Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 5/16/2022

01000 >>> 01400 >>> 1410 >>> 1410.01

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1410.01 Approval - A notice of approval shall be sent for all programs determined eligible.

(1) Approved - The application will be approved for medical, if automatically eligible, or if determined eligible with respect to all factors including financial.

(2) - Approved - Suspended - If the applicant is eligible with respect to all factors other than financial but there is a spenddown (see 6500), the application will be approved in a spenddown status if there appears to be a likelihood that the spenddown will be met within the 6 month eligibility base period using evidence provided by the client and known to the agency. This is an administrative procedure to meet the application disposition time requirements and to preserve the original application date. However, there is no eligibility until the spenddown is met. See 1412 concerning suspension. The individual will however be enrolled with a KanCare managed care organization (MCO). They will be eligible for any value-added services the MCO provides. A medical card will be issued by the MCO and claims billed will be applied to the spenddown.

For all individuals enrolled in KanCare, the MCO will issue a medical ID card. For non-KanCare recipients, medical cards are issued by the fiscal agent.

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