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Kentucky Health Insurance

For residents of Kentucky, health insurance is offered by private insurers through individual or group benefit plans. The state of KY also offers health insurance to high-risk consumers through Kentucky Access. People who are not able to afford to pay for health insurance in Kentucky may qualify for one of the government-subsidized programs available.

There are a number of different Kentucky health insurance options available. Any one option is not the best option for everyone. Choosing the right option for you and your family’s health care needs is an important decision.

Spend a few moments getting a brush up on the ins and outs of health insurance coverage in Kentucky and then when you are finished reading this article use our free health insurance quote tool at the top of the page to compare Kentucky health insurance rates from competing insurance companies and agents side by side. After all, the more you compare then the more of a chance you have to save!

Kentucky Health Insurance: Private Coverage Available

Residents of Kentucky can choose from three types of private health insurance coverage:

  1. HMO (Health Maintenance Organization): When you sign up for an HMO plan, you need to designate one doctor as your Primary Care Physician. Your health care services are provided to doctors and hospitals participating in your local network. If you want to consult a specialist, you need to get a referral from your Primary Care Physician to do so.

  2. POS (Point of Service): With this type of health insurance plan, you have the option of seeing doctors outside of your provider network. If you decide to see a doctor or get (non-emergency) treatment at a hospital that is not included, you will end up paying a minimum of 20% of the cost of the services provided, plus a copayment fee. (These figures don't include your deductible.) The premiums you will pay will also be higher than with an HMO plan.

  3. PPO (Preferred Provider Organization): Signing on with a PPO means that you will be able to see a doctor outside of your network, subject to the same fees as with a POS plan. The difference between a PPO and a POS plan is that the provider networks for a PPO are nationwide instead of local. This plan also allows subscribers to consult a specialist without a referral from their Primary Care Physician (PCP).

Kentucky Health Insurance For High Risk Individuals

Kentucky Access is the name of the state plan that provides health insurance coverage to people who have difficulty in getting private insurance. You may qualify for Kentucky Access in one of the following circumstances:

  1. Your Application for Private Insurance Has Been Declined

  2. You Are Eligible for Coverage under HIPPA (The Health Insurance Portability and Accountability Act)

  3. You Have Been Offered Health Insurance at a Higher Rate than what Kentucky Access costs for a Similar Level of Coverage

  4. You Have a High Cost Medical Condition

  5. You are Eligible for the GAP (Guaranteed Acceptance Program)

  6. You are the Dependent Spouse or Child of a Person Enrolled in the Kentucky Access Program

Kentucky Access Health Insurance Coverage

Under the Kentucky Access Traditional Plan, your annual deductible will be $400 for individual coverage or $800 for a family. There is no cap on the maximum lifetime benefit payable under the plan. Most services are subject to a coinsurance amount ranging from 10-20%.

A Preferred Access PPO Plan is also offered by Kentucky Access. Deductibles of $750 and $1,500 are available for individual enrollees for in-network care and out-of-network care. For family coverage, you will be paying a deductible of either $1,500 or $3,000. The maximum lifetime benefit under this plan is $2 million for both in-network and out-of-network medical expenses.

The Premier Access PPO Plan features deductibles that change depending on whether you choose in-network or out-of-network care. For an individual, deductibles of $400, $1,000 and $1500 are available. If you seek out-of-network care, these rates jump to $700, $1,500 and $2,250.

Deductibles for families are set at $800, $2,000 and $3,000 for in-network services and $1,400, $3,000 and $4,500 for out-of-network services.

The maximum lifetime benefit available to you will depend on the deductible you choose. If your individual coverage has either a $400 or $800 deductible, there is no lifetime limit on your benefits. If you choose a higher deductible, your maximum lifetime coverage under the policy is set at $2 million.

Kentucky Health Insurance: Government Programs

Medicaid (called KyHealth Choices) provides insurance coverage for low-income Kentucky residents who meet guidelines established by the government. KCHIP provides coverage for children who need health insurance in a similar way as Medicaid.

If you do not qualify for one of these programs, but still need help finding medical insurance, then you may want to consider applying for help through Health Kentucky. This program provides health services at no cost to people who do not have health insurance and whose annual income is 100% below poverty guidelines set by the federal government.

Kentucky Group Health Insurance

Many employers in Kentucky offer some form of group health insurance benefits. The question is: is group health insurance in Kentucky the best form of health insurance?

There are some key differences between group health and individual health in KY. Group health insurance is much more expensive than individual health because everyone that applies for coverage with a group plan is accepted regardless of pre-existing health conditions.

However, many times the employer will pay all or some of the premiums for the employees – making group health a smart choice for the employee. If you find yourself as an employee having to bear the premium cost alone – for instance leaving your employer and being offered a Kentucky COBRA health insurance plan then if you are completely healthy it almost always makes sense to choose a much cheaper KY individual health insurance plan.

Kentucky Individual Health Insurance

Individual health insurance in Kentucky has the same type of comprehensive coverage available as with most KY group health plans. Most of the same health insurance companies that offer group health insurance in KY also offer individual health.

The thing to be aware of with an individual health insurance plan in Kentucky is that not everyone is accepted automatically onto an individual health insurance plan (unless one is eligible for a KY HIPAA health insurance plan).

There are laws in place in the state of Kentucky to prevent an insurance company from singling a person out for a rate increase or to drop them from coverage once the have individual coverage but there is not law preventing an insurance company from deciding not to extend coverage to an individual in the first place.

Kentucky Health Insurance Companies

Some of the best Kentucky health insurance companies include:

Anthem Blue Cross and Blue Shield

Golden Rule


Some of the other health insurance companies in KY include:

Clarendon National (Kentucky short term health insurance plans only)

CHA (Kentucky small group health insurance plans only)

Fairmont Specialty Group

Security Life

Assurant Health / Fortis

If you have a prospective Kentucky health insurance carrier or Kentucky health insurance agent in mind that you would like to get more information on then be sure and check them out with the Kentucky Office of Insurance.

Kentucky Health Insurance Quotes

You can get more information about Kentucky health insurance by clicking on the insurance quote tool at the top of this page.

It's free, easy to use, and in no time at all you can compare online Kentucky health insurance quotes from competing insurance companies side by side.

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