Assistance with Hospital Bills in Kentucky
Is there any state help for people who don't have health insurance but don't have Medicaid or Medicare?
Very low-income people in Kentucky who don’t qualify for Medicaid may still be able to get help paying hospital bills.
Any hospital in Kentucky which accepts Medicaid patients must participate in the Disproportionate Share ("DSH") Program. This program prohibits a DSH hospital from billing an indigent (poor) person for services before first finding out if the person would qualify for state assistance. "Indigent" is defined as a household with income less than 100% of the poverty level. Income of the spouse and children of the patient is counted, and if the patient is a minor living with parents, the parents' income is also counted.
What was the poverty income* level at the time I received hospital services?
|Year||Household Of One||Plus Amount for Each Additional Household Member|
* If the family income has fallen in the most recent few months, they can figure the annual income by multiplying the last three months gross income by 4. If that amount turns out to be less than the family’s actual gross income for the year, the lesser amount will be counted.
How does a person or family qualify for DSH coverage of their hospital bill?
- The patient must be a resident of Kentucky;
- The patient is not eligible for Medicaid or KCHIP (the Kentucky Children’s Health Insurance Program);
- The patient is not covered by any third-party payor (insurance);
- The patient is not in the custody of a government agency (such as a prison or foster-care placement)that is responsible for covering their acute health care needs; and
- The household’s resources (property) are less than $2,000 for one person, $4,000 for a family of two, and fifty (50) dollars for each additional countable person. However, resources can be offset against unpaid medical bills. This means that if the family has $6000 worth of property, but $5000 of unpaid medical bills, they will be counted as having only $1000 worth of property. Your home is excluded from the resource calculation, along with the first $4,500 of an automobile.
Who makes the decision that a patient qualifies for DSH?
It is the hospital's job to screen patients before sending them a bill. The patient is required to fill out any necessary forms. Based on the forms, the hospital will notify a patient if they qualify for DSH.
Is there a right to appeal a denial?
Yes. A patient denied DSH help may ask for a fair hearing, which then must be held, by impartial hospital staff, within thirty 30 days of the request. The hospital must notify the patient and the Department for Medicaid Services of its decision within 14 days of the hearing. If the patient is still turned down, they may take the matter to court.
Once a person qualifies for DSH coverage, how long does the coverage last?
Up to six (6) months, after which another determination has to be made.
Reviewed August 2009