Kentucky Medicaid Office

Kentucky Medicaid office (DMS)

Kentucky's Medicaid program is administered by the Department for Medicaid Services (DMS) inside the Cabinet for Health and Family Services, but applications and renewals route through a different agency entirely — the Department for Community Based Services (DCBS), which handles Medicaid applications on behalf of DMS. Members and applicants reach both agencies through kynect, the state benefits portal that also covers SNAP, KCHIP, and related programs.

What DMS does day-to-day

DMS sets program policy, certifies and pays providers, manages contracts with the state's managed care organizations, and runs member services. Day-to-day eligibility decisions sit with DCBS workers in county offices statewide. The split lets DMS focus on coverage rules and provider oversight while DCBS handles the intake side.

How DMS is organized

DMS publishes its work through seven divisions: Health Care Policy, Health Plan Oversight, Information Systems, Fiscal Management, Long-Term Services and Supports, Program Integrity, and Quality and Population Health. The divisions are listed on the DMS landing page along with the Medicaid Advisory Committee and Beneficiary Advisory Council, the federally required member-input bodies for the program.

Where to start

• Apply or check status — kynect.ky.gov (you can also call DCBS at 855-306-8959).
• Member Services for benefit questions — call (855) 459-6328 or email MS.Services@ky.gov.
• DMS website — chfs.ky.gov/agencies/dms for program rules, provider directories, and policy updates.

Who qualifies for Kentucky Medicaid?

DMS frames Kentucky Medicaid eligibility as a function of income and, for some populations, resources. The agency states it plainly: Medicaid is for families and individuals whose income and resources are within the established guidelines, with resources only applying to the aged, blind, or disabled population. Eligibility runs on Modified Adjusted Gross Income (MAGI) for most groups; KCHIP, Kentucky's separate Children's Health Insurance Program, uses the same MAGI methodology.

Five eligibility categories

DMS lists five categories on its Medicaid Enrollment page:

1. Children younger than 19
2. Pregnant women
3. Parents and caretaker relatives
4. Adults age 19 to 64
5. Foster care children 19 to 26 who do not receive Medicaid in another category

Kentucky adopted the ACA Medicaid expansion. DMS describes the expansion using the same federal language: the Affordable Care Act of 2010 created a national Medicaid minimum eligibility level that covers most Americans with household income up to 133 percent of the federal poverty level (the effective 138% adult standard reflects the 5% income disregard built into MAGI).

Spenddown for over-income households

Households whose income is too high to qualify for regular Medicaid may still get coverage through spenddown. DMS describes spenddown as time-limited medical assistance: medical expenses count against excess income for a calendar quarter (the application month plus the two months after, or the three months before). When medical bills equal or exceed the spenddown amount, Medicaid pays for the rest of the period. The aged, blind, and disabled population most commonly uses this pathway.

Aged, blind, and disabled limits

For the non-MAGI category, DMS publishes a $217 monthly income limit and a $2,000 resource limit for an individual. The asset rules exclude items like the home you live in, the vehicle you drive, and certain other property.

Kentucky Medicaid income limits

Kentucky Medicaid does not publish a single income chart. Instead, DMS posts limits for each population on the program page that covers it. For most adults the federal expansion standard applies; for older adults dual-eligible with Medicare, the Medicare Savings Program tiers do most of the work. The figures below are the specific dollar thresholds DMS publishes on the cached source pages — they shift every January when the federal poverty level updates.

Medicare Savings Program (current MSP thresholds)

DMS structures the MSP eligibility screen as three yes/no questions. The income test, after a $20-per-month income disregard, is:

Resources include checking, savings, stocks, bonds, certificates of deposit, annuities, trusts, and life insurance policies. The home you live in, the vehicle you drive, and up to $1,500 set aside for burial expenses or life insurance are excluded.

MSP tiers and what each pays

MSP is administered as three tiers, each tied to a federal poverty level (FPL) band:

• Qualified Medicare Beneficiary (QMB) — pays Medicare Part A and Part B premiums, deductibles, and coinsurance.
• Specified Low-Income Medicare Beneficiary (SLMB) — pays the Medicare Part B premium.
• Qualifying Individual (QI) — pays the Medicare Part B premium for people not otherwise eligible for full Medicaid.

Aged, blind, or disabled (non-MSP)

For Kentucky Medicaid's standard aged/blind/disabled track outside the MSP path, the published monthly income limit is $217 for an individual with a $2,000 resource limit. If income exceeds the limit, the spenddown pathway described above may bring eligible medical bills back under the threshold.

MAGI groups (children, pregnant individuals, parents, expansion adults)

The MAGI populations have no asset test. Income is measured as a percentage of the federal poverty level — the children's standard sits well above the adult expansion ceiling, and KCHIP picks up children whose family income is higher than the Medicaid limit but still modest. Use the kynect prescreening tool to check a specific household's standard before applying.

How to apply for Kentucky Medicaid

One Kentucky Medicaid application can also screen the household for SNAP, KCHIP, and other Kentucky public benefits. DCBS handles the application work on behalf of DMS, and almost everyone starts at kynect, the state's online portal.

Three ways to apply

• Online at kynect — kynect.ky.gov. You can apply yourself or get help from a kynector (a trained community assistor whose help is free).
• By phone — call DCBS at (855) 306-8959. Hearing-impaired residents call (800) 648-6056.
• In person at a DCBS office — staff will help you complete the application, or you can print and fill out the Kentucky Medicaid paper form and bring it with you.

If a paper application is more convenient than the portal, DMS also lets you fax it to (502) 573-2005 or mail it to the Office of the Kentucky Health Benefit Exchange, 12 Mill Creek Park, Frankfort, KY 40601. The Medicaid call center at (855) 459-6328 helps with benefit-side questions; DCBS handles the application paperwork.

What DCBS will ask about

The application covers the people in your household, earned income (job wages or self-employment), unearned income (Social Security, retirement, pensions, other benefits), and resources (bank accounts, trusts, vehicles, life insurance). DCBS uses the answers to determine which Kentucky Medicaid category fits, whether a household member should be referred to KCHIP, and whether a non-MAGI track applies.

Application forms are available in many languages

DMS publishes the Kentucky Medicaid application (form MAP-205) in more than a dozen languages, including English, Spanish, French, Mandarin, Vietnamese, Russian, Arabic, Ukrainian, Somali, Bosnian, Burmese, Haitian Creole, Kinyarwanda, Nepali, and Swahili. The full set is listed on the Apply page.

Renewals run every 12 months

Once enrolled, Kentucky Medicaid members renew coverage every 12 months. DMS first tries to renew electronically using federal and state data; when that confirms eligibility, the household keeps coverage with no paperwork. When data doesn't match, the member gets a pre-populated renewal form and must respond by the printed deadline. Report income, address, and household changes through kynect (or by calling 4-kynect) so renewal notices reach you.

What Kentucky Medicaid covers

Kentucky Medicaid covers more than one million Kentuckians, and DMS delivers most member services through a small set of contracted managed care organizations (MCOs). The agency lists physical health, behavioral health, pharmacy, dental, vision, and transportation as covered services, with extra protections for children under 21 through the federally required EPSDT benefit.

Managed care plans currently under contract

DMS publishes its current MCO roster with the member service phone for each plan:

Anthem Kentucky Managed Care Plan, Inc. is no longer a Kentucky Medicaid MCO as of Jan. 1, 2025. DMS notes the change does not affect any member's Medicaid eligibility — only the plan that delivers the benefit.

KCHIP and KI-HIPP sit alongside Medicaid

Two related programs serve households who don't fit the regular Medicaid track. KCHIP — the Kentucky Children's Health Insurance Program — provides free or low-cost health insurance for eligible children up to age 19. KI-HIPP — the Kentucky Integrated Health Insurance Premium Payment Program — pays for employer-sponsored insurance when at least one person on the policy is a Medicaid member, letting families keep their job-based plan with Medicaid as secondary.

Programs grouped under Medicaid

DMS lists the following member-facing programs on its Member Information landing page: Apply for Medicaid; Renew Your Medicaid; Medicaid Eligibility; Medicaid Identification Card; Medicaid Provider Directory; Managed Care Organizations; Disenrollment from Managed Care; KCHIP; KI-HIPP; kynect Benefits; kynect Resources; Pharmacy; Pregnant Women; and Special Programs (services for women, children, the elderly, individuals with disabilities, and individuals with behavioral health or substance use disorder needs).

EPSDT and children's benefits

Children under 21 enrolled in Kentucky Medicaid receive Early and Periodic Screening, Diagnostic, and Treatment benefits — a federal mandate that covers any medically necessary service for a child, including dental, vision, hearing services, and behavioral health well beyond what adult Medicaid in many states covers.

Long-term services and waiver programs

Kentucky's Division of Long-Term Services and Supports administers the state's Home and Community-Based Services waivers. DMS recently launched a new 1915(c) waiver, Community Health for Improved Lives and Development (CHILD), for residents 21 and younger with complex, multi-system needs — keeping medically fragile children safe, healthy, and as independent as possible within their families and communities rather than in an institution.

Other state Medicaid pages