Healthcare Insurance is Confusing. It doesn't have to be.
We help Kentuckians understand what healthcare plans are available, and which one fits your life best.
87% of uninsured Kentuckians and 55% of those with insurance have skipped or delayed care due to cost.
What's Standing In Your Way?
Coverage Confusion & Enrollment
Wondering when you can sign up? Lost a job or had a big life change? We'll help you find out what coverage you're eligible for, and what might be right for you.
Plan Comparisons & Choosing Coverage
Not sure which type of coverage to choose? HMO, PPO, under COBRA, through kynect; it can be confusing and overwhelming. We explain what those terms mean and help you compare your options.
Stress About Medical Costs
Worried about surprise bills or not being able to afford your prescriptions? We'll show you how your plan affects costs, and what help you may qualify for.
Access & Provider Challenges
In some areas, it's hard to find a doctor. In others, the wait times are long. We help you find coverage that works for you and what to do if you run into problems.
Understanding Insurance Benefits & Terms
Deductibles, networks, referrals... what do they all mean? We explain the words and terms you need to know to help you pick a plan that works for you.
Myths & Misconceptions About Healthcare Coverage
"Medicaid doesn't cover dental." "I don't need insurance if I'm healthy." We tackle common myths and show you what's actually true.
KM, 2024
"Insurance has slowed my care and limited access to treatments and medications..."
Morgan James, NY
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Enrollment Help:
Frequently Asked Questions
Q: Why is healthcare coverage important? A: Healthcare coverage helps pay for doctor visits, medicine, and hospital stays. It also protects you from big medical bills if you get sick or have an accident.
Q: When can I sign up for healthcare coverage? A: You can usually sign up during Open Enrollment, which happens once a year. But if you've had a big life change, you may qualify for a Special Enrollment Period.
Q: What counts as a big life change? A: Things like getting married or divocred, having a bay, losing your job, or turning 26 (which means you're too old to be covered under a parent's insurance) all count. These changes can give you a chance to sign up outside the regular time.
Coverage Help:
Frequently Asked Questions
Q: How do I know which healthcare plan type is best for me? A: Think about your budget, how often you go to the doctor, and if you have a favorite doctor or hospital. We can help you compare plans and pick one that fits your life.
Q: What is kynect? A: kynect is a website for people who live in Kentukcy to sign up for health insurance plans on the Marketplace or Medicaid. You can compare health plans, apply for coverage, and see if you qualify for help paying for it. It's a one-stop shop for finding the right plan.
Q: I've heard of things like Medicare, Medicaid, or the Marketplace. How do I know which one I need? A: It depends on your age, income, job, and health needs. Medicare is for people 65 and older, Medicaid helps people with lower income, and Marketplace plans are for most others. We'll help you figure out what fits you best.
Coverage Help:
Frequently Asked Questions
Q: What if I get a medical bill I didn't expect? A: Surprise bills can happen, but you don't have to panic. Check the bill for mistakes and as your doctor or insurance company to explain the changes. We can help you know what to do and what to look for.
Q: What if I can't afford my medicine? A: Some prescriptions have cheaper versions, called generics. You can also ask about discount programs or help from the drug company.
Q: How can I lower my medical costs? A: You can save money by staying in-network, asking for cost estimates before care, and reviewing your bills for errors. If you are out-of-network or uninsured, you may be able to negotiate a discount from the provider. Using programs like FSAs or HSAs can also help with out-of-pocket costs.
Insurance Terms Help
Frequently Asked Questions
Q: Whats a deductible, and why does it matter? A: A deductible is the amount you pay before your insurance starts helping for anything other than preventative care. For example, if your deductible is $1,000, you pay that much for covered services, then your plan kicks in.
Q: What's the difference between a co-pay and co-insurance? A: A copay is a set amount you pay each time you get care, such as $25 for a doctor visit. Co-insurance is a percentage you pay, for example, like a 20% of the cost.
Q: Why are medical bills so hard to understand? A: They use a lot of codes and confusing terms. We can help you decode what the charges mean and how to spot errors or things your insurance should have paid for.
Facts vs. Myths Help
Frequently Asked Questions
Q: If I'm young and healthy, do I really need health insurance? A: Yes! Even healthy peope can have accidents or get sick. Insurance helps cover the cost one trip to the ER doesn't turn into a huge bill.
Q: Is it true that all healthcare is free if I have insurance? A: Not usually. Insurance helps with costs, but you may still have to pay things like co-pays, deductibles, or co-insurance until you've met your out-of-pocket maximum. Also, insurance doesn't pay for things they classify as uncovered services.
Q: Can I only get health insurance through a job? A: Nope. You can get coverage through the state Marketplace, Medicaid, Medicare, or other programs - even if you don't have a job or your job doesn't offer insurance. However, it's important to know what the qualifications are.
Still Have Questions?
We’re here to help you make sense of your healthcare options, no matter where you’re starting from. We also want to hear about your experience. Not only can this help TAI’s mission to make health care more affordable, accessible, and equitable, but it can help ithers who might be experiencing the same types of situations.