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The Kentucky Medicaid program provides medical assistance to individuals meeting income, resource and technical eligibility requirements. The income limit is $217 and resource limit is $2,000 for an individual. If an individual's income exceeds $217, spenddown eligibility may apply.
There may be a time when you have a health problem that can't be treated by your primary care physician (PCP) alone. Sometimes you may need specialty care or to see a specialist. Prior authorization PDF Opens In New Window is a request to Aetna for you to get special services or see a specialist.
There may be a time when you have a health problem that can't be treated by your primary care physician (PCP) alone. Sometimes you may need specialty care or to see a specialist. Prior authorization PDF Opens In New Window is a request to Aetna for you to get special services or see a specialist.
If you're facing a prior-authorization requirement, also known as a pre-authorization requirement, you must get your health plan's permission before you receive the healthcare service or drug that requires it. If you don't get permission from your health plan, your health insurance won't pay for the service.
No pre-authorization is required for outpatient emergency services as well as Post-stabilization Care Services (services that the treating physician views as medically necessary after the emergency medical condition has been stabilized to maintain the patient's stabilized condition) provided in any Emergency Department ...
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The state contracted with three health plans to manage care for beneficiaries. Three plans, Coventry Cares of Kentucky, Anthem Health Plan, and Wellcare of Kentucky are national, for-profit plans. Anthem Health Plan is the newest MCO in the state. Anthem was selected to serve the Medicaid expansion population.
What is a Prior Authorization? A prior authorization (PA), sometimes referred to as a \u201cpre-authorization,\u201d is a requirement from your health insurance company that your doctor obtain approval from your plan before it will cover the costs of a specific medicine, medical device or procedure.
Prior authorization is not required for emergency or urgent care. Out-of-network physicians, facilities and other health care providers must request prior authorization for all procedures and services, excluding emergent or urgent care.
Call our customer service center to determine if the service you are requesting requires pre- certification. VO: A Letter of Authorization allows Aetna to make sure you're getting the right treatment, and then to assess that treatment before services are received or costs are incurred.
With Medicaid expansion, Kentucky is now able to provide healthcare coverage to those who work, but do not have access to healthcare coverage through their employer or cannot afford coverage. Medicaid provides payments for services straight to healthcare providers who treat these individuals.