TheraTree Pediatric Therapy - TheraTree Blog #Finance TipsTheraTree Pediatric Therapy - TheraTree Blog #Finance Tipshttps://www.theratreepeds.com/blogs/tag/finance-tipsWed, 12 Nov 2025 18:52:24 -0800http://zoho.com/sites/<![CDATA[KY Medicaid Annual Renewals]]>https://www.theratreepeds.com/blogs/post/medicaidThe Kentucky Department for Medicaid Services (DMS) is resuming annual Medicaid renewals which may effect your child's coverage. This blog has important information to help prevent patients from losing Medicaid coverage.]]>

Avoid Loss Of Medicaid Coverage

The Kentucky Department for Medicaid Services (DMS) is resuming annual Medicaid renewals which may effect your child's coverage. During the COVID-19 Public Health Emergency, DMS  stopped all annual renewals to facilitate Medicaid beneficiaries keeping their coverage during the Emergency. Because the Public Health Emergency was ended at the federal level, annual renewals have resumed. This blog has important information to help prevent patients from losing Medicaid coverage.


Critical Bottom Lines: 

  1. Medicaid must have your current and up to date information to avoid loss of coverage. If your contact information has changed or is incorrectly listed, you may miss your notification of renewal.  Verify and update your mailing address, phone number, email and other contact information as soon as possible by visiting kynect.ky.gov​​ or calling 855-459-6328.
  2. If your child's benefits are managed by an MCO your child may have a change of coverage during their review whether passive or actively renewed. Currently, MCO's are holding KY Medicaid accountable for coverage during the review period. Therefore if a healthcare service is provided during this review and the provider is unaware of your review, your service may be denied due to no prior authorization. Medicaid has yet to provide a mainstreamed solution for coverage during the renewal process. 

Different Renewal Requests and Actions

Passive Renewals: Members who have up-to-date and verifiable information in the system can be passively renewed. This means that Medicaid has all information necessary to make an automatic renewal determination within their records to ensure they remain eligible. These individuals will receive a Notice of Eligibility and will not need to act. The Notice of Eligibility notifies a member that their coverage has been continued. 


Action Required for Renewals: Members that are missing specific pieces of information will receive a Request for Information (RFI). A RFI requests additional information to support Medicaid in accurately determining a member’s eligibility. Members who receive a RFI must respond to the RFI prior to their renewal due date to ensure their renewal can be accurately and timely processed.


Additional Action Required for Renewals: Members in which Kentucky Medicaid requires more information from the member because they cannot be passively renewed by the system will receive a prepopulated Renewal Packet. A Renewal Packet requests additional information from the member to be updated within kynect. This information must be submitted prior to their renewal due date to ensure their renewal can be accurately and timely processed and coverage can continue.

Different Renewal Requests and Actions

Members renewal and redetermination date, timelines, and status information is available on  kynect in your benefits page.

  • April 2023: Initial notices of renewals sent to individuals enrolled in Medicaid. 
  • May 2023: Renewal process has restarted. 
    • 90 days prior to member’s end date, members will receive an email and SMS communication from the state that their renewal is upcoming.
    • 50-60 days prior to member’s end date:
      • The state will attempt to automatically renew a member’s benefits.
      • In cases where Medicaid cannot automatically renew benefits, 50-60 days prior to member’s end date notices will be sent out. This means that members will receive notices within the first 2 weeks of a month before the month of their end date.
      • If there has been no response from a member by the 15th of the month of their end date, members will receive follow up outreach to request response and information.
    • End Date of Coverage: 
      • It is important for members to provide all requested information before their renewal date to avoid discontinuation of coverage.
      • Coverage will end for members who are determined to be no longer eligible on their posted renewal date. 
      • Members who do not respond to requests for information or submit their renewal packet information may also be determined ineligible based on lack of information. 
  • April 2024: All initial renewals will be complete and additional annual renewals will continue to occur.


Download Instructions for Viewing Your Renewal Date

Important Communication

The most important action is to  update your contact information in kynect (https://kynect.ky.gov/). Submit multiple ways to be contacted by Medicaid within their kynect profile (e.g., home address, email address, phone number). 


All communications will come from the state Cabinet for Family and Health Services (CHFS) and the Department for Medicaid Services. Check your communication preferences on kynect. 

  • Postal Communication: If you have opted in for paper communications, this will come via postal mail. 
  • Digital Communication: If a member is opted in for digital communications, the notice will be shown in their message center and an email and/or SMS will be sent. 
    • Opt in to receive email and SMS messages on your kynect account as well as with your health plan to ensure you receive all information in the most efficient manner. 
    • Other providers or representatives from your health plan may reach out about your upcoming renewal, but any request for information (RFI) or Medicaid renewal packet will only come from the state.
    • Please note that the state is exempt from the Telephone Consumer Protection Act when communicating with members about their benefits.


Ways to get Information:

  • Kentucky PHE website: https://medicaidunwinding.ky.gov
    •  If there are specific questions about the Medicaid renewal process, Medicaid members can access information sheets and guides here.
  • Monthly Stakeholder Meetings: 
    • Every third Thursday at 11:00 EST. 
    • ​You can register for the June 15, 2023 session through this registration link​​.
    • If you have any questions for DMS that you would like for us to speak to during the upcoming monthly meeting, please submit those questions through this survey. 

How to Renew

Information can be submitted in various means. Members will receive a notice that only requests the information necessary, based on their specific situation, to make a determination. The types of documents needed will be clearly communicated to the member.



1. Complete and Return Forms:

  • Fill in all requested information
  • Return by fax to 502-573-2005 or 502-573-2007
  • Return by mail to P.O. Box 2104, Frankfurt, KY 40602



2. Self-Service Portal:



3. Connecting with kynect or DCBS:

  • Kynect
    • Hours: Mon-Fri 8:00 am to 4:30 pm ET
    • Call  (1-855-459-6328) 
    • Find and visit a kynector or agent office HERE. 
  • DCBS
    • Hours: Mon-Fri 8:00 am to 4:30 pm ET and Saturdays from 9:00 am to 12:00 pm ET
    • Call (1-855-306-8959) 
    • Find  and visit a DCBS office HERE.
Download kynect benefits FAQ

Income Verification: If verification of income is requested, Documents are required for proof of income and will need to upload any of the following:

  • Wage stubs
  • Written statement from or a collateral contact to the employee
  • Previous year tax return
  • Award letters for things such as Retirement, Survivors, and Disability Insurance (RSDI) or Unemployment Insurance Benefits (UIB)
  • The state’s various data sources such as eligibility advisor or state wage data for the previous quarter
  • Personal records for those who are self-employed 
  • “No income” status can be verified through client attestation, through collateral contact to a non-household member, a signed written statement from a non-household member, or Form PAFS-702, Proof of No Income.

Social Security Disability Insurance

The Medicaid renewal process will impact members who currently have Medicaid and are on SSDI. Medicaid will attempt to determine individuals on SSDI Medicaid eligible in another category. If Medicaid is unable to make this determination, the member will be determined ineligible and will receive a termination notice (will no longer receive Medicaid benefits).

MCOs

MCO partners will conduct outreach to members who have received a redetermination package or a request for information from the state. MCOs will help members understand what actions they must take and connect them to navigators or kynectors to provide additional support or guidance, as appropriate. MCOs will outreach to individuals administratively terminated for up to 90 days after their end date to encourage they submit information. 


A member submitting required information and determined eligible within the 90 days will have coverage retroactively reinstated to their end date. MCOs will also outreach to members who have been determined to no longer be eligible for Medicaid to support them in identifying alternative health care coverage options such as a Qualified Health Plan on kynect.

Waiver Participants 

Appendix K  Waiver flexibilities will extend 6-months beyond the end of the PHE May 11, 2023  extending waiver flexibilities to November 11, 2023. This extension is to allow 1915(c) HCBS waivers return to normal operation. Appendix K cannot remain in place beyond its approval end date. To make Appendix K updates permanent, changes would need to be incorporated into the current waiver applications and submitted to CMS for approval. Additionally, waiver-related Kentucky Administrative Regulations must be updated and approved.

All waiver participants will go through a redetermination during the 12 months. For detailed information, please see the 1915(c) HCBS COVID-19 and Appendix K FAQ. There is an outreach plan to support waiver members through the PHE unwinding period. Kentucky is actively preparing for the future of our waiver programs to ensure we continue to support waiver participants as well as possible. 

Ineligibility & Disqualifications

If a member is determined to no longer be eligible for Medicaid, they will receive a discontinuance notice that fully explains the reason for no longer being eligible. The discontinuance notice will also indicate the options to appeal the decision. 


All members have a right to appeal if they do not agree with the decision. Members who have been determined ineligible have 90 days from their Medicaid renewal due date to submit all requested information and be determined eligible for Medicaid coverage. Their coverage will be reinstated back to their end date automatically. If a member submits the requested information and application within 90 days from their Medicaid renewal date and is determined to be eligible, they will have their Medicaid reinstated back to their end date automatically. If a renewal is pending for state action at the time of the member’s renewal date, the member’s coverage will be extended until a determination is made. If no longer eligible, the member’s coverage will end on the first day of the following month.

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