Medicaid Unwinding in Kentucky: What You Need to Know If You Lose Coverage

The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020. From January 2020 to February 2023, the PHE was renewed a dozen times.

People who were eligible for Medicaid coverage at the start of the PHE got to keep their health insurance during the pandemic — even if they no longer met the typical eligibility requirements. This is because all states — including Kentucky — were required to provide continuous coverage during the PHE.

But the PHE officially ended on May 11, 2023, and automatic Medicaid renewals stopped on March 31, 2023. Over the next year, 5 million to 14 million enrollees nationwide could lose Medicaid coverage.

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Kentucky has resumed eligibility reviews for Medicaid. This is called the redetermination process.

If you no longer qualify, your last day of coverage could be as early as May 31, 2023. An estimated 260,000 people in Kentucky could lose their Medicaid coverage over the next year.

Here’s what you need to know about Medicaid changes in Kentucky, and what to do if you lose your insurance coverage.

Why is Medicaid changing nationwide?

Now that the PHE has ended, COVID-19 remains a public health priority — just not an emergency. As a result, Medicaid renewals will no longer be automatic.

The process of determining eligibility and enrolling in Medicaid will return to the way it was before the pandemic. This is being referred to as the unwinding of Medicaid.

The unwinding could affect millions of people in all states, Washington, D.C., and five U.S. territories.

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What’s happening with Medicaid renewal in Kentucky?

Kentucky’s Cabinet for Health and Family Services (CHFS) and its Department for Medicaid Services (DMS) oversee the state’s Medicaid programs. The Children’s Health Insurance Program, known as CHIP in other states, is called KCHIP in Kentucky.

CHFS has published a Medicaid unwinding plan that explains how the state will conduct eligibility reviews for more than 900,000 households over the next year. 

Make sure CHFS has your up-to-date contact information, including your address, phone number, and email. You can confirm or update your information, or report changes to your income or household status, by:

• Logging into your account on the Kentucky Online Gateway self-service portal

• Calling the Kynect helpline at 855-459-6328

What to expect during the renewal process

It’s important to know that renewal information may come from the CHFS or DMS. You can access your renewal date in the Kentucky Online Gateway self-service portal.

There are several ways to respond to a renewal notice:

• By mail: Return your completed forms to P.O. Box 2104, Frankfurt, KY 40602.

• In person: Visit a Department for Community Based Services (DCBS) office near you.

• By phone: Call Kynect at 855-459-6328 or DCBS at 855-306-8959.

• By fax: Fax your completed forms to 502-573-2005 or 502-573-2007.

• Online: Log into your account on the Kentucky Online Gateway self-service portal and click “review benefits” or “upload requested information in RFI.”

• Via a Kynector or insurance agent: You can visit a Kynector or agent office near you.

The timeline of the redetermination process is based on your renewal date, which will be your last day of coverage if you no longer qualify for Medicaid or KCHIP. Here is how the timeline affects you based on your renewal date:

• 90 days before your renewal date: You will receive an email or text saying that your renewal is happening soon.

• 50 to 60 days before your renewal date: The state will attempt to automatically renew your benefits if information from other sources can confirm your eligibility. If your coverage is renewed, no further action is needed. If you cannot be renewed automatically, you will receive a renewal notice by mail, email, or text — depending on the preferences you set on your account.

• 15 days before your renewal date: If you have not responded to your renewal notice, you will receive a reminder to send information.

• Your renewal date: This is the last day of your coverage if you are no longer eligible or if you did not respond to the renewal notice by the deadline.

• Shortly after your renewal date: If your coverage is not renewed, you will receive a discontinuance notice and information on how to appeal the decision.

If you lose coverage because you missed the renewal deadline, you have 90 days from the date your Medicaid coverage ends to submit your renewal information. If approved, your insurance will be retroactively reinstated with no gap in coverage.

If you need to reach the Kentucky CHFS Medicaid office by phone, call 855-459-6328.

What should I do if I lose my Medicaid coverage in Kentucky?

To qualify for Medicaid in Kentucky, you must:

• Be a current resident of Kentucky

• Be a U.S. citizen, a lawful permanent resident, or a qualified noncitizen

• Demonstrate financial need by having an annual household income that is below the income limit for your household size before taxes are withheld

• Need assistance with access to healthcare or insurance coverage

In Kentucky, you may also qualify for Medicaid for reasons other than or in addition to income, including if you are:

• Pregnant

• A child or teenager

• A parent or caretaker of a child who is 18 years old or younger

• Blind

• 65 years old or older and meet certain criteria

• A person with a disability, or you have a person in your household who has a qualifying disability

• A former foster child

• In need of nursing home care

Alternatives to Medicaid in Kentucky

If you choose not to reapply for Medicaid coverage, or, if you’re no longer eligible, you may qualify for other low-cost or free healthcare options. You can also use GoodRx coupons to save on your prescription medications. In addition, you may be able to enroll in an alternative health insurance plan such as:

• Affordable Care Act (ACA) marketplace plan: Kentucky’s ACA health insurance marketplace is called Kynect. You may be able to find an affordable health plan for $10 or less per month if you qualify for a premium subsidy. If you lose Medicaid, you can purchase a plan on Kynect during the unwinding special enrollment period from March 31, 2023, to July 31, 2024.

• Employer plan: Your company may offer employer-sponsored health insurance.

• Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.

• Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.

• Special plans: Short-term insurance can be a great choice if you anticipate that a better option, like job-based health insurance, will be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance.

• Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.

• U.S. Department of Veterans Affairs (VA) benefits: If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.

Kentucky Medicaid resources

Here are some resources to help you learn more about Medicaid in Kentucky and all of the upcoming changes related to the end of the public health emergency:

• Kentucky Medicaid office: Kentucky’s Cabinet for Health and Family Services (CHFS) and its Department for Medicaid Services (DMS) oversee the state’s Medicaid programs.

• Kentucky Medicaid self-service portal: You can visit the Kentucky Online Gateway self-service portal to access your account online 24/7 to confirm or update your contact information as well as access your renewal date.

• Kentucky Medicaid redetermination: Read more about Kentucky’s Medicaid unwinding plan.

• Kentucky Medicaid FAQs: Find answers to frequently asked questions.

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Written by:

Lisa Kaelin

Lisa Kaelin is an author, editor, and artist. She has nearly 2 decades of experience writing and editing online personal finance content.

Edited by:

Cindy George, MPH

Cindy George is the senior personal finance editor at GoodRx. She is an endlessly curious health journalist and digital storyteller.

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