MAP 116 - chfs ky 2026

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The document is a Service Plan Participant Authorization form from the Commonwealth of Kentucky's Department for Medicaid Services, which outlines the participant's approval to share their service plan, confirms informed consent regarding waiver services, and emphasizes the participant's right to choose Medicaid providers for their services.

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Click ‘Get Form’ to open the MAP 116 - chfs ky in the editor.
Begin by entering your first name, middle initial, and last name in the designated fields. Ensure accuracy as this information is crucial for identification.
Review the authorization section carefully. Check the box next to 'I give approval to share the service plan' if you consent to sharing your service plan.
Confirm that you or your Authorized Representative has signed the Service Plan signature sheet by checking the appropriate box.
Indicate your understanding of waiver services by checking the relevant box, ensuring you are informed about your options.
Finally, sign in the provided space to certify that you have made an informed choice regarding services and providers.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Why is Anthem leaving Kentucky Medicaid?

Anthem is not going out of business. They did not get their Medicaid contract renewed with the state of Kentucky. They therefore will no longer be able to provide Medicaid services after January 1st. This is only Anthem Medicaid and has nothing to do with Anthem Medicare or any other form of Anthem.

What is Global Choices insurance?

Your Global Choice Plan automatically includes coverage for medical services, worldwide, prescription drug benefits for prescriptions obtained outside and inside the U.S., vision coverage.

What are global choices in KY?

Global Choices covers basic medical services with new benefit limits and increased cost sharing. Long-term care services are excluded. Family Choices: Family Choices is designed for most children, including children enrolled in Kentuckys State Childrens Health Insurance Program (SCHIP) program.

What is the scl waiver in Kentucky?

The SCL waiver program was developed for Kentucky citizens as an alternative to institutionalization. The focus of SCL is to allow a person to remain in or return to the community, and to build and live a good life.

What is Medicaid called in Kentucky?

Kentucky Medicaid/KCHIP is a state and federal program. It is authorized by Title XIX of the Social Security Act. Kentucky Medicaid/KCHIP provides health coverage for eligible low-income residents.

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What are the 4 types of Medicaid?

Broadly, there are four major eligibility groups covered by most states: children, adults with disabilities, aged adults, and nondisabled adults.

MAP 116 - chfs ky 2026

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