Insurance Coverage & Navigation - Kentucky

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 Helping You Understand Your Options & Get the Care You Need

Finding the right healthcare coverage can be confusing. This guide brings together Kentucky Medicaid, Medicare, private insurance, disability programs, and financial-assistance options—all in one easy place to help individuals and families access the right care without the stress.

 Medicaid helps eligible individuals access:

• Hospital & doctor visits
• Mental health & substance-use treatment
• MOUD services
• Preventive care
• Vision & dental (based on plan)

How to apply:

• Visit kynect.ky.gov
• Call 1-855-306-8959
• Apply through a local DCBS office
   

Who qualifies:
Low-income adults, children, pregnant individuals, adults with disabilities, and seniors

 Medicare includes:

• Part A: Hospital care
• Part B: Doctor visits/medical care
• Part D: Prescription coverage
• Medicare Advantage (private plans with extra benefits)
   

Help with choosing a plan:

• State Health Insurance Assistance Program (SHIP)
• Local Area Agencies on Aging

 Kentuckians can enroll in private coverage through:

• Employer-sponsored plans
• Kynect Marketplace plans
• Insurance companies (Anthem, Humana, UnitedHealthcare, etc.)
   

Plans typically cover:

• Primary care
• Specialist care
• Behavioral health
• Medications
• Emergency services
   

Financial assistance may be available depending on income.

Most insurance types cover:

• Inpatient detox
• Residential rehab
• Outpatient treatment
• MOUD (Suboxone, Methadone, Vivitrol)
• Therapy & counseling
• Peer support
   

For coverage questions, call the number on the back of your insurance card.

If someone needs support choosing or understanding coverage, guide them to:

• Kynectors (free insurance advisors)
• Community Health Workers
• Hospital navigators
• Social workers/case managers
   

These professionals help with:

• Applications
• Plan comparisons
• Eligibility questions
• Updating changes
• Finding in-network providers