Wellcare Of Ky Medicaid Phone Number

Become A Wellcare Provider

“My staff and I love WellCare! We appreciate the high level of customer service extended to our staff and patients. Their concern and commitment to quality patient care is evident. Their comprehensive disease management program ensures patients receive a level of care they need to have a full and prosperous life. WellCare supports local philanthropic events and are avid preventive care advocates. WellCare members can be confident they’re in good hands.”

– Richard Allen Le, M.D.

If you are ready to join Dr. Le, and the more than 69,000 providers nationwide who already partner with WellCare, please send us your information by completing our online form. Please allow time for us to evaluate your request. We will contact you as soon as possible.

Medicaid If You Have A Disability And Need A High Level Of Care

If you have a disability, but don’t qualify for SSI, 1619, or income-based Medicaid, you might still qualify for Medicaid benefits. This situation is most common for people who are elderly or have a disability and need the level of care that a nursing home or other institution offers. In this case, you may qualify for a Medicaid Waiver program, which would let you get the services you need to be able to live in your own home. Learn more about Medicaid Waiver programs.

Wellcare Of Kentucky Contact Phone Number Is :

AddressServicesCompanyGovernmentCompanyCompanyartsCompanyStateCompanyWellcare of Kentucky provider loginWellcare of Kentucky providerWellcare of Kentucky formularyWellcare of Kentucky provider manualWellcare of Kentucky formulary Wellcare of Kentucky prior authorization form medicationWellcare of Kentucky prior authorization

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Ambetter From Wellcare Of Kentucky

Ambetter from WellCare of Kentucky, Centene’s Health Insurance Marketplace product in Kentucky, is pending 2022 QHP Certification. Ambetter exists to improve the health of its beneficiaries through focused, compassionate, and coordinated care. Our approach is based on the core belief that quality healthcare is best delivered locally.

Welcome To Kentucky Health

• Original Medicaid and
• Kentucky HEALTH

Kentucky HEALTH is a new state health and wellness program. Its more like regular health insurance than Original Medicaid. It helps working adults and their families understand how regular health insurance works, including things like:

• Making regular and on-time premium payments
• Tracking co-pays and deductibles

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How Do I Know If Im Enrolled

You should have received a notice from the State that tells you whether you are enrolled in Original Medicaid or Kentucky HEALTH. If you are enrolled in Kentucky HEALTH, you will also get a letter that contains more information.

You might be enrolled in Kentucky HEALTH if you are:

• A Medicaid expansion member
• A parent or caretaker of a child on Medicaid
• A former foster care member
• Receiving Transitional Medical Assistance
• A pregnant woman

You are not enrolled in Kentucky HEALTH if you are:

• Enrolled in Medicare
• Over 64 years of age, blind or disabled
• A child in foster care
• A child involved in a subsidized adoption
• A child enrolled in Medicaid or KCHIP

Is Medicaid Right For You

Medicaid is government-funded health coverage for people in certain situations. You may qualify if you:

• Get Supplemental Security Income benefits or qualify for SSIs 1619 rule, which helps people who used to get SSI. In either case, you automatically get Medicaid coverage and dont need to worry about the rules discussed here. Learn more in DB101s SSI article.
• Have a low income, no matter how much you have in resources or whether you have a disability. Income-based Medicaid is explained on this page.
• Are elderly or have a disability and need the level of care typically offered by a nursing home, hospital, or other institution. Medicaid Waiver programs may pay for services that let you live in your own home instead.Learn more about Medicaid Waiver programs.

Answer the questions on this page to see if you might qualify for income-based Medicaid. If so, its probably your best health coverage option because it doesnt usually have a premium, the copayments for services are generally lower than copayments required by private plans, and Medicaid covers more services than most private plans. Also, if you qualify for Medicaid, you cannot get government help paying for an individual plan on kynect.

Note: The rules for SSI and Medicaid are different if you are less than 18 years old. Learn about them in DB101s Benefits for Young People article.

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Medicaids Rules For Immigrants:

• Undocumented immigrants do not qualify for full Medicaid coverage, but they may qualify for Medicaid coverage for emergency services.
• Most immigrants who have been lawfully present for less than five years do not qualify for full Medicaid coverage. However, they may qualify for private coverage subsidized by the government.
• Immigrants who have been lawfully present for five years or longer and some other noncitizens who meet specific noncitizen requirements qualify for all of the same programs that U.S. citizens can get.

Wellcare Of Kentucky Plan Documents

Your Member Handbook explains your plan coverage in detail. It includes important information about your benefits, your rights, and key contact addresses and phone numbers.

• Spanish

WellCare of Kentucky is proud to b e working with SafeLink Wireless to offer the LifeLine program at no cost to you!

• English

Use this claim form to be reimbursed for eligible out-of-pocket medical expenses. Please submit one form per member.

• English

The Over-the-Counter Catalog includes a detailed list of available items from allergy medications to sunblock to vitamins. It also includes easy instructions on how to order.

• Spanish

The Over-the-Counter Catalog includes a detailed list of available items from allergy medications to sunblock to vitamins. It also includes easy instructions on how to order.

This document outlines the causes, symptoms and treatment of attention deficit/hyperactivity Disorder .

The Mommy and Baby Matters Booklet contains important information for moms-to-be including prenatal, postpartum and newborn care.

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How To Sign Up

You can apply for Medicaid and other benefits, such as SNAP , and Kentucky Transitional Assistance Program , at the same time:

• At your Department for Community Based Services office by mail or in person, or

Note: A quick online pre-screening process can let you see if you might qualify for Medicaid, Kentucky Children’s Health Insurance Program , SNAP, or K-TAP.

For help with your application, visit or call your local Department for Community Based Services office or contact the Call Center at 1-855-306-8959.

Do You Have A Question Comment Or Suggestion

If so, we want to hear from you.

Monday-Friday, 7 a.m.to 7 p.m.

Current Medicare Members

Wellcare Medicare Duals Special Needs Plans1-833-444-9089 October 1 – March 31: MondaySunday, 8 a.m. to 8 p.m.April 1 – September 30: MondayFriday, 8 a.m. to 8 p.m.

Prospective Medicare Members

Monday – Sunday, 8 a.m. to 8 p.m.

Wellcare Medicare Duals Special Needs Plans1-866-527-0056 Monday – Sunday, 8 a.m. to 8 p.m.

Current Prescription Drug Plan Members

Wellcare Classic, Value Script and Medicare Rx Value Plus1-888-550-5252 October 1 – March 31: Monday – Sunday, 8 a.m. to 8 p.m.April 1 – September 30: Monday – Friday, 8 a.m. to 8 p.m.

Prospective Prescription Drug Plan Members

Wellcare Classic, Value Script and Medicare Rx Value Plus1-888-293-5151 Monday – Sunday, 8 a.m. to 8 p.m.

Chat with a Member Services Agent.

Medicaid Providers

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Do You Qualify For Ssi Or 1619

If you have a disability, low income, and low resources, you may qualify for SSI. If you already get SSI benefits, you automatically get Medicaid coverage and do not need to apply separately.

If you dont get SSI benefits yet, you should learn whether you might qualify by reading DB101s SSI article. At the same time, you should apply for Medicaid separately, because it can take Social Security months to review your SSI application and its important for you to have health coverage until then.

If you used to get SSI benefits, but stopped getting them after you started working, you may qualify automatically for Medicaid through a special rule called 1619 as long as your gross income is below $35,658 per year. Learn more about 1619 in DB101s SSI article.

If you do not get SSI benefits and do not qualify for 1619, income-based Medicaid might cover you.

Kentucky Medicaid Program Routine Vision And Eye Medical

As of January 1, 2013, WellCare of Kentucky has expanded into Region 3/31 and Avesis will administer the routine eye care benefit and eye medical benefits for those members. Region 3/31 consists of the following counties: Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble, and Washington.

As of October 1, 2011, Avesis Third Party Administrators, Inc. became the eye care program administrator for WellCare of Kentucky within the Kentucky Department of Medicaid Services. Avesis administers the routine eye care benefit and eye medical benefits for WellCare of Kentucky members.

If you are currently an Avesis participating provider and are interested in participating in the Kentucky Medicaid program for these groups, please sign and return the addendum located here. Please note that all providers will need a Kentucky Medicaid member.

If you are not currently an Avesis contracted provider and are interested in participating in these programs, please complete the Provider Credentialing and Contracting paperwork by following the link below.If you have any questions please contact one of our Provider Services Representatives at 855-469-3368.

Please click here to access KY Medicaid Eye Care Program Provider Forms.

Send Completed Materials by mail to Provider Services

Mail To:

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Expanded Telehealth Services From Wellcare Of Kentucky Keeps Healthcare Accessible During The Covid

• commonwealth journal

LOUISVILLE, Ky. – In response to the COVID-19 pandemic, WellCare of Kentucky is encouraging Medicaid members to utilize its expanded telehealth services to make sure they’re still getting the care and support they need. This is especially important for members who may be feeling sick as they can consult with a doctor from their home. Telehealth services with a doctor in WellCare of Kentucky’s network are available to over 400,000 members at no cost.

Telehealth options give Medicaid members the ability to seek care while still following the #HealthyAtHome guidelines instituted by Kentucky Gov. Andy Beshear. Among the changes in that guidance, Kentucky providers can use regular telephones – meaning only audio – for telehealth visits if video is not a viable option and group outpatient therapy can now be done virtually.

In order to facilitate the use of telehealth options – and to combat loneliness and isolation – WellCare of Kentucky has long provided free smartphones to Kentucky Medicaid members. In light of the COVID-19 pandemic, WellCare of Kentucky is expanding limits on both calls and data for those smart phones.

While a doctor will not be able to make a COVID-19 diagnosis during a telehealth visit, the doctor will be able to assess a member’s condition and make recommendations for recuperating at home or visiting a clinic or hospital. The service can also be used to address a number of other health issues:

· Colds, flu, and fevers

Submitting An Authorization Request

The fastest and most efficient way to request an authorization is through our secure Provider Portal, however you may also request an authorization via fax or phone .

The following information is generally required for all authorizations:

• Member name
• Provider ID and National Provider Identifier number or name of the treating physician
• Facility ID and NPI number or name where services will be rendered
• Provider and/or facility fax number
• Date of service
• CPT codes

Via Provider Portal

As a registered provider, you can submit authorization requests and download or print a summary report for your records. Simply log in and follow these instructions.

Not registered on our secure Provider Portal yet? It only takes a few moments to and start benefitting from the many useful features provided.

NOTE: Authorizations may not be visible in the secure Provider Portal until a final disposition has been determined. As a result, you may receive our fax response before seeing the determination online.

Via Fax

Complete the appropriate WellCare notification or authorization form for Medicaid. You can find these forms by selecting Providers from the navigation bar on this page, then selecting Forms from the “Medicaid sub-menu.

Fax the completed form and any supporting documentation to the fax number listed on the form.

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Is Your Income Low Enough For Income

These are the main income rules for income-based Medicaid:

• If your familys income is at or under 138% of the Federal Poverty Guidelines , you may qualify.
• If you are 18 or younger and your familys income is at or under 218% of FPG , you may qualify for Kentucky Children’s Health Insurance Program coverage.
• If you are pregnant and your familys income is at or under 195% of FPG , you may qualify. The unborn baby is counted as a family member.

Income-based Medicaid counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income benefits and some contributions to retirement accounts. Learn more about what types of income affect income-based Medicaid eligibility.

Note: There are no limits to how much money or other resources you can have for income-based Medicaid.

If your income is low enough and you meet all other requirements, you should sign up for Medicaid.

You may see the income limit for income-based Medicaid listed as 133% of FPG in some places. However, when Medicaid counts your income, theyll knock 5% of FPG off your income if you make more than 133% of FPG. That’s why we say that you can make up to 138% of FPG, because it more accurately shows how much income you could have and still get Medicaid.

Insurance And Managed Care Partners

The companies, insurance carriers and government organizations listed below have contracts with Norton Healthcare hospitals .

The companies, insurance carriers and government organizations listed below have contracts with Norton Healthcare physician practices

For questions regarding a bill from a physician practice, Norton Immediate Care Center or other bill, Call Norton Healthcare customer service at or .

• Advantra Freedom
• Aetna Assurant On the Exchange
• Aetna Better Health of Kentucky
• Aetna Medicare Advantage
• Body Scan of Louisville, LLC
• Body Scan of Louisville
• BOHN
• Campbellsville University Athletics
• Commission for Children with Special Needs
• Cooperative Care & Hospital Agreement
• Department of Juvenile Justice-Commonwealth of KY
• Department of U.S. Army Medical
• Department of Veterans Affairs

• First Health Group Corp
• Frazier Rehab Institute
• Heritage Summit Healthcare
• Hosparus
• Hospice & Palliative Care Svcs. Inc.
• Humana
• Humana Behavioral Health
• Humana Caresource
• Humana Norton + Just for Kids HMO X
• Humana-National Transplant Network
• Indiana Health Network
• Indiana Medicaid
• James Graham Brown Cancer Center
• Jewish Hospital Healthcare Services, Inc.
• Kentucky Colon Cancer Screening Program
• Kentucky Healthcare Co-operative
• Kentucky Medicaid
• Kentucky Racing Health and Welfare Fund
• Kentucky Workers Comp
• KODA
• MDI-CCA Marion County

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