Kentucky: Start Here
Beginner guide for Kentucky—kynect Marketplace, DOI external review, PA deadlines, and what to open next.
Read guideState playbook
Kentucky
State insurers, legislation, and appeal resources for patients and advocates in Kentucky.
4 guides
Kentucky Prior Authorization Law
KRS 304.17A-607—24-hour/5-day UR, deemed authorization, emergency PA limits, and specialty reviewer rules.
Read guideKentucky Health Insurance Appeals and Grievances
KRS 304.17A-617—30-day and 3-day expedited internal appeals, second-level rights, path to IRE review.
Read guideKentucky External Review (IRE)
Binding IRE review—60-day filing with insurer, 21-day standard, 24-hour expedited, KRS 304.17A-623.
Read guidePrior auth & internal appeals
Match the plan on the member ID card. Use the denial letter for where to file appeals.
- Anthem Blue Cross Blue Shield
- Passport Health Plan (Molina)
- Ambetter / WellCare of Kentucky
- Humana (KanCare & commercial)
- UnitedHealthcare Community Plan
- Aetna Better Health of Kentucky
- kynect (Marketplace & Medicaid)
- KanCare / DMS (Medicaid)
External appeals
After internal appeal, for eligible Kentucky fully insured plans only.
- Kentucky DOI — External Review
- Medicaid — DMS fair hearing