Medicaid helps people with low income pay for their visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services.
If you get Supplemental Security Income (SSI) benefits or used to get SSI benefits and now qualify for SSI's 1619(b) status, you get Medicaid coverage automatically and do not need to worry about the eligibility information discussed here.
If not, you may qualify for income-based Medicaid. The income-based Medicaid eligibility rules depend on whether you are:
- 18 or younger, or
- 19 or older.
You can apply for Medicaid:
- Online at kynect benefits
- At your Department for Community Based Services (DCBS) office by mail or in person
- By calling the DCBS Call Center at 1-855-306-8959.
For help with your application, visit or call your local Department for Community Based Services (DCBS) office or contact the Call Center at 1-855-306-8959.
Medicaid if You Are 18 or Younger
If you are 18 or younger, you may qualify for income-based Medicaid if your family’s income is 218% of the Federal Poverty Guidelines (FPG) or less ($68,016 per year or less for a family of four). It doesn't matter how much your family has in resources or whether you have a disability. Note: Income-based Medicaid for children 18 and younger is sometimes called "Healthy Start."
Check whether your family's income is low enough for you to get income-based Medicaid:
Health Coverage Income Limits for Your Family
| Your family size: | |
Income limits for your family: | |
| Income-based Medicaid, adults (138% FPG) | |
| KCHIP Children's Health Insurance Program (218% FPG) | |
| Subsidized private plans, reduced fees (250% FPG) | |
| Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules. Notes:
| |
Note: Some young people with disabilities who don't get SSI and don't qualify for income-based Medicaid may still qualify for disability-based Medicaid. If you have any questions about this, talk to a Benefits Planner.
Medicaid Waivers
Medicaid Waiver programs pay for services that help people with disabilities live in their own homes instead of in nursing homes or other institutions. Medicaid Waiver programs have different rules than regular Medicaid. Kentucky offers six Medicaid Waiver programs that help people in certain situations.
If you qualify, you or your family may have to pay each month for part of your waiver services. This is called a patient liability. You don't have to pay a patient liability if you get SSI benefits or qualify for SSI’s 1619(b) rule.
Learn more about Medicaid Waiver programs.
Medicaid if You Are 19 or Older
If you are 19 or older, you may qualify for income-based Medicaid if your family’s income is 138% of FPG or less ($20,783 per year or less if you are single). If you are pregnant, you can have income up to 195% FPG ($39,858 per year if you are single and pregnant with your first child; the baby counts as a family member according to Medicaid). It doesn't matter how much your family has in resources or whether you have a disability.
Check whether your income is low enough for you to get income-based Medicaid:
Health Coverage Income Limits for Your Family
| Your family size: | |
Income limits for your family: | |
| Income-based Medicaid, adults (138% FPG) | |
| KCHIP Children's Health Insurance Program (218% FPG) | |
| Subsidized private plans, reduced fees (250% FPG) | |
| Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules. Notes:
| |
If you have a disability, don't get SSI, and make too much for income-based Medicaid, you may qualify for disability-based Medicaid or for Medicaid Waivers.
Learn more about income-based Medicaid for adults in DB101's How Health Benefits Work article.
Individual plans on kynect
If you don’t qualify for Medicaid or Medicaid Waivers, look into other health coverage options on kynect. Learn more about private health insurance.
