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Learn About Requirements for Medicaid in Kentucky

“What are the requirements for Medicaid in Kentucky?” is a common question interested petitioners ask before applying for medical assistance. It is important for applicants to know who is eligible for Medicaid in KY and understand how to qualify for Medicaid when they begin an application, so they can be prepared with the information and documentation needed to demonstrate their eligibility. Furthermore, applicants typically ask, “What are the income requirements for Medicaid in Kentucky?” because the Medicaid program is intended for individuals and households who earn below a specific level of income. The Medicaid program was established to provide medical assistance to low-income households and those in a high need for health care services. Therefore, it is very important applicants have a thorough understanding of the income requirements. To learn more about Medicaid eligibility requirements, continue reading the sections below.

Who qualifies for Medicaid in Kentucky?

Kentucky Medicaid benefits eligibility has expanded to provide medical coverage to individuals who formerly did not qualify for the Medicaid program. This Medicaid expansion occurred in 2013 after the Affordable Care Act was passed by the federal government. Despite Kentucky’s expanded Medicaid eligibility guidelines, there is still a basic set of requirements that all applicants must meet in order to qualify for health care assistance. If applicants do not meet standard KY Medicaid eligibility requirements, their application will be automatically denied. The basic list of requirements for Medicaid in Kentucky is as follows:

  • The applicant must be a resident of Kentucky.
  • The applicant must be a citizen of the United States or an alien of legal status.
  • The applicant must be considered low or very low income per his or her household’s gross monthly income.

Applicants may qualify for Medicaid if they belong to a specific category of beneficiaries. Former foster care children meet Kentucky Medicaid eligibility requirements without having to comply with the income restrictions until they are 26 years of age. Senior citizens may also qualify for Medicaid assistance if they do not qualify for other elderly assistance and they meet the basic requirements. A senior citizen is defined as anyone who is 65 years of age or older. Furthermore, the requirements for Medicaid cover blind or permanently disabled individuals who have been confirmed with the Social Security Administration (SSA). It is important that a disability is qualified through the SSA’s standards, or an applicant may not be considered eligible to receive benefits through this program. Families with dependent children are eligible for Medicaid in KY as long as their household size is compliant with the appropriate income level established by the state.

Medicaid eligibility requirements extend to children younger than 18 years of age as long as they meet the income requirements. For children to be eligible for Medicaid without an adult caregiver, their income levels have to account for the household in which they live and any additional income they may receive from parents who do not live in the home. Additional income considered to qualify for Medicaid includes child support. Finally, pregnant women may qualify to receive Medicaid assistance, which includes prenatal and postnatal care. It is important to note that the unborn child accounts for the household size when determining the applicant’s income level.

The groups mentioned above are the traditional recipients of Medicaid benefits. However, since Kentucky Medicaid eligibility guidelines expanded, adults between the ages of 19 and 65 years of age also qualify for health care coverage through Medicaid. This means anyone who meets the basic criteria is encouraged to apply. To learn more about Medicaid requirements, download our free guide.

Note: Children who do not qualify for Medicaid may be eligible for the Kentucky Children’s Health Insurance Program (KCHIP). Any person who is currently incarcerated is not eligible for Medicaid assistance.

What are the income requirements for Medicaid in Kentucky?

The income requirements for Medicaid in Kentucky account for individuals and families who are considered low-income. This means to satisfy Medicaid benefits eligibility, an applicant’s household must fall below the federal poverty level (FPL). Generally, the applicant’s income must fall 133 percent below FPL. However, that limit increases for pregnant women and children. Additionally, the monetary income limit for Medicaid is adjusted by the size of the applicant’s household. For example, a household of six can make a higher gross-adjusted income than a household of two to be considered eligible for medical assistance.

What are the Medicaid application guidelines in Kentucky?

The general Medicaid application guidelines in Kentucky align closely with its Medicaid eligibility requirements because all applicants have to prove they meet the eligibility criteria. In order to prove eligibility for Medicaid, an applicant may be asked to submit supporting documentation, such as copies of tax returns or pay stubs. Additionally, to comply with KY Medicaid benefits eligibility, applicants who are non-citizens may be asked to submit copies of their alien registration papers. To get more information about Medicaid application guidelines, download our free guide today.