Kentucky

Kentucky Medicaid and the new work rules

Medicaid Expansion (the ACA adult group, income-based, ages 19-64) is run by Cabinet for Health and Family Services (CHFS), Department for Medicaid Services (DMS); eligibility is determined by the Department for Community Based Services (DCBS); the Kentucky Health Benefit Exchange (KHBE) runs the kynect application portal. Kentucky expanded Medicaid on 2014-01-01, which is why the new federal work requirement reaches this state — and why what you do before January 1, 2027 matters.

Work rules start January 1, 2027 Medicaid expanded 1,381,203 enrolled 464,026 in the expansion group

Start here

From January 1, 2027, most adults have to show 80 hours a month

The requirement applies to adults aged 19 to 64 covered through Medicaid expansion — around 464,026 people in Kentucky. It is not only about paid work: study, job training, volunteering and a mix of them all count , and earning at least $580 a month satisfies it on its own.

CHFS says it will first check existing state and federal data (such as wage, SNAP/TANF, and disability-benefit records) to see whether a member already meets the requirement or qualifies for an exemption, and will contact the member only if more information is needed. New applicants must show they met the requirement in the single month before applying; current members must show they met it in at least three of the six months before their renewal date.

If your hours swing from month to month, say so. The rule is written per month, which is the wrong shape for farm and fishing work, construction, tourism and seasonal retail — a good month and a dead month average out to a living, but the dead month is the one that fails. Federal law has a provision for exactly this: a seasonal worker can satisfy the requirement using their average monthly income over the previous six months instead of hours worked in the month being checked. It is at 42 CFR 435.552(a)(7), and the law defines who counts as seasonal by pointing at the tax code rather than listing jobs, so do not decide for yourself that it misses you. If your work is seasonal or your hours are irregular, tell the state that when you report, and ask for the six-month average to be used.

2026-04-14 · already happened

Kentucky House Bill 2 (2026 Ky. Acts ch. 179) takes effect, amending KRS 205.5371 to write the federal community engagement requirement into state law.

2026-06-01 · already happened

CMS issues the interim final rule (91 Fed. Reg. 33348) implementing the federal work/community engagement requirement nationwide.

2026-07-01 · already happened

CHFS begins mailing MACE outreach notices to current Medicaid Expansion members.

2026-08-01

Additional MACE communication materials and community-partner stakeholder engagement roll out (August-November 2026).

2026-09-01

120-day advance reminder notices go out to members whose renewal falls in February 2027.

2026-10-01

90-day advance reminder notices go out to the same group.

2026-12-01

Kentucky's Medicaid eligibility system is updated to apply MACE requirements automatically.

2027-01-01

New Medicaid applicants in the expansion group must show they met the requirement in the month before applying.

2027-02-01

First renewals requiring proof of community engagement begin, for expansion-group members whose renewal falls that month.

You do not have to prove anything if any of these describe you

Exemptions are meant to be applied by the state automatically from records it already holds, but records are imperfect. If one of these fits you and you still get asked to report hours, say so and ask them to check — don't assume the notice is right.

Parent or caretaker of a child age 13 or younger, or of a person with a disability

Pregnant, or within 12 months postpartum

Medically frail, or someone with a serious or complex medical condition

A veteran with a total (100%) disability rating

American Indian or Alaska Native

Enrolled in a drug or alcohol treatment program, or a mental health treatment program

Already meeting SNAP or TANF work requirements

Recently released from incarceration

Former foster care youth through age 26

Receiving SSI, Social Security Disability Insurance (SSDI), or Social Security Retirement (SSR) due to a disability

Enrolled in a Section 1915(c) Home and Community-Based Services waiver or the Program of All-Inclusive Care for the Elderly (PACE)

Already entitled to or enrolled in Medicare Part A or Part B

Age 18 or younger, or age 65 or older (outside the 19-64 age range the requirement applies to)

Two things people get wrong

Before you assume this applies to you the way you think

This is not the earlier state requirementKentucky already tried a Medicaid work requirement once, under a completely different legal basis, and it is not the same thing as the rule starting in 2027. In 2018, under Gov. Matt Bevin, Kentucky implemented 'Kentucky HEALTH,' an 80-hour-per-month work requirement approved by CMS as a case-by-case Section 1115 demonstration waiver. A Kentucky Medicaid beneficiary sued, and on March 27, 2019 Judge James Boasberg of the U.S. District Court for the District of Columbia ruled in Stewart v. Azar (366 F. Supp. 3d 125) that HHS had approved the waiver without adequately considering its effect on coverage, and vacated the approval. Newly elected Gov. Andy Beshear withdrew the Kentucky HEALTH waiver entirely in December 2019, before the work requirement ever took effect statewide; the D.C. Circuit Court of Appeals, which had heard oral argument on CMS's appeal in October 2019, later dismissed that appeal as moot. The requirement starting January 1, 2027 rests on a different legal foundation: Congress wrote it directly into the Medicaid statute (Section 71119 of P.L. 119-21, amending 42 U.S.C. §1396a(xx)), and CMS issued a nationwide implementing regulation (91 Fed. Reg. 33348, June 1, 2026). It is not a discretionary waiver a governor can simply withdraw, and Kentucky's 2026 General Assembly reinforced that by codifying it in state law.

Income limits

What you can earn and still qualify

Monthly income, before tax, for the whole household. These are the state's own published figures, which is what its caseworkers actually apply. If you are close to a line, apply anyway — some income does not count, and only the agency can run the calculation for your situation.

Adults 19 to 64133% of the poverty line

1 person: $1,836
2 people: $2,489
3 people: $3,142
4 people: $3,795
5 people: $4,449
6 people: $5,102
7 people: $5,755
8 people: $6,408

Parents and caretakers133% of the poverty line

1 person: $1,836
2 people: $2,489
3 people: $3,142
4 people: $3,795
5 people: $4,449
6 people: $5,102
7 people: $5,755
8 people: $6,408

Pregnant195% of the poverty line

1 person: $2,660
2 people: $3,607
3 people: $4,554
4 people: $5,500
5 people: $6,447
6 people: $7,394
7 people: $8,340
8 people: $9,287

Source: Kentucky Health Benefit Exchange (KHBE), 'Federal Poverty Level (FPL) Chart,' 2026 Medicaid Table, updated March 2026, effective April 1, 2026 ongoing. A note on precision: Kentucky's own Kid's Health (KCHIP) page (kidshealth. We publish the state figure.

January 1, 2027

Two other changes land on the same day

Renewals get more frequent, and back-dated coverage gets shorter.

Renewals every six months Starting with February 2027 renewals, Kentucky must redetermine eligibility for the ACA expansion adult group every six months instead of annually, so members in this group should expect two eligibility checks a year going forward instead of one.

Back-dated coverage is changing on January 1 For Kentucky Medicaid applications filed on or after January 1, 2027, expansion-group adults get one month of retroactive coverage before the application month, while everyone else in Kentucky Medicaid gets two months — both down from three months under prior law. If you have unpaid medical bills, applying sooner covers more of them.

P.L. 119-21 §71112, amending 42 U.S.C. §1396a(a)(34). Applies to applications submitted on or after January 1, 2027.

Do this now

Update your address and phone number first. Everything about the new rules arrives by mail, and a stale address is the most common reason people lose coverage they are still entitled to. Then check whether an exemption applies to you.

Apply, renew or update details Apply online at kynect.ky.gov or call 1-855-459-6328 kynect.ky.gov/benefits is a JavaScript single-page application; it renders a brief 'Loading' screen before the form appears. The state's own work-rules page Read Kentucky's guidance Updated as rules are finalized Talk to a person 1-855-459-6328 kynect Contact Center (apply, renew, report work/community engagement hours; also '855-4kynect') — Mon-Fri 8 a.m.-7 p.m. ET Department for Community Based Services (DCBS) Medicaid eligibility line 1-855-306-8959 Mon-Fri 8 a.m.-4:30 p.m. ET

About the phone numbers: The two numbers reach different offices: the kynect Contact Center (1-855-459-6328) handles applications, renewals, and the new work-requirement questions; DCBS (1-855-306-8959) handles casework on an existing case. Both were confirmed on current CHFS/KHBE pages; the TTY number was confirmed on an earlier CHFS enrollment page but not re-verified against both agencies' current sites in this pass.

Deaf, hard of hearing or speech-impaired: 1-800-648-6056.

EnglishSpanish

Kentucky's kynect benefits portal and Cabinet for Health and Family Services materials are available in English and Spanish, and free interpreter services are available by phone in other languages when you call the kynect Contact Center at 1-855-459-6328 or the Department for Community Based Services at 1-855-306-8959.

If a letter arrives

Most people who lose coverage lose it over paperwork, not eligibility

Nationally, most people who lose Medicaid lose it over paperwork rather than because they stopped qualifying. From January 1, 2027 that matters more, not less.

Cabinet for Health and Family Services (CHFS), Department for Medicaid Services (DMS); eligibility is determined by the Department for Community Based Services (DCBS); the Kentucky Health Benefit Exchange (KHBE) runs the kynect application portal. · Notice of action

NOTICE OF ELIGIBILITY DETERMINATION

Case number: ███████
Date of this notice: 1January 12, 2027

Our records do not show that you met the community engagement requirement for the reporting period.

2If you believe this is incorrect, or if an exemption applies to you, contact us on or before February 11, 2027.

3Coverage for other members of your household is not affected by this notice.

The clock starts on this date. Not the day it reached you. Assume you have less time than it feels like.

"Our records do not show" is not the same as "you did not".The state is matching against databases that are often out of date. If you worked those hours, or an exemption fits you, say so — call 1-855-459-6328.

Your children's coverage is separate. The work requirement does not apply to them. A notice about you does not end their coverage.

You can ask for a fair hearing. It's free, you don't need a lawyer, and asking can keep your coverage running while it's reviewed.

Common questions

Questions people ask about this

Do the new Medicaid work rules apply to me in Kentucky?

They apply to adults aged 19 to 64 who are covered through Medicaid expansion — about 464,026 people in Kentucky. Children, people over 65, and most people covered on grounds of disability or pregnancy are not in that group. There is also a long list of exemptions.

How many hours a month do I have to work?

80 hours a month. Work is not the only way to meet it — study, job training, volunteering and a combination of these count too, and earning at least $580 a month also satisfies it.

Who is exempt from the work requirement in Kentucky?

Exemptions include: Parent or caretaker of a child age 13 or younger, or of a person with a disability; Pregnant, or within 12 months postpartum; Medically frail, or someone with a serious or complex medical condition; A veteran with a total (100%) disability rating; American Indian or Alaska Native; Enrolled in a drug or alcohol treatment program, or a mental health treatment program; Already meeting SNAP or TANF work requirements; Recently released from incarceration.

When do the Kentucky work rules start?

January 1, 2027. Starting with February 2027 renewals, Kentucky must redetermine eligibility for the ACA expansion adult group every six months instead of annually, so members in this group should expect two eligibility checks a year going forward instead of one. Keeping your address and phone number current with the state is the single most important thing to do before then, because everything arrives by mail.

What is the income limit for Kentucky Medicaid?

For adults 19 to 64, about $1,836 a month for one person and $6,408 for a household of 8.

How do I apply for Medicaid Expansion (the ACA adult group, income-based, ages 19-64)?

Online at Apply online at kynect.ky.gov or call 1-855-459-6328, or by phone on 1-855-459-6328. It is free and there is no open-enrollment window — you can apply at any time of year.

How often do I have to renew Kentucky Medicaid?

Adults covered through Medicaid expansion move from a yearly renewal to one every six months starting with renewals due on or after January 1, 2027. Children, people over 65 and most people covered on grounds of disability stay on yearly renewals. Keep your address and phone number current so the renewal notice reaches you, and answer it before the date on the letter — most people who lose coverage lose it over paperwork.

Other states

Guides for neighboring states

The rules change completely at the state line. If you moved recently, or you're helping family somewhere else, start with their state rather than this one.

IllinoisThe new work rules IndianaHIP and the new work rules MissouriThe new work rules OhioThe new work rules TennesseeWho the work rules reach VirginiaThe new work rules West VirginiaThe new work rules

See all 50 states and Washington, D.C. on the map →

Kentucky began mailing Medicaid Community Engagement (MACE) outreach notices to current Medicaid Expansion members on July 1, 2026, and will send a 120-day reminder before each member's first renewal under the new rule.

If your mailing address, phone number, or email on file with kynect is out of date, update it now at kynect.ky.gov or by calling 1-855-459-6328, so you actually receive the notice that tells you whether the new work or community engagement requirement applies to you.

Updating your address takes two minutes and protects everything else. Do that first, then check the exemption list above.

Go to Apply online at kynect.ky.gov or call 1-855-459-6328 →