Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 10/6/2022

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1402 How to Apply - Each household has the right to file an application on the same day it contacts with the agency. Application forms can be requested from any local DCF office, KanCare Clearinghouse, or KDHE-DHCF Outstationed Worker. All requests for medical assistance must be made on KDHE-DHCF forms as follows:

KC1100 - Medical Assistance Application for Families with Children

KC1500 - Medical Assistance for the Elderly and Persons with Disabilities

Such applications are to be submitted to the KanCare Clearinghouse; a central operation established to determine eligibility for all medical programs. A contractor is currently used to manage the Clearinghouse. Applications provided to the local DCF office are immediately transferred to the Clearinghouse for processing.

Note: Online applications are received through the KDHE-DHCF Customer Self-Service Portal (CSSP).

When an application is requested in person, the household shall be encouraged to file the application that same day. When an application is requested over the telephone or in writing, it shall be mailed the same day, when possible, or the following business day.

NOTE: If the applicant household is homeless and they have no street address to list, the application shall be so noted and accepted by the agency.

Neither an application form nor signature is required to add additional household members to an existing medical program unless the medical program has remained active beyond the review period due to timeliness factors. If the medical program has remained active past the required review period, only submittal of a signed application form will constitute a request for coverage.

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