Starting January 1, 2027, Medicaid eligibility will be changing for some members in the Affordable Care Act (ACA) expansion.
Due to new federal laws, Medicaid members eligible for and enrolled in the ACA expansion population, are subject to a Work and Community Engagement Requirement. Most adults must work or participate in other approved activities at least 80 hours a month to keep Medicaid coverage.
For more information regarding this change please visit the Kentucky Health Benefit Exchange (KHBE)
Does this requirement/rule apply to me?
This rule may apply to some adults who:
- Are age 19 to 64
- Have Kentucky Medicaid through the ACA expansion
- Have Medicaid because of their income
- Do not meet an exemption
If you are not sure what Medicaid group you are in, you can:
- Check your most recent Notice of Action letter
- Visit the Kynect Benefits portal
Call the kynect Helpline at 855-459-6328 (TTY: 800-627-4720), Monday - Friday, 8 a.m. - 7 p.m., Eastern time.
Am I exempt from this rule?
Some people may be exempt. This means they may not need to do work or activity hours to keep Medicaid.
You may be exempt if you are:
- Under age 19
- Over age 65
- Pregnant or recently had a baby
- Eligible for Medicare
- Caring for a child age 13 or younger
- Caring for a disabled person
- Meeting SNAP or TANF work rules
- Living with a disability or serious health condition
- Taking part in a substance use treatment program
- A former inmate of a public institution in the last 3 months
- Native American or in another exempt group
The Commonwealth of Kentucky will give more details about exemptions before the rule starts.
What activities may count towards the work requirements?
If the rule applies to you, you may need to do 80 hours each month of 1 or more activities.
These activities may include:
- Working
- Volunteering
- Taking part in a work program
- Going to school at least half time
- Doing more than one of these activities for a total of 80 hours each month
The Commonwealth of Kentucky will explain how to report your hours and what papers you may need.
Keep your information up to date
You must report changes within 30 days.
This includes changes to your:
- Income
- Job
- Address
- People in your home
- Pregnancy status
- Other life changes
This can help you avoid a gap in your Medicaid coverage.
You may get letters from your IDHFS. Read all letters right away. Send any papers they ask for by the due date.
Humana Healthy Horizons can help you prepare
Humana is here to help you learn about resources that may support your health, work and daily needs.
Humana may be able to help you with:
- Finding job training resources using the Humana Community Navigator®
opens in new window tool - Learning about work support programs
- Finding transportation
- Understanding Humana benefits that may help you
- Getting connected to state Medicaid information
Contact Humana Member Services at 800-444-9137 (TTY: 711), Monday - Friday, 7 a.m. - 7 p.m., Eastern time, to ask what help may be available to you.
Humana Workforce Development benefit in Kentucky
Humana Healthy Horizons® in Kentucky offers a Workforce Development Program for eligible members.
Members age 18 and older who take part in Humana’s Workforce Development Program can get up to $200 for approved work needs.
This money may help pay for:
- A job training certificate
- A work license
- Work clothing
- Work gear
This benefit can help you get ready for work or job training.
To learn more, contact Humana Member Services at 800-444-9137 (TTY: 711), Monday - Friday, 7 a.m. - 7 p.m., Eastern time.
Questions?
To find the most current information about the new Medicaid work rule, you can:
- Visit the KHBE
opens in new window website - Use the Kynect Benefits portal
opens in new window to check your Medicaid case - Call the kynect Helpline at 855-459-6328 (TTY: 800-627-4720), Monday - Friday, 8 a.m. - 7 p.m., Eastern time.