Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 5/16/2022

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2011 Minors - Minors who are unable to act in their own behalf are not eligible to receive assistance unless such assistance is applied for by a person meeting one of the following criteria:

a) A court-appointed legal guardian, custodian, or conservator.

b) A representative payee for the minor's Social Security benefits.

c) A responsible adult with whom the child resides, who meets the definition of a caretaker according to 2110.

d) An individual, with whom the child resides, who claims the minor child, or intends to claim the minor child on his/her federal income taxes.

e) A responsible adult, with whom the child resides, who does not meet any of the above criteria can apply for the minor child if they are appointed as the authorized agent by the minor's parent or legal guardian. This authorization is only for purposes of application and maintenance of the minor child's medical assistance case with the KDHE-DHCF and DCF. A completed Required Authorization for Medical Agent for Minor must be on record. This form is generated in KEES as Form # V075.

If the child's parent or legal guardian cannot be located to assign an authorized agent, the relationship of the responsible adult to the child must be confirmed or substantiated. An individual's statement and two corroborative pieces of evidence shall meet the burden of proof unless there is an independent reasonable basis to doubt the veracity of the statement. Corroborative evidence may include but is not limited to: a written statement from a public or private licensed social agency, clergy, attorney, school official, medical provider, or other professional.

f) An individual who meets one of the above criteria to apply on behalf of a child may also request prior medical coverage for the child. This is true even if the individual did not meet the criteria or was not living with the child during the prior medical period. However, eligibility shall be determined based upon the child's situation in the month (see 3100 – MAGI Budgeting Units). Refer to 2110 to determine who is eligible to receive medical assistance on the basis of being a caretaker of a child.

Note: Anytime a minor's health, safety, or current medical condition is judged to be at risk, a referral to the Protection and Prevention Services' (PPS) Report Center is appropriate.

2011.01 - Minors can act in their own behalf and receive assistance under the following circumstances:

(1) - The minor is determined to be emancipated. An emancipated minor is a person who is:

(a) Age 16 or 17 and is or has been married; or

(b) Under the age of 18 and who has had the rights of majority conferred upon him or her by court action; or

(2) The minor is unemancipated (i.e., does not meet the criteria in (1)(a) or (b) above), there is no adult or emancipated minor exercising parental control over the child, and one of the following circumstances exist:

(a) The parents of the minor are institutionalized per Medical-KEESM 8113 or the minor has no parent who is living or whose whereabouts is known, and there is no other caretaker who is willing to assume parental control of the minor; or

(b) The health and safety of the minor has or would be jeopardized by remaining in the household with the minor's parents or other caretakers. Such status must be documented by an independent source such as social services, law enforcement, religious authorities or a battered person's shelter.

If local arrangements are made between the Division of Health Care Finance and Prevention and Protection Services (PPS), a referral may be made to PPS for assistance in determining the status of the minor's parents or other caretakers and any health and safety issues that would exist in such living arrangements. The determination of a minor's ability to act in own behalf under this provision must be approved by the KanCare Clearinghouse Manger, the Eligibility Policy Manager or his or her designee.

The determination must be documented in the case record. Minors able to act in their own behalf are eligible for medical benefits and can qualify under any family medical program (e.g., Medicaid poverty level or CHIP).

(3) The minor is placed into independent living by DCF. In situations where the minor's needs are being met by PPS or a foster care contractor, the minor cannot apply for his/her own needs but may apply on behalf of his/her child providing the child resides with the minor and is not in DCF custody.

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