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4 Administration

• The Kentucky Department for Medicaid Services holds operational responsibility for both the Medicaid expansion and separate child health programs.

Health Care Delivery System

• The service delivery system is the same as Medicaid. Medicaid and KCHIP beneficiaries are served through Medicaid managed care organizations in all of the State except the Louisville Region where beneficiaries are served by a Health Care Partnership, a managed care organization authorized through a section 1115 Medicaid waiver.

Benefit Package

• KCHIP is a benchmark plus package that is based on the State Employees Health Benefits Plan with additional services that bring the package almost to the level of the Medicaid package with the exception of EPSDT, special services and non-emergency transportation.

Cost Sharing

• Enrollees in the separate CHIP are subject to the following copayments: $1, $2, or $3 for prescriptions, $2 for office visits and testing for allergy services, and 5 percent of cost of service (co-insurance) for non-emergency use of the emergency room. There are no premiums.

State Action to Avoid Crowd Out

• Applicants cannot be enrolled in KCHIP if they have had health insurance within the past 6 months, unless they met an exception as defined by the State. Exceptions include loss of employment due to factors other than voluntary termination, death of a parent, divorce when the child's coverage was provided by a non-parental adult, and change to employment that does not offer dependent coverage.

Coordination between CHIP and Medicaid

• The local Department for Community Based Services (DCBS) offices provides eligibility determination for Medicaid, and KCHIP's enrollment process is blended with Medicaid.

Outreach Activities

• The State has conducted media campaigns and outreach activities at schools, clinics, community centers, health fairs, health departments, and housing projects. Other coordination efforts include working with agencies that have contact with eligible populations, such as the Salvation Army, Head Start, food banks and local churches.

Financial Information