Kentucky Medicaid is administered by the Cabinet for Health and Family Services, Department for Medicaid Services (DMS). Most of the program runs under TEAMKY (formerly KY HEALTH), a Section 1115 demonstration with a current term running through December 31, 2029. Five managed care organizations hold Kentucky's current statewide Medicaid contracts: Aetna Better Health of Kentucky, Humana Healthy Horizons of Kentucky, Passport Health Plan by Molina, UnitedHealthcare Community Plan, and WellCare of Kentucky. A sixth plan, Anthem Kentucky Managed Care Plan, held a contract from the same award until a court ruling forced its exit from Kentucky Medicaid managed care effective January 1, 2025; CMS's most recently published enrollment data, for report year 2024, still lists Anthem as one of six MCOs, since that dataset predates the exit.
Aetna Better Health of Kentucky, Humana Healthy Horizons of Kentucky, Passport Health Plan by Molina, UnitedHealthcare Community Plan, and WellCare of Kentucky hold Kentucky's current statewide Medicaid managed care contracts. Anthem Kentucky Managed Care Plan held a sixth contract from the same award until a Franklin Circuit Court ruling forced its exit from the program effective January 1, 2025; DMS reassigned Anthem's members to Humana or UnitedHealthcare. CMS's own 2024 managed care enrollment dataset, the most recent year published, still shows Anthem alongside the other five MCOs, and does not report member counts for any of Kentucky's plans in any year on file. Kentucky does not maintain a single, unified statewide Medicaid provider manual the way many other states do; each MCO publishes and maintains its own provider manual for its own network.
Long-term services and supports are excluded from Kentucky's MCO benefit and remain fee-for-service. Under 907 KAR 17:020, an MCO is not responsible for services provided in an intermediate care facility for individuals with an intellectual disability, services provided under a 1915(c) home- and community-based waiver program, hospice care provided in an institution, or nursing facility care beyond an enrollee's first thirty days of admission. Kentucky's 1915(c) HCBS waivers are administered directly by DMS outside the MCO contracts: the Acquired Brain Injury Waiver and the separate Acquired Brain Injury Long Term Care Waiver, the Home and Community Based Waiver, the Michelle P. Waiver, Model Waiver II, the Supports for Community Living Waiver, and the Community Health for Improved Lives and Development (CHILD) Waiver.
Not integrated into managed care
Behavioral health is carved into the standard MCO benefit rather than delivered through a separate administrator. Under 907 KAR 17:020, both a behavioral health service and a substance use disorder service are among the covered services an enrollee can access from an in-network provider without a referral from their primary care provider.
Carved in
Dental is included in each MCO's standard benefit rather than carved out to a single statewide administrator by DMS; a primary dental or oral surgery service is one of the services an enrollee can access without a referral. Several MCOs subcontract their own dental network to DentaQuest, including Passport Health Plan by Molina and, before its exit, Anthem; the remaining current plans do not name their own dental subcontractor on their public provider pages. The Kentucky Dental Association has pushed for a statewide dental carve-out ahead of the 2026 legislative session, but no such change has been enacted and dental remains part of the standard MCO benefit.
MedImpact Healthcare Systems is Kentucky's single, statewide Medicaid pharmacy benefit manager, covering both the managed care and fee-for-service populations under one formulary and one set of pharmacy policies rather than each MCO running its own pharmacy benefit. Kentucky was the first state in the country to mandate a single statewide Medicaid PBM by statute, and MedImpact's role now extends to the fee-for-service population in addition to managed care.
Non-emergency medical transportation is carved out of the MCO benefit under 907 KAR 3:066 and run as its own statewide program, administered by the Kentucky Transportation Cabinet's Office of Transportation Delivery rather than by DMS directly. Kentucky uses a regional broker model rather than a single statewide vendor; transportation providers contract with the regional broker assigned to the county where they operate, and coverage varies by region rather than by MCO.
Gainwell Technologies operates Kentucky's Medicaid Management Information System (MMIS) and serves as the state's fiscal agent.
Last updated: Aug 29, 2026
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