How to Get Kentucky Medicaid Benefits

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This article is a collection of the best answers to the most frequently asked questions on Kentucky Medicaid.

Medicaid is a program for families and individuals who meet certain income and resource requirements. Within the stated parameters, resources are only available to the elderly, blind, or crippled.

We have scoured the internet to provide you with all you need to know about the Kentucky Medicaid Benefits.

You will learn everything you need to know about Kentucky Medicaid in this article.

What is the Kentucky Medical Program (KMP)?

Medicaid is a government-funded healthcare program for persons who meet specific criteria.  The Kentucky Medical Program is designed to help low-income people and families who do not have or have insufficient medical insurance.

Who is eligible for the Kentucky Medical Program (KMP)?

​Kentucky Medicaid is a state and federal program authorized by Title XIX of the Social Security Act to provide healthcare for eligible, low-income populations.  These populations include children, low-income families, pregnant women, the aged, and the disabled. 

The eligibility for these groups depends on several factors such as family size, income​, and the Federal Poverty Level (FPL). 

Eligibility for people who receive Supplemental Security Income (SSI) and the aged, blind, or disabled, are based on additional requirements such as income and resource limits.

Annual Household Income Limits for Medicaid (before taxes)

Household Size*Maximum Income Level (Per Year)

*For households with more than eight people, add $6,038 per additional person.

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What if a person’s income is too high to qualify for regular Medicaid benefits?

There is a $217 income restriction and a $2,000 resource limit. Spenddown eligibility may apply if your income reaches $217

You can get time-limited medical help through the spend-down program, which uses medical expenditures to cover surplus income. 

The application month and two consecutive months, or the three months before the application month, are used to assess eligibility on a quarterly basis. The spend-down program can be utilized for medical expenditures incurred during the quarter or owing from a previous period.

How do I contact Medicaid in Kentucky?

You can contact Kentucky Medicaid in the following ways


(502) 564-4321

Mailing Address

275 E. Main St. 6W-A

Frankfort, KY 40621

Department for Medicaid Services (DMS): DMS Site Manager

What are the Medicaid plans in Kentucky?

Kentucky state offers three health plans to manage care for beneficiaries: 1) Coventry Cares of Kentucky, 2) Anthem Health Plan and 3) Wellcare of Kentucky.

Coventry Cares of Kentucky

CoventryCares of Kentucky is a part of the Medicaid health plan focused to deliver high-quality health care solutions at an affordable price.

Anthem Health Plan

Anthem Health Plan is the newest MCO (Managed Care Organizations) in the state. Anthem was selected to serve the Medicaid expansion population.

Wellcare of Kentucky

Wellcare of Kentucky is one of the national, for-profit plans like Anthem Health Plan, that offers managed care services to enhance, develop and deliver quality, cost-effective health care solutions. 

What is covered by Kentucky Medicaid?

Kentucky Medicaid covers the following services,

Allergy careMaternity services
AmbulanceMental health services
ChiropracticNursing facility services
DentalOccupational therapy
Diagnostic & radiology servicesOrgan transplants
Durable medical equipmentOrthodontics
Emergency room servicesPain management services
Family planning servicesPhysical therapy
Hearing aidsPhysician office services
Home health servicesPrescription drugs
HospiceProsthetic devices
Hospital servicesUrgent care services

Can I have both Kentucky Medicaid and Medicare?

If you are 65 or older, you can qualify for both Medicare and Medicaid. If your age is below 65 then you can only avail the benefits of Medicaid, if other eligibility criteria are also fulfilled.

Kentucky Medicaid Coverage of Residential Senior Care

Kentucky Medicaid covers hospitalization, rehabilitation, and long-term care at home or in nursing facilities. There are also several community-based initiatives available, such as adult day care and transportation help.

Kentucky Medicaid Waivers?

Handicapped or aged persons can avail of the following six 1915(c) Home- and Community-Based Services (HCBS) Medicaid waivers.

  1. ABI Acute and ABI Long-Term Care Waivers. This waiver is for People who are aged 18 or more with an acquired brain injury.
  2. Home and Community Based (HCB) Waiver. This waiver is for people with age 65 years or older and /or with a disability.
  3. Model II Waiver (MIIW). This waiver is available for people who use a ventilator for 12 or more hours a day.
  4. Michelle P. Waiver (MPW). This waiver is specific for people with intellectual or developmental disabilities.
  5. Supports for Community Living (SCL) Waiver. This waiver is specifically available for people who require extensive support with intellectual or developmental disabilities.
  6. Kentucky Transitions. For individuals who want to move out of a nursing home or institution and into the community.

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Medicaid Eligibility 

What is the highest income limit for Kentucky Medicaid?

The highest income limit for Kentucky Medicaid for individuals is $217 and the resource limit is $2,000 for an individual.

What documents do I need to apply for Medicaid?

You will need to provide the following documents at the time of application.

  1. Social Security Number;
  2. Proof of Identity (driver’s license);
  3. Proof of Citizenship (birth certificate);
  4. Health Insurance;
  5. Pregnancy (doctor statement verifying pregnancy and expected date of delivery), if applicable;
  6. Income of 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 policies, stocks, and bonds).

What is the best Medicaid in KY?

According to the ratings of the National Committee for Quality Assurance (NCQA) Medicaid Health Insurance Plan Ratings 2019-2020, WellCare is considered the best plan with an overall score of 3.5 out of 5.

Where do I find the letter showing the reason(s) for denial or discontinuance from Kentucky Medicaid?

You can check the status of your Kentucky Medicaid health information by using the Medicaid Patient Access Portal.

Where can I upload the documents for Kentucky Medicaid?

You can use Kynect and Kentucky Medicaid Provider Enrollment Portal to upload your documents for an online Kentucky Medicaid application. Open the documents section and use the Document wizard to successfully upload your every document.

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Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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