Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 10/16/2021

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02270 Medicaid Poverty Level -

2271 Medicaid Poverty Level Eligibles - Children under age 19 and pregnant women (including pregnant minors) shall be eligible for medical assistance without a spenddown if countable income (per 2280) does not exceed the following applicable limit:

2271.01 - For pregnant women and children under the age of 1, 171% of the appropriate federal Poverty Income Guidelines;

2271.02 - For children ages 1 through 5, 149% of the appropriate federal Poverty Income Guidelines; or

2271.03 - For children ages 6 through 18, 133% of the appropriate federal Poverty Income Guidelines. Children in this age group with a FPL between 114-133% without other health insurance are a part of the special M-CHIP group that follows Medicaid policies but receives CHIP funding.

However, persons convicted of medical assistance fraud shall not be eligible in accordance with 8420.

The poverty level programs are intended to cover children and pregnant women who are not financially eligible for SSI or Caretaker Medical, as eligibility is considered for these groups first. Persons ineligible under the financial criteria of these programs may meet the eligibility provisions of CHIP as well as the spenddown programs. See 2400 and 2350 and respectively.

NOTE: Persons under the age 19 who are pregnant shall first be determined under the pregnant woman provisions. If ineligible under these provisions, eligibility shall then be determined as a child under either the Medicaid or CHIP program.

2272 General Eligibility Requirements - The general eligibility requirements of acting in own behalf 2010 (including the caretaker requirements), cooperation 2020, social security number 2030, citizenship and alienage 2040, and residence contained in 2050 must be met.

2273 Age/Pregnancy Determination - The child must be under the age of 19. Coverage may be provided through the end of the month of the individual's 19th birthday unless she is a pregnant woman. See 2300 for pregnant woman standards.

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