Kentucky program
Keep your doctor during an insurance change
Your treating doctor can request continued treatment under Kentucky’s special-circumstances rule.
What it is
Your treating doctor can request continued treatment under Kentucky’s special-circumstances rule.
A treating doctor’s departure from the network can disrupt care. Life-threatening illness is a named special circumstance. The doctor requests continued care with your agreement, accepts the plan’s terms and must not have been removed for quality reasons.
Eligibility rules
- Kentucky health benefit plans.
- A special circumstance, including a life-threatening illness.
- The treating provider identifies the circumstance and requests it with the patient's agreement, and accepts the plan's terms.
- You must live in Kentucky.
What you get
- Up to 90 days of continued treatment at plan terms.
- Up to nine months where a terminal illness has been diagnosed.
Amounts and limits
- For a qualifying special circumstance, continued treatment can last up to 90 days after the treating doctor’s network termination or nonrenewal. This does not extend an ended insurance policy.
- Months of continued treatment where a terminal illness has been diagnosed: 9 months.
If you decide to apply
- If your treating doctor leaves the network, ask the clinic whether a continued-treatment request fits your child’s circumstances.
- Have the change notice and treatment dates ready, and ask the clinic whether it accepts the plan’s terms.
Keeping a doctor after a network change: 800-595-6053 · Official page ↗
If you decide to apply
- The decision comes from the plan.
Good to know
The treating doctor makes the request with your agreement. Your usual plan cost sharing continues.
Official sources
“If our network changes, what could continued care protect, what are its limits, and could you help us decide whether to request it?”
Why I’m asking: I want to understand how a coverage change could affect our child’s existing treatment team.
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
Tell the clinic the date and ask for the request before it.
Your social worker
The treating doctor makes the request and accepts the plan's terms for the period.
The care team
The oncologist identifies the special circumstance in the request.
- Who decides
- The plan.
- Ask the care team
- “Our insurance changes on this date. Can you request continued treatment under Kentucky's special-circumstances rule before it does?”
How to apply
First step: Tell the oncology clinic the date of the change and ask the treating doctor to make the request before it.
- Tell the oncology clinic the date the plan or network changes.
- Ask the treating doctor to make the continued-treatment request before that date.
Official application / program page ↗
Where it starts: The treating doctor makes the request. Ask the clinic as soon as the change is announced.
What to gather
- The notice of the plan or network change, with its date
- The treatment plan and its expected end date
How long: Up to 90 days; nine months where a terminal illness has been diagnosed.
What a yes looks like
Written confirmation that the oncologist is covered at plan terms until a named date.
What a no looks like, and the next move
Ask the new plan for a network exception, and ask the clinic who else takes it.
Watch out
- The doctor has to ask, not you. Raise it as soon as the change is announced.
- The doctor also has to accept the plan's terms for the period, so ask the clinic whether it will.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Up to 90 days of continued treatment with the same doctor at plan terms, and nine months in a terminal case.
- $90 — Maximum days after treating-doctor network termination or nonrenewal in a qualifying ordinary case; does not extend an ended policy
- $9 — Months of continued treatment where a terminal illness has been diagnosed
Legal protection: A life-threatening illness is a named special circumstance
What it costs the family: Plan cost sharing continues as before.
The eligibility facts, as published
- Plan type
- Kentucky health benefit plans
- Medical
- a special circumstance, including a life-threatening illness
- Process
- the treating provider identifies the circumstance and requests it with the patient's agreement, and accepts the plan's terms
- Residency
- Kentucky
The trap: The doctor has to ask, not you, and the doctor has to accept the plan's terms for the period. Raise it with the clinic as soon as you hear about the change, not after the old coverage has stopped.
Where I read this
- KRS 304.17A-643 — Continued treatment under special circumstances — Kentucky Legislature, read September 10, 2026
- Kentucky Department of Insurance — Consumer resources — Kentucky Department of Insurance, read September 10, 2026