CHIP in Kentucky

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The Children’s Health Insurance Program (CHIP) in Kentucky is available to qualifying children who are younger than age 19. If adult family members do not have Medicaid eligibility children in their households may still be able to apply for CHIP. Though CHIP and Medicaid enrollment are similar, each program has different enrollment criteria and regulations that govern the program. To get answers to questions like, “What is CHIP Medicaid?” or, “What is covered by CHIP Medicaid?” read the information in the sections outlined below.

Kentucky’s Children’s Health Insurance Program Overview

CHIP is separate from Medicaid for children, as it is designed to help children from families who do not have Medicaid eligibility, yet are still in need of affordable health coverage. Both Medicaid and CHIP are not forms of private health insurance, but instead, are types of government benefits programs. Once a beneficiary has been enrolled, he or she can choose to go to any medical provider that is in-network with the CHIP Managed Care Organization (MCO). All beneficiaries may keep their primary doctors or choose new primary doctors, as long as they are in-network with the MCO.

Those who have children’s Medicaid will have access to the same MCO, but will have different services available to them. CHIP in Kentucky is not an entirely free program, as families of recipients will have to pay small copayments for most medical services. Also, the KY CHIP program comes with an affordable premium. Failing to pay this premium may result in disenrollment from the program. 

Is CHIP Considered Medicaid in Kentucky?

Technically, CHIP is not considered Medicaid in Kentucky, but is a Medicaid extension program. Medicaid is generally used to help those with very low incomes or those who have disabilities afford health care. However, CHIP is meant for Medicaid ineligible children who still need affordable health insurance. Some states allow applicants to apply for Medicaid and CHIP enrollment at the same time, while others have a completely different application process. Make sure to review the qualifications for Medicaid and CHIP prior to applying for coverage. 

Who is eligible for CHIP in Kentucky?

Many residents in the state of Kentucky may be able to be covered by CHIP if they meet the eligibility criteria. KY Children’s Health Insurance Program accepts applicants who are:

  • United states citizens or legal residents.
  • Living in Kentucky.
  • Younger than 19 years of age.
  • From families that meet the income eligibility criteria.

When applying for CHIP you will be asked to provide required documents that prove your identity, address, immigration status and household income. Sometimes, pregnant women are allowed to enroll in Medicaid for children or CHIP. In Kentucky, expecting mothers with Medicaid eligibility can learn how to apply under the Medicaid program but not the CHIP program. The coverage will last for the duration of the pregnancy and a few months following the end of the pregnancy. The same woman is no longer Medicaid eligible after the end of the pregnancy, and she can reapply only if she is pregnant again. In addition, newborns can be enrolled in CHIP.

What services are covered by CHIP in Kentucky?

Many treatments and services are covered by CHIP in Kentucky for eligible beneficiaries including:

  • Doctor’s visits and check-ups.
  • Dental care.
  • Certain diagnostic tests.
  • Vision and hearing tests.
  • Hospital and emergency room visits.
  • Mental health services.
  • Physical therapy.

After applying for CHIP benefits, recipients will receive more information in the mail about which services are covered. Since CHIP is not Medicaid, certain services, like non-emergency medical transport, will not be covered for CHIP beneficiaries, even though they are covered for Medicaid recipients. Since CHIP is considered low-cost government health insurance for children, there will be copays for most treatments. However, copays will not apply to check-ups and preventative care services. There may be limits on the number of certain types of services one can receive in a year. KY CHIP recipients will only be able to have one physical and one eye examination each year. Download our guide to review additional services covered by government-backed healthcare programs.

How To Apply For CHIP in Kentucky

There are many ways to apply for CHIP in Kentucky, yet there is no way to completely apply online. CHIP applications can be downloaded from the internet or found at a doctor’s office, a hospital or a local health department office. In addition KY CHIP applications can be requested via phone.

If you are having difficulty understanding how to apply for CHIP coverage you can contact a Kynect representative by phone or via email. Applications can be turned in to a local office of the Kentucky Department of Community Based Services. All applicants will receive notice of their enrollment via mail.

CHIP enrollment does not last forever, and beneficiaries will have to reapply every year. Kentucky CHIP reapplication paperwork will also be sent through the mail. Giving false information to the Department of Community Based Services while applying for government benefits can result in criminal charges.

Download our free guide to read more information about CHIP coverage.