Written by a parent, not a doctor. Nothing here is medical advice.

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Kentucky program

Free health insurance for your child (Medicaid)

Kentucky's free health insurance for children under 19. It can sit behind your work insurance.

What it is

Kentucky's free health insurance for children under 19. It can sit behind your work insurance.

Medicaid covers cancer treatment and everyday care. Kentucky uses different income lines for different ages and insurance situations. The benefits office decides which category fits your child.

Eligibility rules
  • Your child must live in Kentucky and be under 19. Ordinary income-based child Medicaid has no savings test.
  • Kentucky decides who belongs in your child’s tax household and which income counts. Current monthly income is the test. Annual income divided by 12 is only an estimate, especially after a pay change.
  • The ordinary category uses 200% of poverty under age 1, and 147% at ages 1–5. The uninsured category for ages 6–18 also uses 147%. These figures include the five-point allowance.
  • If your child is 6 to 18 and already has insurance, the free line is much lower: about $2,998 a month for four people. Without insurance it is $4,043, or $5,995 under KCHIP.
  • At age 18, the manual requires school attendance for the ordinary child category. KCHIP has no school rule. The office can check other categories rather than stopping the review at a birthday.
  • The October 1, 2026 federal immigration change preserves the separate option for lawfully residing children and pregnant people. Kentucky publishes this option for children under 19. The office checks your child’s exact status and category.
  • Emergency Medicaid uses its own emergency-medical-condition test. It does not promise coverage for every part of cancer treatment.
Why consider Medicaid with work insurance?
  • Your work plan pays first. For covered care from a clinic enrolled in Medicaid, with any required approval, the clinic generally cannot bill your child the work plan’s deductible, copay or coinsurance. This can hold even when Medicaid pays $0.
  • There is no monthly premium for your child.
  • Medicaid also opens assessment for rides and home nursing.
What needs checking
  • Your child must have active coverage on the service date. Noncovered care, a valid private-pay agreement or a specific lawful charge needs separate review.
  • The counselor can check both plans, the treatment team, pharmacy access and required approvals before you make a coverage change.
What you get
  • No premium and no copays for your child’s covered care.
  • Hospital care, chemotherapy, prescriptions, dental care and vision care.
  • Rides and home nursing when your child meets their separate rules.
Income examples and covered care
  • The published monthly chart is effective April 1, 2026, with no fixed end date. Its dollar columns already include the applicable five-point allowance.
  • For four people, the under-1 line is $5,500 a month. The ages-1–5 and uninsured ages-6–18 line is $4,043. For three people, the latter line is $3,347.
  • For children under 21, EPSDT covers medically necessary care within federal Medicaid benefit categories. It does not guarantee every requested service.
  • Worked example: the work plan allows $5,000, takes $3,000 of it as your deductible and pays $2,000. Because Medicaid would have paid at most $1,500, it pays nothing more, the clinic writes off the rest, and you owe $0, not $3,000.
If you decide to apply
  1. Ask the hospital financial counselor to go through the kynect application with you, including temporary hospital coverage.
  2. Have your child's identification, current income, insurance cards and earlier hospital bills ready.

Medicaid for a child: 855-306-8959 · Official page ↗

After an application
  • The state has 45 days to approve, deny or ask for more; many decisions come sooner. Answer any missing-information letter quickly, because the clock pauses on it.
  • A qualified participating hospital can decide temporary coverage from preliminary information. With a full application filed by the end of the following month, temporary coverage normally continues until the regular decision. Without that application, it ends on the last day of the following month. The hospital can confirm which forms it submitted.
  • Earlier eligible bills can reach back three months before the application month through 2026. For child applications from January 1, 2027, that becomes two months. Eligibility is checked for each earlier month.
  • Approved children generally have 12 months of continuous coverage, subject to the program’s exceptions. A longer period for young children should be confirmed with DCBS rather than assumed.
Good to know

Your work plan pays first. For covered care from an enrolled clinic, Medicaid’s rules can protect you from the remaining bill.

Billing and appeals
  • Billing protection requires a Medicaid-covered service, an enrolled clinic, any required approval and active coverage on the service date. The employer plan pays first. The clinic generally cannot collect its deductible, coinsurance or copay from your child, even when Medicaid pays nothing.
  • Noncovered services, dates outside coverage, a valid informed private-pay arrangement or a specific lawful Medicaid charge need separate review. An insurer’s statement is not necessarily a bill you owe. The counselor can check the claim and both plans’ notices.
  • For a Medicaid managed-care denial, Kentucky allows 60 calendar days after receipt of the notice to appeal. An ordinary decision is normally due within 30 calendar days. Urgent review must be as fast as health requires and no later than 72 hours.
  • The plan can take up to 14 extra days only if it writes to explain why.
  • If the plan cuts a service your child already gets, ask within 10 days of the letter for it to continue during the appeal. If you lose, the plan can ask you to repay the cost of that continued care.
  • The state-hearing window is 120 calendar days from the plan’s appeal decision. Continuing services after an unsuccessful appeal has a much shorter federal deadline: the hearing and continuation request must be made within 10 calendar days of the decision notice.

Federal background: Medicaid and Medicaid as second insurance.

Official sources
Ask your social worker

“What are the benefits and drawbacks of adding Medicaid to our child’s coverage, and could you help us decide whether to apply?”

Why I’m asking: I want to understand whether Medicaid could reduce treatment bills without disrupting our child’s care.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

File on kynect today. Report this month's income and any insurance, name the months with old bills, and choose a plan the oncology group takes.

Your social worker

The oncology social worker or financial counsellor helps you file, asks the hospital about temporary Medicaid, and chases the 30-day decision.

The care team

Nothing for the ordinary child categories. Medical records matter only if you are asked about a disability category.

Who decides
The Department for Community Based Services (the state benefits office) checks the income. The Medicaid health plan you pick runs the coverage.
Ask your social worker
“Can you help me file on kynect today, ask the hospital about presumptive eligibility while we wait, and list the bills from the three months before?”

How to apply

First step: Apply at kynect.ky.gov/benefits or call 855-306-8959 this week, and ask the hospital counsellor today about temporary Medicaid while the office decides.

  1. Apply on kynect this week and ask the hospital counsellor today about temporary Medicaid while the office decides.
  2. List the months with bills so the three-month look-back covers the admission.
  3. Pick a Medicaid health plan the hospital and the oncology group both take.

Official application / program page ↗

Where it starts: Apply at kynect.ky.gov/benefits or by phone on 855-306-8959. Ask the hospital's financial counsellor the same day whether it can open temporary Medicaid (presumptive eligibility) for a child under 19.

What to gather

  • Child's birth certificate or identification and Social Security number
  • Kentucky address
  • This month's income for each parent in the tax household
  • Insurance cards, if any
  • Hospital bills from the three months before you apply

How long: The posted standard is 30 days from the application. A participating hospital can open temporary coverage the same day. Once approved, coverage reaches back up to three months, and two months for applications from January 1, 2027.

What a yes looks like

A notice with coverage dates and a choice of Medicaid health plan. Check the hospital and the oncology group are in the plan before you choose. Twelve months of continuous coverage follows.

What a no looks like, and the next move

Read whether the office said no on income, on a document or on the category. If it is income, ask in the same application about the spend-down and appeal by the date on the notice.

Watch out

  • Kentucky counts the tax household and this month's income, not last year's return.
  • Your child can keep private insurance and have Medicaid too. Do not cancel the work plan to apply.
  • The published dollar figures already include the five-point allowance. Adding it again puts the line too high.

Dates that change this

2026-04-01: The income table was updated in March 2026 and runs from April 1, 2026 onward. Kentucky did not publish a standing annual date, so the 2027 figures may arrive at a different time of year.

2027-01-01: Coverage reaches back up to three months before the application month now. From January 1, 2027 that becomes two months for a child.

2026-10-01: The October 1, 2026 federal immigration change preserves the separate option for lawfully residing children and pregnant people. Kentucky publishes that option for children under 19. DCBS checks the child’s exact status and category. Emergency Medicaid has its own emergency-medical-condition test; it does not promise coverage of all cancer treatment. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Full Medicaid with no premium and no child copays. For four people the published monthly lines are $5,500 under age 1 and $4,043 at ages 1 to 5, allowance included, effective April 1, 2026.

  • $5,500/month — Under age 1, household of 4, published monthly line (200% column, allowance included)
  • $4,043/month — Ages 1 to 5 and the uninsured 6-to-18 category, household of 4, published monthly line (147% column)
  • $3,347/month — Ages 1 to 5 and the uninsured 6-to-18 category, household of 3, published monthly line (147% column)
  • $109/month — Ordinary category for a child aged 6 to 18 who already has insurance, published percentage (no dollar cells published)
  • $3 — Retroactive coverage before the application month, current rule
  • $12 — Continuous coverage once approved

Covers: Hospital and clinic care · Chemotherapy and prescriptions · Anything medically necessary for a child under 21 (the federal child benefit) · Shift nursing and aide hours at home when approved · Rides to appointments · Dental and vision

Legal protection: No premium and no copay for a child · Twelve months of continuous coverage once approved

What it costs the family: No premium. No copays for children.

The eligibility facts, as published

Age
under 19
Age max exclusive
19
Income
MAGI budget group. Published categories: under 1 at 195% base and 200% with the five-point allowance; ages 1 to 5 at 142% and 147%; the uninsured 6-to-18 category at 142% and 147%; the ordinary 6-to-18 category at 109% with no allowance (MS 2910, revised April 13, 2026)
Insurance status condition
none for the ordinary categories: Medicaid pays after any other liable coverage (MS 1050). The 147% category for ages 6 to 18 and the 218% category are for children who have no insurance
Residency
Kentucky
School condition
the manual still requires a child aged 18 to be attending school for an ordinary Medicaid category; the KCHIP category has no school rule
Continuous eligibility
12 months for a child (907 KAR 20:100 section 10(2))
Retroactive months
3 now; 2 for a child from 2027-01-01
Processing standard
30 days from application (MS 1320, revised February 2020, with documented exceptions)

Decisions this site cannot make: DCBS office MAGI determination through kynect · Hospital presumptive eligibility (a participating hospital, children under 19)

Expect friction on: Choosing a Medicaid health plan the oncology group takes

The trap: Kentucky counts the tax household and this month's income, not last year's return and not everyone under the roof. Do not cancel a work plan to apply: Medicaid sits behind it. The five-point allowance is already inside every dollar figure the state publishes; do not add it again.

Where I read this

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