PDCHC has been posting and trying to keep you up to date with the latest information regarding changes to medicaid and Kentucky Health. Well, as of June 30, 2018 at around 4:00pm PDCHC, along with the rest of the state, got word that Kentucky Health as it was intended, would NOT be starting on July 1, according to a block by a federal judge. But what does that really mean? What is changing? What isn’t? We were a little confused at first as well, but we’ve got it all sorted out and here is everything you need to know.
First, My Rewards and the PATH program have been stopped. If you got a letter in the mail or were otherwise notified that you would be required to meet a community engagement standard, that is no longer the case. This is part of what was struck down by a federal judge. If you were required to make a My Rewards account for dental and vision services, those will no longer be covered.
According to Gov. Matt Bevin’s team, the state needed to make “significant cut backs and benefit reductions” in order to continue to fund the Medicaid program under the expansion made by the Affordable Care Act (aka Obamacare). Because of these cuts more than 450,000 people in the state of Kentucky will be without dental and vision coverage. My Rewards was the program in place to cover vision and dental services, without My Rewards, there is no system in place to pay for these, meaning it falls on the patient to cover the costs — for now.
Park DuValle Community Health Center CEO, Ms. Ann Hagan-Grigsby, gave her remarks (below) about the changes that have come from Kentucky Health and the block by the Judge last Friday.
“As expected, there were inevitable system issues, confusion, and new challenges to work through. Patients and staff are both still confused about the changes. Dental and vision services are integral to patients being able to have fully functional lives. If you are in pain or cannot even smile due to dental issues, it is difficult to maintain a job or feel healthy or confident enough to obtain one. If your vision is impaired, you are limited in your ability to obtain employment, educate yourself or participate in health education courses. Our sliding fee scale is available to any patients who bring proof of low income status, but the payments do not cover the costs of care and impede the ability of federally qualified health centers like ours, to continue to afford provision of the level of care needed by the vulnerable populations we serve. We will continue to make sure that dental care is available to patients and we will try to obtain vision care for those without insurance coverage, just as we did before Medicaid covered them, but the challenges to assuring care for thousands of patients , now without coverage, is both challenging and somewhat daunting.”
-Ann Hagan-Grigsby, CEO Park DuValle CHC
For now, patients don’t have to do anything to keep their medical coverage through medicaid. All benefits stay as they were previously. However, if you were not listed as “Medically Frail” you do not have dental and vision benefits. If you were deemed “Medically Frail” you should have received a letter in the mail. You or your doctor can still file a medically frail form if you think you should be listed as such. The process for this stays the same as it would have had Kentucky Health went on as planned.
If you had already paid a premium due to Kentucky Health changes, you should be hearing from your Managed Care Organization (MCO) soon about what is to happen to those funds. All MCOs are still requiring co-payments as proposed by the Kentucky Health changes.
Remember: Children (up to age 19), pregnant women, those considered “Medically Frail” and former foster youth (up to age 26) are still completely covered for medical, dental, and vision services. This has not changed, and is not set to change as of now.
Overall, Kentucky Health is still in a state of limbo. We don’t know what is going to happen next, what services will be covered and what will not. We will continue to update our blog with more information as it becomes available.
For more information directly from Kentucky Health click here.