Home of the Kentucky Derby, the nation’s gold supply, and bluegrass, Kentucky is full of industry and excitement. Though the headquarters of Kentucky Fried Chicken and Yum! Corporation (Taco Bell, Pizza Hut, etc.) reside in the state, there is also a significant amount of clean air and nature to counter the prevalence of these fast food giants. Kentucky has a beautiful array of caves, rivers, and the Appalachian mountains running through the state for its residents to enjoy.
Those who live in Kentucky have the benefit of very low prices on health insurance, and have the option of several great companies to decide between. Anthem Blue Cross Blue Shield of Kentucky, Humana and UnitedHealth Care are all represented in the state, and offer much better pricing than the majority of country. Due to variation in plan and company availability and cost in different areas, it is worthwhile to get a quote to see what is offered near you. Enter your zip code below to begin the process, or you can receive assistance if you have any questions by talking with one of our licensed agents at 888 803 5917.
According to statistics gathered by the UnitedHealth Foundation, Kentucky residents are not the healthiest in the nation, ranking 43rd out of 50 states. Though there was an improvement overall in the past year, there are still a number of reasons why individuals in the state are continuing to live in poor health. The smoking population is one of the highest in the U.S., with nearly 25% of all adults (822,000 people) considered habitual smokers. The number has decreased, however, which indicates progress and more emphasis on health if numbers continue to get smaller. Obesity is also a problem among adults in Kentucky, affecting close to 1.1 million residents over age 19. Another issue in the midst of health problems is the rate of uninsured individuals having increased, so less people are able to seek proper medical care.
Some of the causes for Kentucky’s improvement in overall health include the low percentage of binge drinking adults recorded in the state, at 12% for 2011. There is also a moderate use of early prenatal care. Despite the unhealthy nature of Kentucky residents, there is still always room for improvement by taking the right steps, such as getting a health plan that fits the needs of you and your family. By getting insurance, you can not only see doctors and specialists for various types of care, but every insurer offers a wellness program to promote healthy living. As they are very affordable, plans are not too large an investment in Kentucky, though there are public programs for those who do not have the means to pay for insurance (see Public Health Options below).
Health Insurance Plans
Anthem Blue Cross Blue Shield of Kentucky
- Premier Plus plans give you the opportunity to use in or out-of-network providers for a largest number of covered services Anthem offers. When using the PPO network, you can receive preventive care immediately for no charge. These plans also offer unlimited primary care physician visits for a copay as soon as your plan starts, and several prescription drugs coverage options. Unlike many plans, an annual vision exam is included in your coverage for a copay. After meeting the deductible, which ranges from $250 to $10,000, you pay either 20% or 0% coinsurance for in-network care.
- SmartSense Plus plans provide a lower cost, more limited amount of coveragefor those who want to save money and still receive necessary care. These plans have deductible options from $500 to $10,000, and cover either 70% or 50% of in-network care after the deductible is met. Before deductible, preventive care is covered at 100% within the network, and the first three doctor’s office visits are a $35 copay for non-preventive visits. Maternity care is not covered with SmartSense plans, but prescription drugs, inpatient and outpatient hospital care and other professional services are included.
- Lumenos HSA plans are high deductible plans qualified for use with a health savings account. These plans offer a large selection of services for either 50%, 80% or 100% coverage after you meet the deductible. Deductible options in Kentucky range between $1,500 and $5,000 for individuals, and the higher your deductible the less you pay for covered services after it has been met. You can also receive care with non-network providers for a smaller percentage of coverage. Connecting your plan to an HSA offers a great deal of benefits, including tax advantages and control over your health care expenses. Funds can be used to pay for medical services and payments only.
- Copay plans are much like a group health plan you receive through an employer, with immediate benefits like non-preventive doctor’s office visits and prescription drugs for a fixed price. Having a set cost for services can be very convenient, and some types of care are no charge, such as in-network preventive care. Three types of copay plans are available in Kentucky, including Enhanced Copay 80, Copay 80 and Copay 70. After you meet the deductible, you pay either 20% or 30% coinsurance based on the plan you choose.These plans have high deductibles with many options between $1,000 and $7,500 for individuals.
- 100% After Deductible plans come in three types in Kentucky: Value 100, HSA 100 and Enhanced HSA 100. Each of these plans covers in-network care at full cost once you have reached your deductible. There are a variety of high deductibles to choose from, and many covered services you can receive in or out-of-network. When using in-network providers, preventive care is covered at 100% as soon as your plan begins. HSA plans are also qualified for use with a health savings account, which has many advantages including tax breaks and allocating money to go specifically towards health care costs.
- Copay plans from UnitedHealthOne offer the choice of either 100%, 80% or 70% coverage after deductible, and certain types of medical care are covered from the day your plan starts. Whether you choose Copay Select Value, with a limited number of four doctor’s office visits or Copay Select, with unlimited visits, you pay a $35 copay. Deductibles for individuals range from $1,000 to $10,000, and once they have been met you have access to network or non-network care for surgery, inpatient stays, emergency care, X-ray and lab work and more. Prescription drugs are also covered in both plans, though Value plans only offer generics.
- High Deductible plans are available in several types, including Saver 80, Plan 80 and Plan 100. You can choose Saver 80 if low monthly premiums and access to moderate amount of major medical services is your priority. Or on the other end of the spectrum, you can receive 100% in-network coverage after deductible on most hospital and physician services. Plan 80 falls in between, with prescription coverage and a large variety of medical services available. All of these plans cover preventive care at 100% as soon as your plan begins with in-network doctors, which includes immunizations, well child care, routine physical exams and screenings for various diseases.
- Health Savings Account plans have high deductibles and the ability to open a health savings account for greater control over your medical expenses. These plans come in two types in Kentucky, HSA 70 and HSA 100, which indicated the coverage you get in-network after you meet the deductible. HSA 100 plans offer a greater number of services, including all levels of prescription drugs for a discount, and in-network care for no cost after deductible. Deductibles range from $2,500 to $5,000 for individuals for HSA 100 plans, and $1,250 to $5,000 for HSA 70 plans. You can use money from your HSA to pay for health care services, or save for the future and receive tax benefits.
Public Health Options
In the state of Kentucky, public health programs are available for low-income families and individuals with certain illnesses and physical conditions. Medicaid is offered to uninsured residents of Kentucky who meet income criteria and other guidelines, and includes pregnant women, persons over age 65, disabled individuals, and children under 19. For more information on who qualifies for Kentucky Medical Assistance, visit our Medicaid Eligibility by State page. Other services are helpful to residents who cannot afford health care services and do not have insurance, including cancer screening, and preventive care for various diseases and conditions. To see a full list of services, visit the Kentucky Cabinet for Health and Family Services.
- Medicaid: medical insurance for uninsured Kentucky residents with limited income and various health conditions.
- Kentucky Women’s Cancer Screening Program: screening for breast and cervical cancer, follow-up services and more for women ages 40 – 64 with no insurance and a low income.
- Kentucky Immunization Program: providing vaccinations to individuals who do not have access to immunizations through health insurance in Kentucky.
- Adult Preventive Program: preventive health services for low-income adults without health insurance coverage, including health screenings for cancer, diseases, vision and hearing, testing for diseases and conditions, immunizations as needed and wellness promotion.
Health Insurance Laws
In Kentucky, the individual health insurance market has certain guidelines to follow when it comes to offering health care coverage. For the most part, pre-existing conditions have the largest effect on health insurance companies, which are treated more fairly in Kentucky than many other states. A pre-existing condition is defined in Kentucky by the objective standard, which means any condition an individual has actually been treated for or sought medical advice prior to applying for health insurance. If it has been decided that you have a pre-existing condition, the insurer can decide not to sell you a plan, or provide you coverage at a higher rate than normal.
Individuals with pre-existing conditions can also receive an exclusion period with their plan of up to 12 months. This allows the insurance company to cover all other benefits besides treatment relating to your condition for a certain time allotment. Elimination riders are not permitted in Kentucky, which is a permanent exclusion period. If you are switching from one insurance company to another, you can use your previous plan as a credit towards the exclusion period to pay for uncovered expenses. There is an insurance alternative for individuals with pre-existing conditions, which is operated by the U.S. Department of Health & Human Services: the Pre-Existing Condition Insurance Plan.
The Pre-Existing Condition Insurance Plan offers medical insurance for a low monthly premium and does not exclude certain types of care, and has a variety of services available through qualified health care professionals. PCIPs were created by the Affordable Care Act, to bridge the gap between current and future legislation. In 2014, all insurance companies will be required to sell individual health plans to persons with pre-existing conditions. The use of elimination riders and exclusion periods, as well as elevated premiums based on health status will diminish. Kentucky will also have a state health exchange, which is currently in the works to provide “essential benefits” and competition against the main insurance companies.
Part of the protective HIPAA law that helps individuals with insurance to remain insured is the guaranteed renewability provision. According to this law, your health insurance company has to ask if you wish to renew your plan for another year when your plan is about to expire. This avoids any breaks in your coverage and helps keep people in good standing with their insurance company. The same law also protects individuals as soon as they purchase their plan, by allowing them to continue their benefits even if their health status changes after they have enrolled. A health insurer in Kentucky cannot cancel your coverage based on health status, they can only do so if you have committed fraud or any other act to violate your agreement.