. MAGI provides a standardized calculation of income.

There is No Wrong Door in applying for assistance. Individuals or families may apply for Medicaid in the following ways:

Eligiblity is divided into five categories:

  1. Children under age 19;
  2. Pregnant women;
  3. Parents and Caretaker Relatives;
  4. Adults Age 19 - 64;
  5. Foster Care children after age 18 up to 26 that are not receiving Medicaid in another category.
Once eligibility has been determined, refer to the Member Information page.

              

                 

Apply

Applications for Medicaid may be filed at your local Department for Community Based Services (DCBS) Office.

Note: To apply for KCHIP, please visit the website. At the time of application, applicants are asked to provide proof of:

  • Social Security Number;
  • Proof of Identity (drivers license);
  • Proof of Citizenship (birth certificate);
  • Health Insurance;
  • Pregnancy (doctor statement verifying pregnancy and expected date of delivery), if applicable;
  • Income Non-pregnant parents applying for Medicaid for themselves should bring proof of resources (last three months' bank statements, checking or savings account statements, life insurance polices, stocks and bonds).

Having the required information available at the time of application will likely speed up the application processing.

If you cannot come to the office to apply for Medicaid, you may call the DCBS office in your county of residence to make other arrangements. To have someone else apply for you, MAP-14 - Interested Party Authorization Form is required.

Medicare Savings Programs

Kentucky Medicaid provides partial financial assistance with Medicare premiums, deductibles, or coinsurance - through the Medicare Savings Program (i.e., Qualified Medicare Beneficiaries, Specified Low-Income Medicare Beneficiaries, and Qualifying Individuals) - to certain low income Medicare beneficiaries who are not entitled to the full Medicaid benefit package. Fill out an application for the Kentucky Medicare Savings Program.

Documentation