Kentucky HEALTH is a new state health and wellness program. It’s more like regular health insurance than Original Medicaid. It helps working adults and their families understand how regular health insurance works, including things like:
- Making regular and on-time premium payments
- Tracking co-pays and deductibles
- Managing health care spending
Cost Sharing Requirements
Kentucky HEALTH members must pay either monthly premiums or co-pays. (Pregnant women are exempt.)
Monthly household premiums are between $1 and $15, depending on the member’s income. This monthly premium covers the member’s share of all provider visits for that month.
Members will only have a co-pay if:
- The member’s household income is at or below the federal poverty level; and
- The member did not pay the required monthly premium
Providers are expected to collect the appropriate co-pay from the member at the time of service.
Community Engagement (PATH) Requirements
The PATH Program (Partnering to Advance Training and Health) gives members access to employment and community engagement resources. Members can use PATH for job searches, skills training, volunteer opportunities, and much more ― all at no cost to the member.
All adult Kentucky HEALTH members must complete 80 hours of PATH activities each month unless they qualify for an exemption. Benefits can be suspended or terminated if this requirement is not met each month.
Members who DO NOT have to meet PATH requirements include:
- Phụ nữ có thai
- Medically Frail adults
- Former foster youth
- Full-time students
- Primary caregiver of a dependent
- Employed full-time or working 20 or more hours per week
- Members already meeting work requirements for food stamps or TANF