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Kentucky Medicaid Member Information Page

Welcome

This is the Kentucky Medicaid Member Information page. Listed below are some frequently asked questions and information regarding member services. Click below to view:

If you have further questions or need assistance, please contact us by referring to the contact information on the lower left of this page.

Whats New

Important Notice Regarding Non-Emergency Medical Transportation

Managed Care Information

KY Spirit information for members and providers

UPDATE - Frequently Asked Questions (FAQ's) for the Kentucky Spirit Transition

July 2, 2013 - Read the:

Attention Members - Information on how to change your Managed Care Organization (MCO)

Federal regulations allows members to change their through a process called Disenrollment for Cause. This process is for members who want to change their current MCO and are not within the 90-day timeline to change. For more information on the process, refer to How to change your MCO

Region 31 Managed Care Organization (MCO) Update

November 2012 - Letters in both English and Spanish have been mailed with details regarding newly assigned managed care organization (MCO). View the: Region 31 Assignment letter: English - Versión en Español; Region 31 Side-by-Side Comparison: English - Versión en Español.

Members have from Nov. 13 to change from your assigned MCO to another MCO, call us toll-free at 1 (855) 446-1245. You have until Dec. 14 to call us to make a change and choose a different plan. You can call Monday through Friday from 8 a.m. to 5 p.m. Eastern time.

Medicaid Managed Care Contracts Awarded for Jefferson and Surrounding Counties

FRANKFORT, Ky. (Oct. 4, 2012) - The Commonwealth of Kentucky has signed contracts with four managed care partners to provide health care services to approximately 175,000 Medicaid recipients in Louisville and 15 surrounding counties.

MCO Update for Providers and Members

Members: (Oct. 25, 2011) Letters have been mailed to Medicaid members with details regarding the start of managed care on Nov. 1. The letter provides information about the member's managed care organization (MCO) assignment. This letter also provides information regarding the MCOs' covered benefits, services and cost-sharing amounts as well as additional information for instructing members on how they may change MCOs. Members will be able to change MCOs for 90 days after managed care begins.

Important prior authorization information regarding RSV (respiratory syncytial virus) vaccine

(Oct. 10, 2011) Magellan Medicaid Administration, the pharmacy benefit administrator for the Department for Medicaid Services, is handling prior authorizations (PAs) for the RSV vaccine for dates of service prior to Nov. 1, 2011. For services rendered on or after that date, the member's assigned managed care organization (MCO) will be responsible for authorizations. The MCOs will honor all existing PAs issued by Magellan for at least 30 days on or after Nov. 1.

MCO Provider Directory is available

Members can search the Managed Care Online Provider Directory to confirm which networks physicians and other health care providers have joined.

Updated Member Information Regarding Medicaid Managed Care

(Sept. 21, 2011) - For updated information, view the Nov. 1, 2011 MCO Member Letter

New Managed Care Website

(Aug. 23, 2011) - Kentucky Medicaid is pleased to announce that it now has a new managed care website for members and providers. This website is intended to assist Medicaid members and providers in finding information about the transition to managed care coming Nov 1.

Update: During the week of Aug. 22, letters were mailed to Medicaid members with details regarding their newly assigned managed care organization (MCO). This letter also provides information regarding the MCOs' covered benefits, services and cost-sharing amounts as well as additional information for instructing members on how they may change MCOs if desired. The deadline to change MCOs has been extended to Oct. 5. Members will also be able to change within 90 days after managed care begins on Nov. 1.

Attention Members
Important Medicaid Change

Click here to review the Member Letter.

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General Questions
Benefit Plans

Kentucky Medicaid has four benefit plans for members. You are placed in one of these plans based on your medical needs. The four plans are:

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Coverage Information

To find out what services may be covered by Kentucky Medicaid, click on one of the FAQs listed below or you may visit the Programs and Services page listed on the left or here.

What services may be Covered?

What Drugs may be Covered?

Do some services need Prior Authorization?

What services are not covered?

How do I receive transportation services?

What are the cost?

What services are available if I need long term care?

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When do I?

 

Regulations and Publications
 

Regulations
907 KAR 1:900

Publications

 

Last Updated 9/23/2013
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