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Commonwealth of Kentucky Cabinet for Health and Family Services Department for Medicaid Services MAP 95 (Rev. 6/07) REQUEST FOR EQUIPMENT FORM RECIPIENTS NAME: DOB: MAID or MEMBER #: DX: Estimated.

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Your Payer ID is 00660 (Professional ID) or 00160 (Institutional ID). Note: If you use a billing company or clearinghouse for your EDI transmissions, please work with them directly to determine which payer ID they want you to use.

Department for Medicaid Services - Cabinet for Health and Family Services.

​​​​​​​​​​​​​​​​​​​​​​Medicaid provides medical assistance to eligible low-income Kentuckians. Use the links below to learn more about some available programs and services. If members have any questions, please contact Member Services toll-free at (800) 635-2570.

Kentucky Medicaid/KCHIP is a state and federal program. It is authorized by Title XIX of the Social Security Act. Kentucky Medicaid/KCHIP provides health coverage for eligible low-income residents.

Visit the Kentucky Department for Medicaid Services website. Scroll down to “Forms” & select the forms needed.

Mandatory enrollment When you first enroll in a Medicaid managed care plan, you have 90 days to try the plan. During this 90-day period, you can switch for any reason to a new plan.

These are the main income rules for income-based Medicaid: If your family's income is at or under 138% of the Federal Poverty Guidelines (FPG) ($20,120 per year for an individual; $41,400 for a family of four), you may qualify.

To change your managed care organization, call toll free (855) 446-1245 or (800) 635-2570 from 8 a.m. to 6 p.m. Eastern time to speak with a Medicaid services representative or go online to the kynect website. All plan changes made during open enrollment will take effect on Jan. 1, 2023.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232