Kentucky Medicaid Waiver Calculator

Earlier this year, Gov. Matt Bevin got the green light from the federal government to start an experiment with Medicaid. Since the program began in the 1960s, Medicaid has offered health insurance to people based on their income or disability status. That income eligibility level increased with the Affordable Care Act.

Bevin's experiment will mean some groups of people – starting July 1 – will have to do a few new things to keep coverage. That can include a monthly payment (called a premium), a community engagement requirement (you might have heard it called a "work requirement") and a bunch of other new criteria.

The calculator below was created to help you understand what, if anything, you’re going to have to do differently starting July 1 to keep your Medicaid health insurance. It's based on current information, but may not include all the details to make every possible determination about your particular circumstance.

To use the calculator, go through each step below to select the factors that describe your personal situation. Please note that the state hasn’t fully finalized this criteria, and the interactive will be updated as more information is available.

This app does not collect or store your personal information.

Last updated: March 12, 2018

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The amount paid, often on a monthly basis, for health insurance. The cost of the premium may be shared between employers or government purchasers and individuals.


A fixed dollar amount paid by an individual at the time of receiving a covered health care service from a participating provider. The required fee varies by the service provided and by the health plan.

My Rewards Account

All adults (expansion adults, low-income parents, former foster care youth, and those receiving ESI premium assistance) will have a My Rewards incentive account if they are paying monthly premiums of at least $1.00. The incentive account may be used to access additional, prior authorized, benefits not otherwise covered once sufficient funds are accrued. These benefits include dental, vision, over the counter (OTC) medications, and limited reimbursement for the purchase of a gym membership. Pregnant women can have a My Rewards account without having to pay premiums.


Enacted in 1965 under Title XIX of the Social Security Act, Medicaid is a federal entitlement program that provides health and long-term care coverage to certain categories of low-income Americans. States design their own Medicaid programs within broad federal guidelines.


Enacted in 1965 under Title XVIII of the Social Security Act, Medicare is a federal entitlement program that provides health insurance coverage to 45 million people, including people age 65 and older, and younger people with permanent disabilities, end-state renal disease, and Lou Gehrig’s disease

Federal Poverty Level (FPL)

The federal government’s working definition of poverty that is used as the reference point to determine the number of people with income below poverty and the income standard for eligibility for public programs. For an individual in 2018, the FPL is $12,140. For a family of four, it's $25,100.

Retroactive eligibility

Federal law directs state Medicaid programs to cover (and provides federal matching funds for) medical bills incurred up to 3 months prior to a beneficiary’s application date.



The information contained in this site is for general guidance only. The application and impact of the Medicaid waiver and laws can vary widely based on the specific facts involved, and certain details are still being finalized. Given the changing nature of rules and regulations, and ongoing litigation challenging the waiver, there may be delays, omissions or inaccuracies in information contained in this site. Before making decisions about future life events, you should consult with your doctor, insurance company or the state Medicaid office.

While we have made every attempt to ensure that the information contained in this site has been obtained from reliable sources, Louisville Public Media is not responsible for any errors or omissions, or for the results obtained from the use of this information. In no event will Louisville Public Media, or employees thereof be liable to you or anyone else for any decision made or action taken in reliance on the information in this site or for any consequential, special or similar damages.


About the Data

Sources: U.S. Department of Health and Human Services; Kentucky HEALTH; The Henry J. Kaiser Family Foundation
Data and language compiled by Lisa Gillespie and Alexandra Kanik
Calculator developed by Alexandra Kanik