Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)


Eligibility Policy - 4/26/2024

02000 >>> 02350

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02350 Medically Needy Coverage Related to Children and Pregnant Women - Medical assistance is available for children and pregnant women who are not financially eligible for Family Medical coverage and do not meet the Medicaid poverty level criteria. (See 2271.) Eligibility shall always be determined first for the Medicaid poverty level programs prior to Medically Needy.

2350.01 Age - The person must be under the age of 19 if not pregnant. If pregnant, age is not a factor.

2350.02 Income and Resource Methodologies - The income methodologies of 5000 are to be used in determining eligibility for this group. For a prior medical Spenddown, the prior medical income should be determined using the budgeting methods of 6130 and related sections. There is no resource requirement. The protected income level is based on the number of IBU members (see 3000). Expenses for medical services paid or incurred by the eligible persons or IBU members are allowable in determining eligibility. (See 6500)

2350.03 Medically Needy Spenddown Postpartum Medical Coverage - Eligibility as a pregnant woman ends 12 months following the month of birth of the child(ren) or termination of pregnancy provided that the woman was accurately receiving FFP medical the month of birth or pregnancy termination (including prior eligibility).

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