Kentucky health insurance for low income

March 22, 2022 2:45 PM

A friend is considering a move to Kentucky to stay with friends. They have not been very successful at holding a job over the past few years due to mental health issues, so they've been getting their insurance for free in their current state through ACA, I believe.

I don't know all the details but I do know they go to the doctor regularly, have gotten some therapy, had ER visits, some dental work, etc. and they don't get billed for anything.

I Googled and it says: Kentucky has implemented the Affordable Care Act's Medicaid expansion. Kentucky adults (up to age 64) with household income up to 138 percent of the federal poverty level are eligible for Medicaid.

Which sounds good, but being the state of Mitch McConnell I am leary. Will my friend be ok moving there, from a health-insurance standpoint?

posted by Serene Empress Dork to Health & Fitness (3 answers total)

Best answer: Kentucky is one of the few red states to have really embraced the ACA (one guess which party has held the governorship there several times since 2010). There was some... back and forth... but ultimately their implementation of the ACA is called Kynect. They will either be routed to Medicaid if they have little or no income, or an ACA plan with copays and deductibles based on their income.

As Kynect (and Medicaid) are state-administered program, Kentucky does have some leeway to change things, and of course poorer, more rural and Southern areas tend to have more access-to-care problems in the first place; it doesn't do you any good to have mental health care fully funded by Medicaid when there's only one clinic that takes it in your community.

Unfortunately this is kind of difficult information to figure out. An ACA navigator (disclosure: I was one for a long time, in Illinois) is apparently called a Kynector there and getting in touch with one of them may be helpful. Or if the friends know people who are low-income and/or have a lot of complex health conditions, those people might be able to give the lay of the land in the city or community they'd be living in.
posted by tivalasvegas at 4:05 PM on March 22, 2022 [3 favorites]

Response by poster: Thank you, tivalasvegas. That is encouraging. I'm not sure what part of Kentucky they are in, hopefully it's not too rural or poor to have adequate mental health providers.
posted by Serene Empress Dork at 7:33 PM on March 22, 2022

One possibility for mental health visits could be telehealth visits. Where much of physical medicine cannot be carried out remotely - though some can - mental health seems to be well suited for this. This might be especially helpful if your friend settles in a rural location. Hospitals tend to take Medicaid, Medicare, and most locally issued insurance, and also have the set-up for telehealth, where individual clinicians might not accept all insurance. Kentucky also has medical schools, and the trainees in psychiatry need patients (they are supervised by fully-qualified psychiatrists) Colleges that offer psychology counseling degrees also have trainees then need patients (again with supervision). Not knowing the particular kind of help your friend needs, this may give them more leeway for finding a clinician. After they move and get coverage, perhaps they would welcome help from you in finding a practitioner.
posted by citygirl at 8:38 PM on March 22, 2022 [1 favorite]