Kentucky has a 4.4 million population and around 94% of the population has health insurance coverage either through their employers or through government-funded plans. However, uninsured residents of Kentucky have several options available to them, if they are looking for a health insurance plan. No matter whether a person is self-employed, unemployed, or has a low income, the person can have access to both preventative as well as major medical healthcare coverage. Initially, the state had its own exchange and had an enrollment website called Kynect. Kentucky state-run exchange was considered among the most successful state-run exchanges in the country. However, due to the efforts of the state’s former Gov. Matt Bevin, the Kentucky exchange transitioned to the HealthCare.gov platform. Nevertheless, Kentucky still maintains its state-run exchange and is one of the several states that have state-run exchanges but use HealthCare.gov for enrollment of health plans.
Now the state will once again have a completely state-run exchange and its governor has notified CMS that the state will transition back to Kynect as of November 2021. The open enrollment period for 2021 health plans has ended way back in December 2020, but a COVID-related enrollment window has been opened by the Biden administration, giving residents of the state an additional six months to obtain health coverage in 2021. This window is going to end on August 15, 2021, after which residents will have to wait for the next open enrollment period to enroll in a health plan. This special enrollment window can be used by both uninsured residents seeking a health plan as well as by the residents who would like to switch to a different health plan for the rest of the year. The state witnessed a record low enrollment in 2021, with quite fewer people signing up during open enrollment but the additional COVID-related enrollment window is likely to increase enrollment number in Kentucky.
Vital Statistics Related to Kentucky Health Insurance
- Kentucky has a population of around 4.4 million, out of which 96% of the population have access to a health insurance plan.
- Kentucky will switch to state health insurance exchange for the enrollment for the 2022 health plan, however for 2021 coverage residents were using HealthCare.gov for health plan enrollments.
- The COVID-related special enrollment period is currently running in the state that will end on August 15, 2021.
- Less than 78,000 people have enrolled during the open enrollment period for health coverage in 2021, though the number is likely to improve with the COVID-related special enrollment window.
- The uninsured rate in Kentucky has significantly dropped under the ACA due to the state’s expansion of Medicaid.
- The average cost of health insurance in Kentucky for a 40-year-old in 2021 is $470.
- The cheapest silver plan in most of the counties of Kentucky is the Anthem Silver Pathway X Transition HMO 4650 for HAS plan.
Types of Individual Plans available in Kentucky
Not every individual has a similar type of healthcare requirement, so the need for health insurance will also vary from one person to another. A person who is young and healthy will certainly not need much healthcare compared to sick and old people. Thus, a particular type of health plan cannot be recommended to both, as both the person will need to choose a health plan depending upon their health requirements and budget. Therefore, to cater to the healthcare need of people of diver medical conditions, age, and budget, the health insurance market in Kentucky has categorized their health plans into different metal-tiers. The health plans in Kentucky are categorized into different metal-tiers like catastrophic, expanded bronze, silver, and gold plans.
Gold plans are the highest metal-tier plan available in Kentucky that covers the greatest share of out-of-pocket costs, thereby allowing members of the plan to have lower deductibles, copays, and coinsurance. However, the said benefits are offered to members at the expense of a higher monthly premium. In Kentucky, the cost of a gold plan on average is 19% higher than the average cost of a silver plan. Individuals who expect to incur high medical expenses due to chronic health conditions or costly prescriptions are the best in terms of cost-effectiveness, as these plans will cover around 80% of the medical costs while the members will have to pay the remaining 20% of the medical costs.
The silver metal-tier plan is designed for individuals having low-income or average medical costs because the coverage and cost of silver plans fall between gold and bronze plans. A silver plan is an ideal option for individuals who prefer a lower monthly premium compared to a gold plan but require a higher health coverage than a bronze plan. However, silver plans are greatly preferred by most people because these plans are eligible for cost-sharing reduction subsidies that further lower the out-of-pocket expenses for low-income individuals and families. A silver plan covers about 70% of the healthcare costs of the members while the rest 30% of the costs are paid by the members.
Both bronze and catastrophic health plans are designed for young and healthy individuals. These plans have the cheapest monthly premiums and also offer the lowest health coverage. Furthermore, catastrophic plans are available for individuals younger than 30 or who can qualify for an exemption. Whereas, bronze plans are available to all, and premiums of bronze plans are cheaper compared to silver and gold plans, but individuals have to pay more out-of-pocket costs before their coverage kicks in. On average, a bronze plan covers about 60% of the healthcare costs while members are required to pay the remaining 40% of the healthcare cost. Thus, this plan is only recommended to individuals who are financially able to cover a large portion of healthcare costs that will arise due to medical emergencies.
Average Cost of Health Insurance by Metal-tier in Kentucky
|Type of Health Plan||Cost for 21-Year-Old||Cost for 40-Year-Old|
Private Health Insurance Options in Kentucky
Kentucky uninsured residents who are seeking access to health coverage can obtain quotes from the two private health insurance carriers currently operational in the state. Besides these private health insurers, residents of the state also need to be aware of public assistance programs. Like many states, Kentucky has also created a high-risk insurance pool called Kentucky Access to provide coverage to individuals having a medical history that prevented them from having affordable coverage on the individual market. Most of the residents of the state did not know that they qualify for Medicaid assistance. A good number of families and children in the state are eligible but not yet enrolled in Medicaid or the Kentucky Children Health Insurance Program simply because they are not aware of this fact. Uninsured residents of the state should also know that health coverage in their state is not as expensive as they think and reasonably healthy adults can also enroll in a high-deductible health plan that may protect them from the potential financial calamity.
Health Insurance Carriers in Kentucky
Currently, two health insurance companies are available on the Kentucky state exchange:
- Anthem Blue Cross and Blue Shield
- CareSource Kentucky Co.