This guide, including the FAQs below, was developed to help you understand the health coverage options available to you and your family in Kentucky. The health plan options offered by Kentucky’s ACA Marketplace may be a good choice for many consumers.
Kentucky residents use a fully state-run health insurance Marketplace – Kynect – to shop for and purchase ACA Marketplace/exchange plans. From 2017 through 2021, Kentucky used the federally-run HealthCare.gov enrollment platform, but reverted to a state-run platform as of the 2022 plan year.
Kynect provides access to health insurance products from four private insurers. All four will continue to offer Marketplace coverage in Kentucky in 2025, with a weighted average rate increase — before subsidies — of 7.9% (details below).
The federal government helps pay for insurance through an income-based advance premium tax credit if you buy coverage from the exchange. Most enrollees qualify for this financial assistance. 1
Kentucky had been planning to create a Basic Health Program that would have been operational as of 2024, 2 but paused implementation of the BHP in late 2022. 3 As of 2024, Minnesota, New York, and Oregon are the only states with BHPs.
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Learn about Kentucky's Medicaid expansion, the state’s Medicaid enrollment and Medicaid eligibility.
Use our guide to learn about Medicare, Medicare Advantage, and Medigap coverage available in Kentucky as well as the state’s Medicare supplement (Medigap) regulations.
Short-term health plans provide temporary health insurance for consumers who may find themselves without comprehensive coverage. Learn more about short-term plan availability in Kentucky.
To qualify for health coverage through the Kentucky Marketplace, you must: 4
Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. In addition, to qualify for financial assistance with your Marketplace plan you must:
In Kentucky, the open enrollment period for individual and family health insurance runs from November 1 to January 15. 9
Enrollments must be submitted by December 15 to have coverage effective January 1. Enrollments submitted in the final month of the open enrollment window have an effective date of February 1 instead. 4
Outside of open enrollment, a special enrollment period (usually linked to a specific qualifying life event) is necessary to enroll or change your coverage. If you have questions about open enrollment, you can learn more in our comprehensive guide to open enrollment . We also have a comprehensive guide to special enrollment periods .
Several bills were considered in 2024 in Kentucky that would have made pregnancy a qualifying life event, but none of them passed. 10 Similar legislation was considered in 2023 but did not pass. 11 (There are several state-run exchanges where pregnancy is a qualifying life event.)
To enroll in an ACA Marketplace plan in Kentucky, you can:
You may find affordable health insurance options in Kentucky through its state-run health insurance exchange. Kentucky residents use Kynect (not HealthCare.gov) to shop, review, and enroll in health coverage as well as to determine any available subsidies.
Of the nearly 72,000 people with effectuated coverage through Kynect in early 2024, 86% were saving money on premium payments amounting to an average savings of $517/month. The subsidies resulted in an average net premium of $198/month (including the enrollees who paid full price). 1
(Note that the chart below shows some different metrics, and uses data from all enrollments submitted during the open enrollment period, whereas the numbers above are based on effectuated enrollment in early 2024.)
People with household incomes of no more than 250% of the federal poverty level also qualify for cost-sharing reductions (CSR). CSR benefits reduce deductibles and other out-of-pocket expenses, as long as the enrollee selects a Silver plan. 13 Forty percent of the people with effectuated enrollments through Kynect had CSR benefits as of early 2024. 1
Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan is the cheapest health insurance option for you.
There are four insurers offering individual and family health plans through Kynect for 2024. 15 All four will continue to offer Marketplace coverage in 2025. 16
There are 20 counties in Kentucky where Anthem is the only option for 2024. In the rest of Kentucky’s counties, at least one additional carrier offers plans on the exchange. 15
The following average rate changes have been approved for 2025 for Kentucky’s individual market insurers: 17 (Average rate changes are calculated before subsidies are applied.)
Source: Kentucky SERFF Filings 17
According to the SERFF filings, the carriers have the following enrollment in 2024: 17
Using those enrollment numbers, the weighted average approved rate increase for 2025 is about 7.9%, applicable to full-price plans. But most enrollees receive premium subsidies, and thus do not pay full price. The net premium change from one year to the next depends on how a specific plan’s premium changes as well as how much the premium subsidy amount changes.
For perspective, here’s a summary of how average pre-subsidy premiums have changed in Kentucky’s individual/family market over the years:
74,882 people enrolled in private coverage through Kynect during the open enrollment period for 2024 coverage. 28
Most states have experienced record-high Marketplace enrollment in 2023 and 2024 — due in large part to the American Rescue Plan (ARP), which expanded enrollee access to ACA’s premium subsidies. 29 However, Kentucky has not followed that trend (see chart below for prior year enrollment data).
Enrollment in Kentucky’s Marketplace declined for several years, from 2019 through 2023. Although it did grow in 2024, the enrollment total was still well below the record high set in 2015, before Kentucky transitioned to the HealthCare.gov platform for a few years.
Source: 2014, 30 2015, 31 2016, 32 2017, 33 2018, 34 2019, 35 2020, 36 2021, 37 2022, 38 2023, 39 2024 40
Kentucky Health Benefit Exchange
Administrative site for Kentucky’s Marketplace
Kentucky Health Insurance Advocate, Kentucky Department of Insurance
Assists people insured by private health plans, Medicaid, or other plans in resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
(877) 587-7222 /[email protected]
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
