Kansas Department of Health & Environment

Kansas Family Medical Assistance

Manual (KFMAM)

Eligibility Policy - 5/30/2023

06000 >>> 06500 >>> 6513 >>> 6513.01

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6513.01 Eligibility staff responsibility - The eligibility worker is responsible for determining the appropriate eligibility base period and the total spenddown amount. In addition, eligibility staff shall reduce the total spenddown amount by the following allowable expenses, which have been reported and verified. These are documented in KEES.

a. Health insurance premiums;

b. Expenses for non-participating members of the budgeting unit;

c. Due and owing expenses;

d. Allowable nursing facility/institutional expenses (excluding general hospital).

No other medical expenses are to be entered in KEES for persons attempting to meet a spenddown. If these expenses satisfy the spenddown in full, the individual will be eligible for reimbursement of medical expenses immediately.

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