The Kentucky qualified health plan (QHP) is a health insurance plan that has been certified by the Kentucky Department of Insurance to provide essential health benefits and meet other requirements under the federal Patient Protection and Affordable Care Act (ACA).
A QHP must provide 10 essential health benefits, including mental health and substance abuse services, prescription drugs, hospitalization, and more. For a full list of essential health benefits, see https://www.healthcare.gov/coverage/essential-health-benefits/.
QHPs are offered by private health insurance companies and sold through the Kentucky Health Insurance Marketplace. All QHPs offered in the Marketplace are required to provide consumers with a Summary of Benefits and Coverage, which is a document that outlines the key features and benefits of the plan.
To be certified as a QHP, a health insurance plan must meet certain requirements, including:
-Offering a comprehensive set of benefits that meets or exceeds the essential health benefits
-Limiting cost-sharing (such as deductibles, copayments, and coinsurance) so that out-of-pocket costs do not exceed certain percentages of a consumer’s income
-Providing coverage to individuals with pre-existing health conditions
-Enrolling consumers throughout the year, not just during an annual open enrollment period
For more information about QHPs, see https://www.healthcare.gov/glossary/qualified-health-plan/.
