All children, especially those living in low-income and vulnerable families, need access to affordable health care. Having health insurance means children are able to access critical preventive and ongoing care needed to stay healthy. It means that kids can visit the doctor, dentist, eye doctor, and mental health professionals to support their healthy development.
A parent’s health—and health insurance status—affects the health and well-being of other family members, especially their children. When parents are insured, they are more likely to be healthy and ensure the health of their children and their children are more likely to have health coverage. Although health insurance is important, many low-income parents have historically faced limited affordable health coverage options. They often earn too much to qualify for Medicaid but could not afford to purchase private insurance.
Coming in 2024, a new solution for these families will be available through the Basic Health Program (BHP), which is being developed by the Department for Medicaid Services (DMS). A BHP is a bridge between the Medicaid Program and coverage through a qualified health plan on the State Based Exchange or other commercial health insurance. It will provide more affordable options that include no deductibles and lower premiums and cost sharing amounts. A BHP also has continuous enrollment for individuals to apply at any time during the year.
Adults under the age of 65 with incomes between 138% to 200% of the Federal Poverty Level (FPL) are eligible for the BHP. The benefits are the same as the state’s Essential Health Benefit Benchmark Plan, which include:
- Ambulatory patient services
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Vision and dental benefits are included for individuals up to age 21. Vision and dental plans may be offered at an additional expense for adults age 21 or older.
In addition to this exciting new program, recent changes have been made to support the health and well-being of pregnant and postpartum mothers on the state and federal level:
- Senate Bill 178 of 2022 provided the Cabinet for Health and Family Services the opportunity to extend Medicaid coverage for pregnant women in Kentucky to 12 months postpartum to ensure they have access to uninterrupted care in the critical first year after welcoming a new child. Kentucky’s Department of Medicaid Services (DMS) submitted a state plan amendment to the Centers of Medicare and Medicaid (CMS), which recently received approval.
- The Health Resources and Services Administration (HRSA) launched the National Maternal Mental Health Hotline – 1-833-9-HELP4MOMS. This free, confidential support hotline is available 24/7 to pregnant women and new moms in both English and Spanish. Check out more ways you can support new moms from our partners at the Kosair Charities Face It Movement.
Having health insurance allows parents to access the doctor, dentist, eye doctor, and mental health professionals for preventive and ongoing care. When parents and caregivers can stay healthy, they can support their family and promote a more prosperous commonwealth – healthier Kentuckians means a healthier workforce.
DMS will be seeking public input to develop Kentucky’s Blueprint, which is the form the state must submit for Centers for Medicaid and Medicare Services (CMS) approval. Keep an eye out for public comment notices as well as other communications from DMS about the BHP. If you have questions, please send those to BHP.Question@ky.gov.