State Guides

Kentucky

Kentucky residents are now able to choose quality health insurance plans from Pivot Health.  These plans, described below, offer Kentucky individuals and families the ability to choose the benefit structure that best meets their insurance coverage needs and budget.

  • Short Term Health InsuranceAlso known as short term medical, or temporary health insurance, this plan provides comprehensive benefits coverage for physician visits, in-hospital care, urgent care facility visits and much more.  No provider network restrictions mean that you may seek treatment from any doctor or hospital to access benefits. You’ll know within minutes of applying if you have been approved for coverage, thanks to Pivot Health’s fast, user-friendly online application process.  Qualified applicants may choose any coverage start date – even within 24 hours after you apply.  
  • Supplemental Insurance CoverageDo you find yourself struggling with your major medical insurance plan’s high deductibles and costly coinsurance rates?  Then supplemental insurance may provide you the financial support you need.  The cash benefits provided by a supplemental coverage plan help you pay out-of-pocket medical expenses, such as insurance deductibles, copayments or coinsurance.  Cash payments provide you the flexibility to use the cash for any expenses you incur due to a serious illness or accident.  By working with your primary major medical coverage – whether you have an individual plan or employer-sponsored coverage – a supplemental insurance plan helps you protect your financial security from costly expenses related to medical care.

 

With your Pivot Health insurance plan you also receive many additional non-insurance benefits, such as:  

Unlimited access to discounted telehealth doctor consultations.  Don’t spend your precious time in a health care provider’s waiting room.  Instead, connect directly with a doctor at whatever time of day works for you – telehealth is available 24/7.  And it saves money compared to a standard office or urgent care facility visit.

Discounts on eye care and eyewear.  With savings of 15 percent to 40 percent on eye exams, eyeglass lenses, frames for eyeglasses and contact lenses, it’s never been so affordable to maintain good eye health.  

Savings on prescription drugs.  Enjoy discounts of up to 75 percent on prescription drugs at thousands of pharmacies across the nation.

Health Exchange Challenges in Kentucky

A recent County Health Rankings report shows that approximately 16 percent of Kentucky residents under the age of 65 have no health insurance – significantly higher than the national uninsured rate of 9.1 percent.  Uninsured rates in Kentucky vary by county:  Oldham County has the lowest rate at 10 percent, while Todd County’s rate is more than twice that, at 23 percent.

During the past year, Kentucky has experienced several changes affecting the health insurance exchange.  Up until 2017, the state operated Kynect (the state’s exchange and enrollment website).  But Kentucky Governor Matt Bevin, who took office in late 2015, spent much of 2016 transitioning the state exchange to the Healthcare.gov platform, which is the federally-operated exchange.  As part of the transition, people who had Kynect coverage were required to enroll in a new plan through Healthcare.gov (which was described as more cumbersome than the Kynect enrollment system), or else their coverage was terminated.

Another significant issue affecting exchange enrollees was a reduction in insurance carrier and plan choices. Aetna, Baptist Health (Bluegrass Family Health), UnitedHealthcare and WellCare all withdrew from Kentucky’s individual exchange at the end of 2016.  This left just one insurance carrier option for exchange enrollees in 59 of the state’s counties, starting in 2017. Also in 2017, Anthem Blue Cross Blue Shield reduced their plan offerings to HMO-only options in 74 Kentucky counties.   

Rising premium costs have added to the woes of Kentucky residents purchasing individual exchange plans in 2017.  The Kentucky Department of Insurance approved premium rate increases ranging from 20.55 to 33.7 percent.  Approximately 75 percent of Kentuckians receive federal premium subsidies to help pay for their exchange plan premiums, and won’t be significantly affected by the 2017 premium adjustments.  The increases are staggering, though, for those Kentucky residents who purchase exchange plans but don’t receive federal premium subsidies, as well as for those who buy off-exchange plans.    

A higher-than-national-average rate of uninsured residents reduced insurance carrier and plan choices, and rising premium rates all underscore the importance of offering the Bluegrass State residents access to a broader range of health insurance choices.  

  • Pivot Health’s short term health insurance enables Kentucky residents to purchase comprehensive coverage at a fraction of the cost of major medical insurance coverage – with no provider network restrictions.
  • Pivot Health’s supplemental health insurance provides Kentuckians the opportunity to select insurance designed to provide financial protection against the coverage gaps of high deductible major medical insurance plans.  This supplemental insurance – also called “gap” coverage – helps insureds pay for high deductibles, out-of-pocket costs, coinsurance, copayments, and other costs that they typically incur before their high deductible major medical plans begin to pay benefits.

A Report on Kentucky’s Well-Being

The recent Gallup-Healthways State of American Well-Being report examined how well-being varies by state.  Kentucky ranked 49th out of the 50 states, based on survey responses to questions covering different categories of well-being.  

Kentucky residents reported lower-than-average ratings (ranking 40th, 41st, 44th and 49th, respectively) for the following categories:

  • Financial: managing your economic life to reduce stress and increase security
  • Social: having supportive relationships and love in your life
  • Purpose: liking what you do each day and being motivated to achieve your goals
  • Physical: having good health and enough energy to get things done daily

The most positive ranking for Kentuckians was a 29th place for feeling well about Community:  liking where you live, feeling safe and having pride in your community

The State of Health in Kentucky  

The 2017 Commonwealth Fund’s Scorecard on State Health System Performance gave Kentucky an overall ranking of 39 out of 51 (the 50 states plus the District of Columbia).  This is the most recent version of the organization’s scorecard of its comparison for states in the U.S.

The Commonwealth Fund’s Scorecard rated Kentucky in several areas, including:

  • Uninsured adults aged 19 to 64: 8th ranking (8 percent in Kentucky, compared to U.S. average of 13 percent)
  • Uninsured children ages 0 to 18:  11th ranking (4 percent, compared to the U.S. average of 5 percent)
  • Adults who went without care because of cost in the previous year:  21st ranking (12 percent in Kentucky, compared to the U.S. average of 13 percent)
  • Individuals under age 65 with high out-of-pocket costs relative to annual household income:  27th ranking (15 percent, compared to U.S. average of 14 percent)
  • At-risk adults who did not have a routine doctor visit in the previous two years:  10th ranking (11 percent in Kentucky, compared to U.S. average of 13 percent)
  • Adults that did not visit a dentist in the previous year: 27th ranking (16 percent, the same as the U.S. average of 16 percent)
  • Adults with age- and gender-appropriate cancer screenings:  28th ranking (67 percent in Kentucky, compared to the U.S. average of 68 percent)
  • Hospitalized people who said the hospital staff managed pain well, were responsive to calls for help and who explained medications and their side effects:  18th ranking (69 percent, compared to U.S. average of 68 percent)
  • Breast cancer deaths per 100,000 females: 27th ranking (20.9 in Kentucky, compared to U.S. average of 20.6)
  • Colorectal cancer deaths per 100,000 people: 46th ranking (17.4 percent, compared to the U.S. average of 14.3 percent)
  • Suicide deaths per 100,000:  33rd ranking (16 percent in Kentucky, compared to U.S. average of 13 percent)
  • Adults who report fair or poor health or activity limitations:  48th ranking (32 percent, compared to the U.S. average of 26 percent)
  • Adults who smoke:  50th ranking (26 percent in Kentucky, compared to the U.S. average of 17 percent)
  • Adults who are obese: 46th ranking (36 percent, compared to the U.S. average of 29 percent)
  • Children (ages 10-17) who are overweight or obese: 45th ranking (36 percent in Kentucky, compared to U.S. average of 31 percent)
  • Percent of adults who have lost 6 or more teeth due to decay or disease:  49th ranking (18 percent, compared to U.S. average of 10 percent)

Kentucky rated positively in key categories, including:

  • Adults with a usual source of care
  • Adults receiving age-appropriate vaccines
  • Children with emotional, behavioral, or developmental problems who received needed mental health care in the past year
  • Home health patients who got better at walking or moving around
  • Home health patients whose wounds improved or healed after an operation

2017 Health Insurance Plans in Kentucky

The following companies participate on the individual exchange in Kentucky this year:

  • Anthem Blue Cross Blue Shield (offered in all 120 Kentucky counties)
  • CareSource Kentucky (offered in 61 Kentucky counties)
  • Humana (offered only in Jefferson County)

Pivot Health offers in Kentucky:

  • Short term health insurance
  • Supplemental health insurance

Medicaid in Kentucky

Effective January 1, 2014, Kentucky expanded Medicaid under the terms of the Affordable Care Act.  However, Governor Matt Bevin, who took office in December 2015, submitted a proposal to the federal Health and Human Services department to change the state’s Medicaid expansion.  

Governor Bevin’s Kentucky HEALTH proposal included:

  • Cost-sharing requirements
    • Monthly premiums ranging from $1 to $15
    • Participation in two health savings accounts (one for the $1,000 deductible; the other for a rewards account that could be used for some dental and vision services, as well as gym memberships and over-the-counter medications)
  • Elimination of dental and vision coverage
  • Requirement that able-bodied adults without dependents either participate in job-training or community engagement, such as volunteering

Bevin stated that the proposal would ensure the long-term sustainability of Kentucky’s Medicaid program, while also helping enrollees become more familiar with commercial insurance and become more self-sufficient.  Since Medicaid was expanded in 2014, enrollment in the program has grown by more than 570,000 people, and critics of the Kentucky HEALTH proposal claim the program will restrict coverage and care for Medicaid enrollees.

Your Health Care Coverage Choices

If you are a Kentucky resident and do not have health insurance:  Pivot Health’s short term health insurance offers you the choice of comprehensive medical coverage to meet your benefit and budget needs.

If you are a Kentuckian and have a high deductible health insurance plan:  Pivot Health’s supplemental insurance can help relieve the burden of costly out-of-pocket expenses, such as deductibles, coinsurance, copayments and more.

Pivot Health: offering you choices and flexibility to help meet your coverage and budget needs over time.