Kentucky Health Insurance

Kentucky (KY)

Individual Health Insurance Regulations

Medical insurance is instrumental in safeguarding your future against unforeseen financially-crippling situations like sickness and injury. As the main earning member of your family, it becomes your duty to secure your family's health care needs through an appropriate health plan. Before opting for a health policy, it is wise to access your budget and family's basic medical needs. If you live in Kentucky, you can choose from various options of medical insurance. The Kentucky Department of Insurance supervises the regulations under which the Kentucky health insurers can sell private health insurance to individuals and families.
Kentucky does not require its individual health insurance policies to be guarantee issue. Because individual health plans are medically underwritten, insurance companies may decline an application based upon a pre-existing medical condition or past health history. During the application process, the insurance company has the option to decline you for coverage based on the information provided in your application, it can offer to provide you with coverage that includes certain limitations on pre-existing health conditions or approve your application for full coverage. Benefits for each individual policy will vary according to the specific design plan marketed by each carrier. There is a 12-month exclusionary period allowable for pre-existing conditions with a 6 month look-back clause. For those that are coming onto an individual health plan from another qualified health plan, the insurance companies are required to give credit toward prior coverage. An insurance company may also charge a higher premium for persons that have health risk concerns. Kentucky also has a set of standardized health plans that must be offered by all insurance companies selling individual medical insurance in the state. This includes an indemnity plan, an HMO plan and a PPO plan.
Search for plans and the costs associated with them using the search box above. We provide individual, family, Medicare supplemental, group and student health plan quotes for you to compare on all states and zip codes. Remember that having coverage leads to a healthier lifestyle as you are able to get regular doctor checkups and therefore a low-cost premium.


Kentucky (KY)

Small Group Health Insurance Regulations

Defined as a group of employees with numbers between 2 and 50, small group health coverage in Kentucky is issued on a guarantee issue basis. Under guarantee issue regulations, no group may be declined coverage because of their current or past medical history. Under an employer-sponsored group health plan, employers may require eligible employees to incur a waiting period. Once determined eligible to join the plan, issuance of coverage is guaranteed and may not be denied or altered in any way due to your health status. Under Kentucky law, group health insurance carriers have a 6 month look back period and can recognize a 12-month exclusionary period for pre-existing conditions on all applicants who do not have prior creditable coverage. Credit for prior coverage is required so long as there is no break in coverage of more than 63 days. Rates are medically underwritten and, depending on the health status of the group, may vary plus or minus 35 percent of the indexed rate.


Kentucky COBRA and Continuation Coverage

Regardless of size, all employer groups in Kentucky are regulated by some form of COBRA benefits. Employers with 20 or more employees fall under federal COBRA regulations. Under the federal COBRA laws, the employer is obligated to provide the option to a departing employee to remain on the group health plan for a minimum of 18 months. In special cases, some persons may be entitled to 36 months of continued COBRA coverage under federal law. The COBRA recipient is responsible for paying the insurance premiums that the employer was paying for the coverage along with 2% administrative costs.
Employers with less than 20 employees fall under Kentucky mini-COBRA law, that is, Chapter 304 of the Kentucky Insurance Code. To be eligible for mini-COBRA an individual must have had at least 3 months of prior plan coverage to be eligible and must elect such coverage within 31 days of the notice of eligibility being sent by the insurer. If proper notice is not given, the individual will have an additional 60 days to elect coverage, up until 90 days following termination. COBRA continuation coverage provides an additional 18 months of coverage under the employer-sponsored plan. Qualified disabled persons may extend coverage for an additional 12 months.
Individual conversion plans are also available from many insurance companies that will allow you to convert your group health plan into personal coverage. The state high risk pool is an alternative option of coverage for individuals who have lost their coverage and have had 18 months of prior coverage without a lapse of more than 63 days.