KY MEDICAID MARKET
Kentucky
monitoring
No current verified market signal.
Last verified: unavailable
Last verified: unavailable · no state-specific item
No current verified signal
Precapture is monitoring this market. No state-specific public intelligence item is currently published.
Plans in this market
Parent, plan, and program come from the plan graph. Enrollment and share use the latest CMS reported count. Operations counts are CMS MCPAR. A dollar amount is not on this page.
Plans in this market 40
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| Independence Blue Cross | Passport Health Plan | not reported | 332,955 (2020) | 24.4% calculated | not reported |
| CVS/Aetna | Aetna | not reported | 249,504 (2022) | 16.7% calculated | not reported |
| CVS/Aetna | Aetna - Managed Care Organization | not reported | 222,208 (2024) | 17.0% calculated | not reported |
| CVS/Aetna | Aetna Better Health of Kentucky | not reported | 209,951 (2019) | 17.2% calculated | not reported |
| CVS/Aetna | Aetna Better Health of Kentucky | not reported | 245,649 (2021) | 17.3% calculated | 25 sanctions, 60,152 appeals resolved |
show all 40
| Parent | Plan | Programs | Latest CMS enrollment | Share | MCPAR operations |
|---|---|---|---|---|---|
| Centene | WellCare | not reported | 488,328 (2022) | 32.7% calculated | not reported |
| Centene | WellCare - Managed Care Organization | not reported | 480,105 (2023) | 32.1% calculated | not reported |
| Centene | WellCare of Kentucky | not reported | 474,204 (2020) | 34.7% calculated | not reported |
| Centene | Wellcare - Managed Care Organization | not reported | 419,036 (2024) | 32.1% calculated | not reported |
| Centene | Wellcare of Kentucky | not reported | 433,390 (2019) | 35.4% calculated | not reported |
| Centene | Wellcare of Kentucky | not reported | 476,077 (2021) | 33.6% calculated | 11 sanctions, 7,237 appeals resolved |
| Elevance | Anthem | not reported | 174,447 (2022) | 11.7% calculated | not reported |
| Elevance | Anthem - Managed Care Organization | not reported | 157,364 (2024) | 12.1% calculated | not reported |
| Elevance | Anthem BCBS | not reported | 162,688 (2021) | 11.5% calculated | not reported |
| Elevance | Anthem Blue Cross Blue Shield Medicaid | not reported | 121,663 (2017) | 9.7% calculated | not reported |
| Elevance | Anthem Blue Cross Blue Shield Medicaid | not reported | 129,757 (2018) | 10.3% calculated | not reported |
| Elevance | Anthem Managed Care Plan of Kentucky | not reported | 131,161 (2019) | 10.7% calculated | not reported |
| Humana | Humana | not reported | 168,446 (2022) | 11.3% calculated | 24 sanctions, 41,234 appeals resolved |
| Humana | Humana - Managed Care Organization | not reported | 142,985 (2024) | 11.0% calculated | not reported |
| Humana | Humana CareSource | not reported | 142,760 (2017) | 11.4% calculated | not reported |
| Humana | Humana-CareSource | not reported | 145,537 (2019) | 11.9% calculated | not reported |
| Humana | Humana-Caresource | not reported | 147,854 (2018) | 11.7% calculated | not reported |
| Molina | Molina | not reported | 333,594 (2022) | 22.3% calculated | not reported |
| Molina | Molina - Managed Care Organization | not reported | 280,749 (2024) | 21.5% calculated | not reported |
| Molina | Passport by Molina | not reported | 326,833 (2021) | 23.1% calculated | 14 sanctions, 34,450 appeals resolved |
| not reported | NEMT - Transportation Cabinet | not reported | 1,449,651 (2024) | 100.0% calculated | not reported |
| not reported | NEMT - Human Services Transportation Delivery | not reported | 1,232,903 (2018) | 100.0% calculated | not reported |
| not reported | NEMT Human Services Transportation Delivery | not reported | 1,201,648 (2019) | 100.0% calculated | not reported |
| not reported | NEMT-Human Services Transportation Delivery | not reported | 1,251,301 (2017) | 100.0% calculated | not reported |
| not reported | Passport Health Plan | not reported | 304,106 (2019) | 24.8% calculated | not reported |
| not reported | NEMT Human Services Transportation Delivery | not reported | 1,582,351 (2021) | 100.0% calculated | not reported |
| UnitedHealth | UHC | not reported | 79,751 (2022) | 5.3% calculated | 12 sanctions, 10,843 appeals resolved |
| UnitedHealth | United Healhcare | not reported | 37,031 (2021) | 2.6% calculated | not reported |
| UnitedHealth | UnitedHealthcare - Managed Care Organization | not reported | 81,613 (2024) | 6.3% calculated | not reported |
| not reported | Aetna Better Health of Kentucky | not reported | 275,507 (2016) | 21.8% calculated | not reported |
| not reported | Anthem Blue Cross Blue Shield Medicaid | not reported | 110,346 (2016) | 8.7% calculated | not reported |
| not reported | Humana- Caresource | not reported | 133,456 (2016) | 10.6% calculated | not reported |
| not reported | NEMT-Human Services Transportation Delivery | not reported | 1,225,842 (2016) | 100.0% calculated | not reported |
| not reported | Passport Health Plan | not reported | 296,309 (2016) | 23.5% calculated | not reported |
| not reported | WellCare of Kentucky | not reported | 446,992 (2016) | 35.4% calculated | not reported |
CMS reported enrollment
CMS reporting years in this file run from 2016 through 2024. Retrieved 2026-11-01. The latest reporting year is 2024, which is behind the retrieval date. Enrollment figures are the CMS cell for that reporting year. Share is calculated from CMS reported total enrollment for that state, program, and year. Precapture does not combine rows. A year missing from a trend was not reported. A plan and region with more than one CMS row in a year has no trend and no year-over-year change. The dataset says a reported 0 may not truly represent 0 when a state suppressed a small count. CMS reported.
Kentucky Managed Care (Comprehensive MCO)
Kentucky Managed Care (Comprehensive MCO) 14
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Aetna Better Health of Kentucky | Aetna | CVS/Aetna | Statewide | not reported | not reported | not reported | not reported | 2019: 209,951 |
| Aetna Better Health of Kentucky | Aetna | CVS/Aetna | Statewide | not reported | not reported | not reported | not reported | 2018: 223,876; 2020: 224,154; 2021: 245,649 |
| Anthem BCBS | Anthem | Elevance | Statewide | not reported | not reported | not reported | not reported | 2020: 163,385; 2021: 162,688 |
| Anthem Blue Cross Blue Shield Medicaid | Anthem BCBS | Elevance | Statewide | not reported | not reported | not reported | not reported | 2018: 129,757 |
| Anthem Managed Care Plan of Kentucky | Anthem | Elevance | Statewide | not reported | not reported | not reported | not reported | 2019: 131,161 |
show all 14
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Humana-CareSource | Humana | Humana | Statewide | not reported | not reported | not reported | not reported | 2019: 145,537 |
| Humana-Caresource | Humana | Humana | Statewide | not reported | not reported | not reported | not reported | 2018: 147,854 |
| Humana | Humana | Humana | Statewide | not reported | not reported | not reported | not reported | 2020: 170,548; 2021: 167,911 |
| Passport Health Plan | Amerihealth | AmeriHealth | Statewide | not reported | not reported | not reported | not reported | 2018: 311,716; 2019: 304,106; 2020: 332,955 |
| Passport by Molina | Molina | Molina | Statewide | not reported | not reported | not reported | not reported | 2021: 326,833 |
| United Healhcare | United Healthcare | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2021: 37,031 |
| WellCare of Kentucky | WellCare | Centene | Statewide | not reported | not reported | not reported | not reported | 2018: 446,322; 2020: 474,204 |
| Wellcare of Kentucky | Wellcare | Centene | Statewide | not reported | not reported | not reported | not reported | 2019: 433,390 |
| Wellcare of Kentucky | Wellcare | Centene | Statewide | not reported | not reported | not reported | not reported | 2021: 476,077 |
Kentucky Managed Care Organization Program (Comprehensive MCO)
Kentucky Managed Care Organization Program (Comprehensive MCO) 13
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Aetna - Managed Care Organization | Aetna | CVS/Aetna | Statewide | CMS reported 222,208 (2024) | 17.0% | -22,704 (-9.3%) | +0.7 pts | 2023: 244,912; 2024: 222,208 |
| Aetna | Aetna | CVS/Aetna | Statewide | not reported | not reported | not reported | not reported | 2022: 249,504 |
| Anthem - Managed Care Organization | Anthem | Elevance | Statewide | CMS reported 157,364 (2024) | 12.1% | -22,885 (-12.7%) | +0.0 pts | 2023: 180,249; 2024: 157,364 |
| Anthem | Anthem | Elevance | Statewide | not reported | not reported | not reported | not reported | 2022: 174,447 |
| Humana - Managed Care Organization | Humana | Humana | Statewide | CMS reported 142,985 (2024) | 11.0% | -23,190 (-14.0%) | -0.1 pts | 2023: 166,175; 2024: 142,985 |
show all 13
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Humana | Humana | Humana | Statewide | not reported | not reported | not reported | not reported | 2022: 168,446 |
| Molina - Managed Care Organization | Molina | Molina | Statewide | CMS reported 280,749 (2024) | 21.5% | -47,838 (-14.6%) | -0.4 pts | 2023: 328,587; 2024: 280,749 |
| Molina | Molina | Molina | Statewide | not reported | not reported | not reported | not reported | 2022: 333,594 |
| UHC | United Health Care | UnitedHealth | Statewide | not reported | not reported | not reported | not reported | 2022: 79,751 |
| UnitedHealthcare - Managed Care Organization | UnitedHealthcare | UnitedHealth | Statewide | CMS reported 81,613 (2024) | 6.3% | -14,694 (-15.3%) | -0.2 pts | 2023: 96,307; 2024: 81,613 |
| WellCare - Managed Care Organization | WellCare | Centene | Statewide | not reported | not reported | not reported | not reported | 2023: 480,105 |
| WellCare | WellCare | Centene | Statewide | not reported | not reported | not reported | not reported | 2022: 488,328 |
| Wellcare - Managed Care Organization | WellCare | Centene | Statewide | CMS reported 419,036 (2024) | 32.1% | not reported | not reported | 2024: 419,036 |
Kentucky Medicaid Managed Care (Comprehensive MCO)
Kentucky Medicaid Managed Care (Comprehensive MCO) 10
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Aetna Better Health of Kentucky | Aetna | CVS/Aetna | Statewide | not reported | not reported | not reported | not reported | 2017: 242,770 |
| Aetna Better Health of Kentucky | not reported | unmatched | All 8 Regions in the state. Statewide | not reported | not reported | not reported | not reported | 2016: 275,507 |
| Anthem Blue Cross Blue Shield Medicaid | Anthem Blue Cross Blue Shield | Elevance | Statewide | not reported | not reported | not reported | not reported | 2017: 121,663 |
| Anthem Blue Cross Blue Shield Medicaid | not reported | unmatched | All 8 MCO Medicaid Regions. Statewide | not reported | not reported | not reported | not reported | 2016: 110,346 |
| Humana CareSource | Humana | Humana | Statewide | not reported | not reported | not reported | not reported | 2017: 142,760 |
show all 10
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| Humana- Caresource | not reported | unmatched | All 8 Medicaid MCO regions. Statewide | not reported | not reported | not reported | not reported | 2016: 133,456 |
| Passport Health Plan | Passport Health Plan | Passport Health Plan | Statewide | not reported | not reported | not reported | not reported | 2017: 304,883 |
| Passport Health Plan | not reported | unmatched | All 8 Medicaid MCO regions. Statewide | not reported | not reported | not reported | not reported | 2016: 296,309 |
| WellCare of Kentucky | WellCare | Centene | Statewide | not reported | not reported | not reported | not reported | 2017: 438,994 |
| WellCare of Kentucky | not reported | unmatched | All 8 Medicaid MCO Regions. Statewide | not reported | not reported | not reported | not reported | 2016: 446,992 |
Kentucky Non-Emergency Medical Transportation (Non-Emergency Medical Transportation)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| NEMT - Human Services Transportation Delivery | NEMT - Human Services Transportation Delivery | NEMT-Human Services Transportation Delivery | Statewide | not reported | not reported | not reported | not reported | 2018: 1,232,903 |
| NEMT Human Services Transportation Delivery | State Non-Emergency Transportation | State Non-Emergency Transportation | Statewide | not reported | not reported | not reported | not reported | 2019: 1,201,648; 2020: 1,418,458; 2021: 1,582,351 |
Non-Emergency Medical Transportation (NEMT)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| NEMT - Transportation Cabinet | NEMT - Transportation Cabinet | NEMT - Transportation Cabinet | State-defined | CMS reported 1,449,651 (2024) | 100.0% | -192,559 (-11.7%) | 0.0 pts | 2023: 1,642,210; 2024: 1,449,651 |
Non-Emergency Medical Transportation (Non-Emergency Medical Transportation)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| NEMT - Transportation Cabinet | NEMT - Transportation Cabinet | NEMT - Transportation Cabinet | State-defined | not reported | not reported | not reported | not reported | 2022: 1,494,070 |
Non-Emergency Transportation Program (Non-Emergency Medical Transportation)
| Plan | CMS parent | Parent | Region | 2024 enrollment | 2024 share | Change from prior reporting year, calculated | Share change, calculated | Trend |
|---|---|---|---|---|---|---|---|---|
| NEMT-Human Services Transportation Delivery | NEMT-Human Services Transportation Delivery | NEMT-Human Services Transportation Delivery | Statewide | not reported | not reported | not reported | not reported | 2016: 1,225,842; 2017: 1,251,301 |
Plan operations (CMS MCPAR)
Counts, rates, dates, and status are the CMS MCPAR cells for that plan, program, and reporting year. The appeal rate is calculated from CMS reported appeals resolved in favor of the enrollee divided by CMS reported appeals resolved. It is not a CMS-published rate. A plan links when the name matches one enrollment plan in that same state and program. Unmatched is shown and is not guessed. A sanction amount is not on this page. Retrieved 2026-11-02. CMS MCPAR.
National plan operations · Federal compliance deadlines
Appeals, grievances, and enrollment share (2024)
Appeals, grievances, and enrollment share (2024) 6
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| Aetna Better Health | CVS/Aetna | Medicaid Managed Care Organization Contract | 34,962 | 236 | 0.7% calculated | 2,813 | 15.2% | 16.8% |
| Anthem Blue Cross/Blue Shield | unmatched | Medicaid Managed Care Organization Contract | 5,669 | 156 | 2.8% calculated | 368 | 10.9% | 12.1% |
| Humana Healthy Horizons | Humana | Medicaid Managed Care Organization Contract | 27,945 | 136 | 0.5% calculated | 1,022 | 9.6% | 10.7% |
| Passport by Molina | Molina | Medicaid Managed Care Organization Contract | 12,345 | 36 | 0.3% calculated | 1,653 | 20% | 22.2% |
| United Healthcare Community Plan | UnitedHealth | Medicaid Managed Care Organization Contract | 5,043 | 61 | 1.2% calculated | 96 | 5.6% | 6.2% |
show all 6
| Plan | Parent | Program | Appeals resolved | In favor of enrollee | Appeal rate | Grievances resolved | Medicaid enrollment share | Managed care enrollment share |
|---|---|---|---|---|---|---|---|---|
| WellCare of KY | Centene | Medicaid Managed Care Organization Contract | 696 | 911 | 130.9% calculated | 534 | 28.8% | 31.9% |
Sanctions (2024)
Sanctions (2024) 33
| Plan | Parent | Topic | Date | Corrective action plan | Remediation status |
|---|---|---|---|---|---|
| Aetna Better Health | CVS/Aetna | Reporting | 2024-03-18 | No | Yes, remediated |
| Aetna Better Health | CVS/Aetna | Reporting | 2024-07-25 | No | No, no remediation |
| Aetna Better Health | CVS/Aetna | Other, specify (Alignment of Clinical Criteria) | 2024-07-19 | No | Yes, remediated |
| Aetna Better Health | CVS/Aetna | Other, specify (MCO Reported Data Breach of Incentives) | 2024-03-18 | No | Yes, remediated |
| Aetna Better Health | CVS/Aetna | Reporting | 2024-03-18 | No | Yes, remediated |
show all 33
| Plan | Parent | Topic | Date | Corrective action plan | Remediation status |
|---|---|---|---|---|---|
| Aetna Better Health | CVS/Aetna | Reporting | 2024-04-12 | No | Yes, remediated |
| Aetna Better Health | CVS/Aetna | Reporting | 2024-04-12 | No | Yes, remediated |
| Aetna Better Health | CVS/Aetna | Reporting | 2024-02-12 | No | Yes, remediated |
| Aetna Better Health | CVS/Aetna | Reporting | 2024-07-03 | No | Yes, remediated |
| Aetna Better Health | CVS/Aetna | Reporting | 2024-08-14 | No | Yes, remediated |
| Aetna Better Health | CVS/Aetna | Timely access | 2024-07-22 | No | Yes, remediated |
| Anthem Blue Cross/Blue Shield | unmatched | Performance improvement | 2024-04-29 | Yes | Yes, remediated |
| Anthem Blue Cross/Blue Shield | unmatched | Performance improvement | 2024-08-07 | Yes | Yes, remediated |
| Anthem Blue Cross/Blue Shield | unmatched | Reporting | 2024-03-11 | No | Yes, remediated |
| Anthem Blue Cross/Blue Shield | unmatched | Other, specify (A subcontractor Icario Call Center Representative, fraudulently accessed member's accounts) | 2024-04-22 | No | Yes, remediated |
| Anthem Blue Cross/Blue Shield | unmatched | Reporting | 2024-10-25 | No | Yes, remediated |
| Anthem Blue Cross/Blue Shield | unmatched | Performance improvement | 2024-09-30 | No | Yes, remediated |
| Anthem Blue Cross/Blue Shield | unmatched | Performance improvement | 2024-03-28 | No | Yes, remediated |
| Anthem Blue Cross/Blue Shield | unmatched | Performance improvement | 2024-04-29 | Yes | Yes, remediated |
| Humana Healthy Horizons | Humana | Reporting | 2024-03-11 | Yes | Yes, remediated |
| Humana Healthy Horizons | Humana | Reporting | 2024-03-01 | Yes | Yes, remediated |
| Humana Healthy Horizons | Humana | Financial issues | 2024-10-01 | Yes | Yes, remediated |
| Humana Healthy Horizons | Humana | Performance improvement | 2024-10-15 | No | Yes, remediated |
| Humana Healthy Horizons | Humana | Performance improvement | 2024-06-15 | No | Yes, remediated |
| Humana Healthy Horizons | Humana | Performance improvement | 2025-01-10 | Yes | No, no remediation |
| Humana Healthy Horizons | Humana | Reporting | 2024-11-01 | No | Yes, remediated |
| Humana Healthy Horizons | Humana | Reporting | 2025-01-12 | No | Remediation in progress |
| Humana Healthy Horizons | Humana | Other, specify (SFY 2023 Medicaid Annual Compliance Review conducted by IPRO.) | 2024-05-23 | No | Yes, remediated |
| Passport by Molina | Molina | Performance improvement | 2024-07-15 | No | Yes, remediated |
| Passport by Molina | Molina | Other, specify (External Independent Third-Party Review documentation requirements untimely.) | 2024-07-01 | No | Yes, remediated |
| Passport by Molina | Molina | Other, specify (SFY 2023 Medicaid Annual Compliance Review conducted by IPRO.) | 2024-05-02 | No | Yes, remediated |
| Passport by Molina | Molina | Other, specify (30 day notice to providers on changes in reimbursement rate or methodologies.) | 2024-07-12 | No | Yes, remediated |
| WellCare of KY | Centene | Performance improvement | 2024-10-10 | No | Remediation in progress |
Award history
- Medicaid managed care December 2019 award: cancelled. On January 10, 2020, the Cabinet for Health and Family Services said Governor Beshear canceled managed care contracts awarded by the prior administration in early December, and that the Finance and Administration Cabinet issued a new request for proposals that day. The release does not name the contractors on the canceled award or a solicitation number for it.
- Medicaid managed care 758 2000000202: awarded. The June 25, 2020 Medicaid Oversight and Advisory Committee presentation says the RFP was released January 10, 2020, contracts were issued May 28, 2020 to Aetna Better Health of Kentucky, Humana, Molina Healthcare, United Healthcare, and WellCare, the award was announced May 29, 2020, and the contract start date is January 1, 2021. The Finance and Administration Cabinet page titles that set New MCO Contracts Awarded effective January 1, 2021, under RFP 758 2000000202, and also posts a contract with Anthem Kentucky Managed Care Plan Inc. The presentation does not print evaluation scores or a contract end date.
Retrieved 2026-11-03. Sources and scores
Early procurement signals
No official early-procurement document has been retrieved for this state. This is not a finding that no signal exists. Early signals
Contract amendments
No official Medicaid managed-care contract amendment has been retrieved for this state. This is not a finding that no amendment exists. Contract amendments
Medicaid policy
Indiana rows are official policy instruments. Other states show only Federal Register notices of hearings on SPA disapprovals, which are a narrow slice and not waiver or SPA coverage.
Federal Register notices of hearings on SPA disapprovals are read from the Federal Register JSON API. That covers no approved SPAs, waivers, or section 1115 demonstrations.
Coverage not_collected.
No official Medicaid managed-care policy instrument has been retrieved for this state. This is not a finding that no waiver, state plan amendment, or rule exists. Medicaid policy
Federal Register SPA disapproval hearing notices (2015 or later): 0
Plan financials
No official Medicaid plan financial filing has been retrieved for this state. This is not a finding that no filing exists, and it is not a zero. Plan financials. Coverage: not_collected.
Federal compliance deadlines
Cited federal Medicaid managed care deadlines, with the Federal Register citation, the effective date, the compliance date, and the plan obligation.