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additional coverage

For children in families with incomes from 150% to 200% FPL, Kentucky will provide a KCHIP benefit package that uses the state Employees HMO as the benchmark plus additional coverage. In Appendix H, a side-by-side comparison of the KCHIP separate insurance program benefits package and the State Employees HMO Plan has been provided. Please see attached.

For children in families with incomes from 150% TO 200% FPL, Kentucky will provide a KCHIP benefit package that will be essentially the same as the State’s Title XIX Medicaid plan with the exception of non emergency transportation and EPSDT special services.

Kentucky’s EPSDT Special Services coverage includes medically necessary and appropriate health care, diagnostic services, treatment, and other measures described in section 1905(a) of the Social Security Act to correct or ameliorate defects and physical and mental illnesses, and conditions identified by EPSDT screening services, which are not covered under the Kentucky State Medicaid Plan (Title XIX). Excluded from EPSDT Special Services coverage are any services listed as exclusions in 1905(a), including, but not limited to physical structural changes to a residence, recreational equipment, specified educational tools, including computers, and environmental devices, including air conditioners.

Children with FPL of 150% or above are not eligible for EPSDT services or non-emergent transportation.

6.1.4.5.

Coverage that is the same as defined by existing comprehensive state-based coverage 6.1.4.6.

Coverage under a group health plan that is substantially equivalent to or greater than benchmark coverage through a benefit-by-benefit comparison (Please provide a sample of how the comparison will be done) 6.1.4.7.

Other (Describe)