Whitesburg KY

Are you without health insurance? You can now get coverage through Medicaid

The program has no current end date while coronaviris crisis is continuing

Kentuckians without health insurance will be presumed qualified for Medicaid during the coronavirus pandemic.

Healthcare providers cannot advertise the Presumptive Eligibility, but it is available to people who are uninsured.

“Presumptive eligibility has been around as long as I can remember, but it was limited to pregnant women,” said Teresa Cooper of the Kentucky Primary Care Association. “What they did with COVID, was they opened that up to everybody.”

Persons who are uninsured can go to the doctor’s office, tell them they are uninsured and want to apply for Medicaid. They will be directed to an assistant who will enter their income and household size information into a computer.

“A number will be generated for them, and they can receive services that day,” Cooper said.

The person still needs to meet the requirements to receive Medicaid, but they don’t have to wait for a determination from the state of whether they qualify.

“As long as they met the criteria to be presumed eligible, Medicaid will pay that bill,” Cooper said.

If they are later denied after a review, they will not have to return that money as long as they submitted their information in good faith.

“They will be covered from the date they’re presumed eligible until they get coverage or until the local office works their application and denies them,” Cooper said.

There is no current end date for the program “because we’re in a fluid COVID situation,” Cooper said.

Even if the program ends before the review is complete, Cooper said the person will continue to be covered until a decision is made.

Under Kentucky’s Medicaid Expansion, which was made possible by the Affordable Care Act (commonly known as Obamacare), individuals or families earning up to 133 percent of the poverty line qualify for Medicaid. That’s about $34,846 for a family of four, or $22,929 for a couple.

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