Community Health Workers & Enrollment

Who is a Kentucky Community Health Worker (CHW)?

• Frontline public health worker
  Public health is the science of protecting and improving the health of people – by multiple partners, not just confined to public health departments
• A trusted member of the community or has a particularly good understanding of the community served
• A link between health and social services and the community
• Makes services easier to access
• Improves the quality and cultural competence of service delivery

Kentucky has adapted this definition of a CHW from the American Public Health Association (2018)

MEDICAID

Kentucky Medicaid is a state and federal program authorized by Title XIX of the Social Security Act to provide health care for eligible low-income residents including children, families, pregnant women, the aged and the disabled. Eligibility is determined by several factors, including family size, income and the federal poverty level.

KCHIP

The Kentucky Children's Health Insurance Program (KCHIP) provides free or low cost health insurance for Kentucky's children. Eligibility is determined by several factors, including family size, income and the federal poverty level. Also:

• Either 18 years of age and under or a primary care giver with a child(ren) 18 years of age and under, and
• A U.S. Citizen, National, or a Non-Citizen legally admitted into the U.S, and
• Uninsured

MEDICARE

A federal health insurance program for people: Age 65 or older. Under 65 with certain disabilities. Any age with end-stage renal disease.

Qualified Health Plan

A Qualified Health Plan (QHP) is an insurance plan that’s certified by the Kentucky Exchange, provides essential health benefits, follows established limits on cost-sharing (like deductibles, copayments, and out-of-pocket maximum amounts), and meets other requirements under the Affordable Care Act. All qualified health plans meet the Affordable Care Act requirement for having health coverage, known as “minimum essential coverage.”

• You may be eligible to enroll in QHP during Open Enrollment period or with a qualifying event.
• Open Enrollment is a period of time each year when an individual can enroll in health insurance. During the open enrollment period, an individual can enroll in medical and dental plans offered by Kentucky’s state-based exchange.

Tiffany Taul-Scruggs, Patient Service Outreach Coordinator for Sterling Health Care, speaks on the impact of Medicaid services at the 2023 Kentucky Voices for Health Annual Meeting.