C: Marketplace/kynect Plans
C-1, Marketplace/kynect Plans
Known as a health insurance exchange, and as kynect in Kentucky, the health insurance Marketplace is where non-incarcerated U.S. citizens living in the U.S. or legal residents of the U.S. can purchase ACA-compliant individual/family health insurance plans. Qualified households are able to receive income-based subsidies with or without cost sharing reductions to make coverage and care more affordable.
C-2, Marketplace/kynect Plans
These are the ten essential benefits covered by the Affordable Care Act (ACA) and included in Marketplace plans. Some may be available to you at no cost.
Ambulatory patient services (outpatient services)
Maternity and newborn care
Mental health and substance use disorder services, including behavioral health treatment
Rehabilitative and habilitative services (those that help patients acquire, maintain, or improve skills necessary for daily functioning) and devices
Preventive and wellness services and chronic disease management
Pediatric services, including oral and vision care
C-3, Marketplace/kynect Plans
Formerly called the Kentucky Health Benefit Exchange, kynect is the online Marketplace through which you can purchase individual/family health insurance in the Commonwealth of Kentucky. Qualified households are able to receive income-based subsidies with or without cost sharing reductions, to make coverage and care more affordable.
Authorized health insurance navigators who assist consumers and small businesses with eligibility, enrollment forms, and applying for Medicaid and Qualified Health Plans (QHPs).
Qualified Health Plans (QHPs)
Insurance plans that are certified by the Health Insurance Marketplace, and therefore provide essential health benefits, follow established limits on cost-sharing (like deductibles, co-payments, and out-of-pocket maximum amounts), and meet other requirements under the Affordable Care Act.
C-4, Marketplace/kynect Plans
Kentucky Marketplace aka kynect (commercial):
Only way to purchase individual plans in Kentucky
Limited number of carriers
Only HMO plans available
HSA linked plans may be available
Plans on the Marketplace are eligible for premium subsidies and cost sharing reductions for qualified enrollees
kynect Qualified Health Plan insurance carriers in 2023:
To see which carriers offer plans in which Kentucky counties, visit: https://khbe.ky.gov/Plans/Pages/2022-Health-Insurance-Companies.aspx
kynect Marketplace Tiers
Bronze, Silver, Gold (No Platinum)
Tiers refer to the level of benefits. As a rule, the lower the tier, the lower the premiums and the higher the deductibles and out-of-pocket maximums
Learn how to enroll in a kynect plan, view the different types of available coverage, eligibility, and more: https://kynect.ky.gov/healthcoverage
C-5, Marketplace/kynect Plans
The Marketplace generally considers your household to be you, your spouse if you are married, and your tax dependents. Your eligibility for savings is generally based on the income of all household members, even those who do not need insurance.
C-6, Marketplace/kynect Plans
Premium Tax Credit
A premium tax credit is a tax credit, or subsidy, used to lower your monthly insurance payment (called your premium). The amount of tax credit is based on household income and is only available on insurance plans purchased on the Marketplace. As a rule, the lower your household income, the greater the subsidy. Subsidies do not apply to group or employer sponsored health care coverage.
Cost Sharing Reductions (CSR)
A discount for Marketplace plans that lowers the amount you must pay for deductibles, co-payments, and co-insurance. If you qualify for CSRs, you must enroll in a plan in the Silver category to get these extra savings.
These and associated educational materials have been developed using our available resources. They are not intended to serve as advice or recommendations on selecting a specific type of coverage or plan. Any errors or omissions are unintentional.
These materials were supported by funds made available by the Kentucky Department for Public Health’s Office of Health Equity from the Centers for Disease Control and Prevention, National Center for STLT Public Health Infrastructure and Workforce, under RFA-OT21-2103.
The contents of these materials are those of the authors and do not necessarily represent the official position of or endorsement by the Kentucky Department for Public Health or the Centers for Disease Control and Prevention.