Benefits for Young People
- The Basics
- Why Benefits Matter
- Key Programs
- SSI Eligibility for Young People
- Medicaid Eligibility for Young People
- Private Health Coverage for Young People
- Other Programs
- Next Steps
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Medicaid Eligibility for Young People
Medicaid helps people with low income pay for their visits to the doctor, hospital stays, prescription drugs, medical equipment, and other medical services.
If you get Supplemental Security Income (SSI) benefits or used to get SSI benefits and now qualify for SSI's 1619(b) status, you get Medicaid coverage automatically and do not need to worry about the eligibility information discussed here.
If not, you may qualify for income-based Medicaid. The income-based Medicaid eligibility rules depend on whether you are:
- 18 or younger, or
- 19 or older.
You can apply for Medicaid:
- Online at kynect benefits
- At your Department for Community Based Services (DCBS) office by mail or in person
- By calling the DCBS Call Center at 1-855-306-8959.
For help with your application, visit or call your local Department for Community Based Services (DCBS) office or contact the Call Center at 1-855-306-8959.
Medicaid if You Are 18 or Younger
If you are 18 or younger, you may qualify for income-based Medicaid if your family’s income is 218% of the Federal Poverty Guidelines (FPG) or less ($68,016 per year or less for a family of four). It doesn't matter how much your family has in resources or whether you have a disability. Note: Income-based Medicaid for children 18 and younger is sometimes called "Healthy Start."
Check whether your family's income is low enough for you to get income-based Medicaid:
Your family size: | |
Income limits for your family: | |
$15,060 | |
$5,380 | |
$15,060 | |
$5,380 | |
Income-based Medicaid, adults (138% FPG) | |
KCHIP Children's Health Insurance Program (218% FPG) | |
Subsidized private plans, reduced fees (250% FPG) | |
Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules.
Notes:
|
Note: Some young people with disabilities who don't get SSI and don't qualify for income-based Medicaid may still qualify for disability-based Medicaid. If you have any questions about this, talk to a Benefits Planner.
Medicaid Waiver programs pay for services that help people with disabilities live in their own homes instead of in nursing homes or other institutions. Medicaid Waiver programs have different rules than regular Medicaid. Kentucky offers six Medicaid Waiver programs that help people in certain situations.
If you qualify, you or your family may have to pay each month for part of your waiver services. This is called a patient liability. You don't have to pay a patient liability if you get SSI benefits or qualify for SSI’s 1619(b) rule.
Medicaid if You Are 19 or Older
If you are 19 or older, you may qualify for income-based Medicaid if your family’s income is 138% of FPG or less ($20,783 per year or less if you are single). If you are pregnant, you can have income up to 195% FPG ($39,858 per year if you are single and pregnant with your first child; the baby counts as a family member according to Medicaid). It doesn't matter how much your family has in resources or whether you have a disability.
Check whether your income is low enough for you to get income-based Medicaid:
Your family size: | |
Income limits for your family: | |
$15,060 | |
$5,380 | |
$15,060 | |
$5,380 | |
Income-based Medicaid, adults (138% FPG) | |
KCHIP Children's Health Insurance Program (218% FPG) | |
Subsidized private plans, reduced fees (250% FPG) | |
Subsidized private plans (no income limit) | -- |
If your family's income is at or below the limit for a program, you may qualify if you meet other program rules.
Notes:
|
If you have a disability, don't get SSI, and make too much for income-based Medicaid, you may qualify for disability-based Medicaid or for Medicaid Waivers.
Learn more about income-based Medicaid for adults in DB101's How Health Benefits Work article.
If you don’t qualify for Medicaid or Medicaid Waivers, look into other health coverage options on kynect. Learn more about private health insurance.
Learn more
School and Work Estimator
Young people with disabilities can use the School and Work Estimator to find out how a job can affect their cash benefits and health coverage - and how staying in school can help.
Getting Past the Myths
There are many myths about people losing their benefits if they work that are just not true.
Building Your Assets and Wealth
Discover ways to save up money while working.
Get Expert Help
SSI and SSDI
1-800-772-1213
How Work Affects SSI and SSDI:
- Contact a Work Incentives Planning and Assistance (WIPA) counselor
-
OVR clients: Contact the Office of Vocational Rehabilitation
1-800-372-7172 (V/TTY) -
Call the Ticket to Work Help Line
1-866-968-7842
Medicaid
- Contact your Department for Community Based Services (DCBS) office
-
Call Medicaid Member Services
1-800-635-2570
Medicare
-
Call Medicare
1-800-633-4227 -
Call the Kentucky State Health Insurance Assistance Program (SHIP)
1-877-293-7447
Work Preparation
-
Contact the Kentucky Office of Vocational Rehabilitation (OVR)
1-800-372-7172 (V/TTY) - Contact your Kentucky Career Center
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