Medicaid Changes in Kentucky
Medicaid requirements are changing. Here's what Kentucky Medicaid members need to know about who may be affected, what they need to do and when they need to act.
What is Changing for Kentucky Medicaid?
A new federal law (the One Big Beautiful Bill Act) and new Kentucky state law are adding work requirements — also called community engagement requirements — to Medicaid.
Beginning January 1, 2027, many adults ages 19 to 64 who have Medicaid will need to complete and report at least 80 hours per month of qualifying activities to keep their coverage.
Qualifying activities include:
- Working at a job (employed, self-employed, and/or seasonal)
- Taking part in a work program or job training
- Volunteering or doing community service
- Attending school or an education program at least half-time
- A combination of any of these activities
- Reporting an income or at least $580 or more per month
- If work is seasonal, earn an average of that same amount over the last 6 months
The state will also review Medicaid eligibility more often than it has in the past.
If you are applying for Medicaid, you must show you met the work or community engagement activities in the month before you apply.
If you are already enrolled, you must show at each renewal that you met the work or community engagement requirement in at least three months during the six month period between renewals.
How to Report Your Community Engagement Requirements:
If Kentucky Medicaid is unable to confirm that you meet or are exempt from the work or community engagement requirement, you will be required to provide documentation when you apply for Medicaid and when you renew your coverage. You may also need to report if your circumstances change.
You should report the following:
- Type of activity (work, school, job training or community service)
- Number of hours for that month
- The name of your employer, school, program or community service organization
You may need to show proof (verification) of your hours. The following are accepted forms of verification:
- Employment/Wage Verification:
- Pay stubs or a letter from your employer
- PAFS-700 Verification of Employment and Wages form
- Work Program/Job Training Verification:
- Signed letter from a job training program
- School or Education Program Verification:
- School schedule or attendance record
- Community Service Verification:
- Signed letter from a community service organization
Self-Attestation
In 2027, individuals applying for or renewing coverage will be able to self-attest that they are completing work or community engagement activities (or are exempt from the requirement) if Kentucky Medicaid is unable to confirm compliance based on available information. You can self-attest as part of the application and renewal process.
In 2028 and beyond, most individuals will not be able to self-attest and will be required to submit documentation showing they are completing work or community engagement activities (or are exempt from the requirement) if Kentucky Medicaid is unable to confirm compliance using available information.
- Note that individuals who qualify as Medically Frail (see below for more details) will be able to self-attest to being Medically Frail, and therefore exempt from the requirement, one time beginning 2028.
- New enrollees will also be able to self-attest one time beginning 2028.
Who May Be Exempt?
Not everyone has to meet the work requirement. You may be exempt if one or more of the following applies to you:
- You are under 19 or over 64 years old
- Enrolled in Medicare Part A or Part B
- You are a parent or caretaker of a dependent child age 13 or younger
- You are a caregiver for a person with a disability
- You are medically frail or have a serious health condition that keeps you from working, such as:
- A serious physical, intellectual or developmental disability (including blindness)
- A substance use disorder
- A serious mental health condition
- Another serious or complex medical condition
- You are pregnant or had a baby up to 12 months ago (postpartum)
- You are taking part in a drug, alcohol or mental health treatment program
- Are an inmate of a public institution (jail or prison) or were released in the last 90 days
- You are a veteran with a total (100%) disability rating
- You are under age 26 and were formerly in foster care
- You are a recognized member of a federally recognized tribe (certain American Indian or Alaska Native individuals)
- You are already following the work rules for Supplemental Nutrition Assistance Program (SNAP) or Temporary Assistance for Needy Families (TANF)
- Receiving Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI), or Social Security Retirement (SSR) due to disability
- Enrolled in a 1915(c) Home and Community-Based Waiver or the Program for All-Inclusive Care for the Elderly (PACE)
Short Term Hardships
You do not have to meet the work or community engagement requirement if you are experiencing certain short-term hardships. A short-term hardship only applies to the month in which the hardship impacts you.
- You are staying in a hospital or nursing facility (receiving inpatient hospital services)
- You or your dependent must travel more than 25 miles from your home for more than 1 week or 5 business days for medical care that is not available in your community because of a serious or complex medical condition.
- You live in an area with very high unemployment (automatically granted using federal data)
- You live in an area affected by a federally declared emergency or disaster, such as a major flood, tornado, or other natural disaster (automatically granted using federal data)
Use the Kentucky Kynect Benefit's Pre-Screening Tool to find out if the work requirements apply to you by visiting https://kynect.ky.gov/benefits/s/prescreening
How to Report Your Exemption:
Existing information will first be checked to see if you have a situation that exempts you from meeting the work or community engagement requirement. You can also tell Kentucky Medicaid when applying for Medicaid, renewing your coverage or reporting a change.
What You Can Do Now
Even if the changes do not take effect in your state right away, there are steps you can take now to prepare.
1. Watch your Mail
Update your address, phone number, and email address with Kentucky Medicaid. You can do this by:
- Logging into the Self-Service Portal
- Calling kynect at 1-855-459-6328 Monday through Friday 8 a.m. to 7 p.m. ET
- Calling the Department for Community Based Services (DCBS) at 1-855-306-8959 Monday through Friday 8 a.m. to 5 p.m.
- Calling or visiting a kynector - Search for a kynector
- Visiting a DCBS office - Find a DCBS office
Look for mail, emails, and texts from Kentucky Medicaid. Read all communications carefully and respond by the date listed.
2. Know Your Renewal Date
Know your renewal date by checking it in kynect benefits: https://kynect.ky.gov/benefits. Kentucky Medicaid will send you letters, emails and texts when your renewal date is coming up.
3. Begin to Gather Documents and Track Activities
Begin gathering important medical or legal documents so you are ready if you need to show Kentucky Medicaid that you qualify for an exemption. Additionally, begin to keep a record of any work, volunteer, job training, or school hours you complete each month.
4. Do Not Wait: Take Action Before Your Deadline
Because these requirements begin January 1, 2027, confirming your status early gives you time to fix any problems before your coverage is affected.
Important Dates
Changes will take effect at different times. Your state Medicaid agency will notify you if a change affects your coverage or if you need to take action.
- If you are applying for Medicaid, you must show you met the work or community engagement activities in the month before you apply.
- Example: You are applying for Medicaid in February 2027. You must show that you met the requirement in January 2027 to qualify.
- If you are a current Medicaid member, you must show you met the work or community engagement requirement for at least three of the six months between renewals. You can check your renewal date in Kynect benefits.
- Example: Your renewal is due in September 2027. Your last renewal was in March 2027. You must show that you met the requirement in any three of the six months from April through September 2027.
Your may have additional deadlines. Be sure to review any notices from Kentucky Medicaid for deadlines that apply to you specifically.
Date | What happens | What you need to do |
November 1, 2026 - January 15, 2027 | The ACA Open Enrollment Period allows you to sign up for a health insurance plan through the federal or state Marketplace. | If you think you may not meet the Medicaid work requirements or qualify for an exemption, call The WellFund at 812-329-2579 to explore Marketplace coverage options. |
| October 2026 | Beginning with January 2027 renewals, you must show that you have met the requirement for any three months in the six-month period between renewals. | If your renewal date is within or after February 2027, you must show that you have met the hour requirements November, December, and January. Ensure you are tracking your volunteer, job training, or school activity hours in order to submit them with your application. |
| December 2026 | If you apply for Medicaid on or after January 1, 2027 and must report work or community engagement activities, you must work or do community engagement in the month before you apply. | Medicaid applications beginning within or after January 2027 must have December hours logged. Ensure you are tracking your volunteer, job training, or school activity hours in order to submit them with your application. |
January 1, 2027 |
| Watch for continuing notices from your state Medicaid agency. Report exemptions, qualifying activities, or eligibility reviews as required. |
Worried You Might Lose Medicaid? The WellFund Can Help.
If you think you may no longer qualify for Medicaid because of the new work requirements, please contact The WellFund. We can help you understand your options and, if you do lose Medicaid coverage, help you enroll in coverage through the Health Insurance Marketplace and explore any premium assistance you may qualify for.
Call The WellFund at 812-329-2579, Monday through Friday from 8:00 a.m. to 5:00 p.m. or email at Deaconess@TheWellFund.org. We strongly encourage you to call if you have questions or need help. There is no charge for this service.
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