Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 10/6/2022

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2010.02 Not Legally Incapacitated - A competent adult may apply for assistance for himself or herself. Any adult who has not been determined to be legally incapacitated is presumed to be able to act in their own behalf. Act in own behalf is further defined as being able to perform all activities that a consumer would perform for themselves, including the ability to appoint an additional Medical Representative or Facilitator.
For medical applications, the following individuals may apply on behalf of an adult who has not been determined legally incapacitated:
- Spouse,
- Opposite sex partner with whom there is a mutual child,
- Tax filer - a tax filer may apply for anyone they claim or intend to claim as a dependent,
- Durable power of attorney (for financial decisions), or
- Representative payee for Social Security benefits may apply on behalf of an adult who has not been determined legally incapacitated.

For any other individual to apply, they must be appointed by the applicant as a Medical Representative. A signed written authorization from the person for whom they are applying must be obtained. The KC6100 Medical Representative Authorization Form or medical representative section on the application form may be used for this purpose and must be signed by the adult. Two witness signatures are required if the applicant/recipient signs with a mark. Attorneys representing the consumer must provide a statement on the attorney’s letterhead indicating they are representing the consumer in their Kansas Medicaid matter. The designated medical representative shall act in the place of the individual for whom they are applying. The medical representative shall receive copies of all notices and is responsible for completing the review and reporting changes.

Once appointed, the Medical Representative(s) shall have authority to act on behalf of the consumer until revoked or the Medical Representative passes away.

The medical representative(s) should be someone who is trusted and knowledgeable about the individual's circumstances and needs, including their income, resources, and household situation. Except in very limited circumstances, it would not be appropriate to appoint or accept a medical representative who has little or no prior experience with the individual. This would include those whose primary interest is in collecting on outstanding medical bills rather than in fully representing the interests and needs of the applicant for medical assistance.

In rare instances where the individual is unable to file their own application and obtaining written consent is not possible, the application shall be accepted and a referral completed to Adult Protective Services (APS) to have a guardian or conservator appointed if appropriate. For example, an individual may have been in an automobile accident and is in a coma. The application would not be denied or delayed because an appropriate person is not available to file.

When someone other than the individual is acting in their behalf, all notices must still be sent to the applicant/recipient in addition to the authorized representative.

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