Best Health Insurance Plans In Kentucky

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Looking for health insurance in the Bluegrass State? According to a study by US News, Kentucky has the fifth-worst health care in the nation. That study was based on access, quality, and good public health. Not to worry though, as the state still has plenty of health care options.

Health Care Choices in Kentucky

The Kentucky Department of Insurance is a great resource for health care, but you can also find coverage through these options:

  1. Employer-provided
    1. From your employer
    2. Through your spouse's employer
    3. Through COBRA
  2. Individual or family plans
    1. Through HealthCare.gov
    2. Directly from a health insurance company
  3. Government-assisted
    1. Medicare
    2. Medicaid (Kentucky HEALTH)

Where do most Kentucky residents get their health insurance coverage?

Kentucky Health Insurance Sources
Sources Percent
Employer-Provided 44%
Individual or family 10%
Medicaid 21%
Medicare 16%
Uninsured 6%
Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population

Nine percent of Americans are uninsured, meaning Kentucky is ahead of the curve. That’s good news for policyholders, as more uninsured people leads to higher rates for insured people.

Kentucky Health Insurance Costs and Rate Factors

Kentucky residents spend an average of $8,004 per year on health care expenditures, only a few dollars less than the national average. What determines your rates in KY? Health care costs vary from person to person, but here’s what insurers primarily look at:

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Body Mass Index

According to the CDC, a high body mass makes you more likely to suffer from serious health conditions. That’s why insurers will look at your body mass to determine your risk-level. People with higher BMIs pay more for health insurance.

In 2016, KY had a 34.2 percent obesity rate, the seventh highest in the country. 42 percent of state residents who used QuoteWizard to shop for health insurance have a BMI in the obese range.

Tobacco Use

Smokers pay more for health insurance because of the high risks that come from tobacco use. About 24.5 percent of KY residents are smokers, the second-highest rate in the nation.

Age

According to HealthCare.gov, health insurance plans cost up to three times more for older people than for younger people. Kentucky residents who used QuoteWizard to compare health care plans are, on average, 41 years old.

Plan Type

It’s no surprise that the more health insurance coverage you want, the more you’ll have to dish out in monthly premiums. Marketplace plans come in metal tiers: bronze, silver, gold, and platinum.

So, how much is health insurance in Kentucky? These are the average monthly costs for a middle-aged KY resident in 2018:

Kentucky Martketplace Plan Rates
Bronze Silver Gold
$313 $410 $527
Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier

A gold plan costs about 68 percent more than a bronze plan. That’s because gold plans cover 80 percent of costs, whereas bronze plans cover 60 percent of costs.

You may qualify for a catastrophic plan, the lowest level of coverage. These types of plans have a yearly deductible of $7,150 but make up for that cost with low monthly premiums. Still, it may be worth it to get a bronze or silver plan to avoid that cost when you need to use your insurance.

Location

Your zip code plays a larger role in your health care costs than you may think. Every state has different rules, regulations, and providers surrounding their health care marketplace.

Also, health insurance rates tend to be community-rated. That means your rates can depend in part on the combined claims everyone files. So, if your neighbors file an abnormally high number of claims, your prices could inflate.

That means how health-conscious your state is also plays a role in your premium. According to America’s Health Rankings, KY is the eighth unhealthiest state in the country.

Kentucky Health Insurance Companies

There are a few options to choose from when it comes to health insurance companies in Kentucky:

These insurance companies offer individual and family plans. Check company websites to find out more about how plans may vary based on your zip code.

Kentucky Health Insurance Laws

The Affordable Care Act limits what insurers can use to price your policy.

There’s a limit to how much you can pay out-of-pocket for a marketplace plan. In 2018, the out-of-pocket maximum is $7,350 for an individual plan and $14,700 for a family plan.

Kentucky state law requires that insurance companies provide some coverage for the following services:

  • Home health care
  • Hospice
  • Diabetes education
  • Autism spectrum disorders
  • Reconstructive surgery
  • OB/GYN annual visit
  • Hearing aids

There are additional services that providers need to offer coverage for. Find the full list on cms.gov.

Medicare and Medicaid in Kentucky

Medicare and Medicaid are both government-funded programs. The coverage and specifics vary state to state, but the programs always cover two different groups of people. Medicare aids seniors, whereas Medicaid helps low-income families and children.

Medicare

Medicare is meant for seniors 65 years and older. There are plenty of coverage options within Medicare. These categories include parts A, B, C, D, and supplemental coverage plans. You may also qualify for one of these Medicare Savings Programs:

Qualified Medicare Beneficiary (QMB):

  • Single person with a monthly income lower than $1,032.
  • Couple with a monthly income lower than $1,392.

Specified Low-Income Medicare Beneficiary (SLMB):

  • Single person with a monthly income lower than $1,234.
  • Couple with a monthly income lower than $1,666.

Qualified Individual (QI-1):

  • Single person with a monthly income lower than $1,386.
  • Couple with a monthly income lower than $1,872.

Medicaid

KY is a state with expanded Medicaid, called Kentucky HEALTH. These are the state’s Medicaid financial requirements:

Kentucky Medicaid Financial Requirements
Household Size Maximum Yearly Income
1 $15,800
2 $21,307
3 $26,813
4 $32,319
5 $37,825
6 $43,331
7 $48,851
8 $54,384

Kentucky Office of the Insurance Commissioner

Website:
Homepage
Insurance Commissioner:
Nancy G. Atkins
Insurance Hotline:
(800) 595 - 6053
Office Hours:
Monday - Friday
8:00 am to 5:00 pm
File a Consumer Insurance Complaint
Complaint Page

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