En español | Most Kentucky residents can buy health insurance through kynect, the state’s Affordable Care Act (ACA) marketplace, during open enrollment, which begins this fall for 2024 health insurance coverage.
Residents who experience a qualifying life event, such as a marriage, a divorce, the birth of a child, a move or the loss of health insurance, may be eligible to buy or change coverage outside the open enrollment period. This is called special enrollment.
Most people enrolled in ACA marketplace plans have seen their premiums go down because the 2021 American Rescue Plan Act (ARPA) increased tax credits for insurance premiums and expanded the number of households that qualify for them. Every household that pays more than 8.5 percent of its income for a marketplace plan now qualifies for federal tax credits to help with coverage. These enhanced subsidies are available through 2025.
Before the 2021 law, such tax credits were only available to people earning less than a certain salary ($54,360 for one person).
Most Americans with a marketplace plan can save an average of about $800 per year, according to the federal government.
First, use kynect’s plan comparison tool to estimate costs and see what sorts of plans and benefits you may qualify for — or enter personal information like your name and zip code to set up time to speak with an assister, which could be a “kynector” or an insurance agent, who can explain the options available to you. Or speak with a kynect call center representative by calling 855-459-6328.
Once you’re approved for a plan, you’ll need to pay your first monthly premium for your coverage to begin.
To apply and enroll:
Coverage and cost depend on where you live, the type of plan you choose, your household income, your age and the ages of those in your family.
If you qualify for Medicaid, you’ll be able to get free or low-cost coverage and may not need to worry about premiums or copays, depending on your level of income.
All kynect qualified health plans cover 10 “essential” benefits, including:
Insurance companies cannot deny coverage because of preexisting conditions. When you apply, you can identify your medical needs and choose a plan that makes financial sense for you and your family.
For individuals up to age 21 dental and vision services are included in marketplace plans. Dental plans for adults 21 and older are not currently available through the state-based marketplace, but separate vision plans can be purchased through kynect.
Every eligible household that pays insurance premiums that exceed 8.5 percent of its annual income qualifies for federal tax credits for insurance premiums through 2025.
According to Megan O’Reilly, AARP vice president of government affairs for health and family, subsidy recipients ages 50 to 64 have seen average annual savings of more than $950.
Yes. If you qualify for a premium tax credit, you may also qualify for a cost-sharing reduction, an ACA provision offering extra savings, that would help you pay for such out-of-pocket expenses as deductibles and copays. You must enroll in a Silver-level plan to get this assistance.
Kynect plans are organized into three categories:
Kentucky residents 29 and younger can also apply for a catastrophic plan offering low premiums but with high deductibles.
If you already have coverage through your employer or directly through an insurance provider but are eligible for lower premiums, you can switch to a qualified health plan. But you may not qualify for tax credits if you opt out of your employer’s plan — unless those premiums exceed a certain portion of your household income. The premiums would need to be more than 9.12 percent of your household income for individual coverage to qualify for the tax credits.
If you lose your COBRA coverage, you may be able to sign up for a kynect plan during a 60-day special enrollment window. Try to apply and select your plan through kynect before your COBRA coverage ends to make sure there’s no gap in coverage.
If you already have a marketplace plan and want to adjust your coverage, you’ll need to wait until the next open enrollment period opens this fall, unless you experience a qualifying life event.
That depends. Because not all doctors accept all plans, you should check with your physician’s office to see whether he or she accepts a particular marketplace plan. Widely accepted insurance providers, including Anthem and CareSource, offer plans in 100 counties. Two new providers, Ambetter from WellCare of Kentucky and Passport Health Plan by Molina, are available in select counties.
It depends. You can enroll as a family. But in some cases, some family members may also be eligible for subsidies or other programs such as Medicare, Medicaid or the state’s CHIP, depending on age, income, and disability or caregiver status. Such families may choose to enroll separately. They may still be able to see the same doctor or go to the same medical practice, depending on the types of insurance plans accepted.
This guide was updated on Feb. 1, 2023, with new information about open enrollment.
This story is provided by AARP Kentucky. Visit the AARP Kentucky page for more news, events, and programs affecting retirement, health care, and more.
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