Guidelines for Kansas Medicaid

The Kansas Health Policy Authority (KHPA), through various plans like the HealthWave program for children, administers the federal Medicaid program. Medicaid shouldn't be confused with Medicare, which is an entitlement program designed to assist elderly and disabled people with health care costs and is fully funded by the federal government. Medicaid is also a health care entitlement program, meaning that, as long as you qualify for benefits, you'll receive them. But the cost of Medicaid is shared between the federal government and the states. Medicaid is the largest provider of children's health care in the United States.

Who's Eligible?

• Kansas' Medicaid programs are tailored almost exclusively to help pay for health care for children and for people who care for children. An exception is assistance provided for people over 65 and disabled persons. Income and age guidelines must be met within each category of eligible recipients.

Parents and Guardians

• You must have a child or children living in your home under age 19 to qualify for this Kansas Medicaid program. Kids also must be Kansas residents and U.S. citizens (or qualified aliens). The program can provide coverage to parents and children who live together, or will cover children and their legal guardians or other relatives who provide care. If the children live apart from their parents, the parents are not eligible for coverage. There are maximum income limits in order to qualify. A family's income is compared against thresholds established for the Kansas TANF (Temporary Assistance for Needy Families) program, which is administered through the Kansas Social and Rehabilitation Services (SRS). Where you live within the state of Kansas is one criterion for determining assistance levels, as is family size. A family of three, for example, has an income limit of $349 to $429 a month. Any trust fund owned by a family member is counted as income. Families who exceed established thresholds may qualify for the state's children-only coverage.

Pregnant Women

• There are no asset requirements for pregnant women, who must be U.S. citizens or qualified aliens, and must be Kansas residents who plan on staying in Kansas. Family size consists of the woman, her unborn child, the baby's father if he lives with the woman, and the woman's parents if the woman is a child and the parents live with her. All the woman's earned and unearned income, and the father's unearned income, must be included on the application. Income includes wages, unemployment benefits, Social Security payments, VA benefits and child support. Parent income also is counted if the woman is under 19 and living with her parents. A $200 employment-expense deduction is allowed for each working household member. Kansas limits monthly income for a family of two (woman and unborn baby) to $1,822. For a family of three the income maximum is $2,289, and for a family of four it's $2,757.

Children

• In 2001, Kansas integrated its own Medicaid program with the federal State Children's Health Insurance Program (SCHIP), establishing the Kansas HealthWave program for children. The same residency and citizenship requirements must be met as for the pregnant women program, and the same criteria defining income are used. There are no asset or resource criteria. Kansas follows the household income thresholds established by federal FPL (federal poverty level) guidelines. Some states increase the minimum FPL guidelines. A home with a child age 6 through 18 qualifies for assistance if its household income is $903 or less, which equals 100 percent of the FPL. For households with a child age 1 through 5, the income limit is $1,201, or 133 percent of FPL. Pregnant women or women with children under 1 year old are limited to $1,354, or 150 percent of the FPL. A household of six would have income limits of $2,461 to $3,692. If your income level exceeds guidelines, you may still qualify under Kansas's HealthWave 21 program, which is based on a 241 percent FPL.

Disabled People & Seniors

• Seniors 65 and older and qualifying disabled people also may be eligible for Medicaid. There are fairly restrictive asset limits for seniors.