Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 11/21/2024
1403
1404 Who May File - An application for assistance shall be made by the individual in need or by another person able to act in the individual's behalf. See 2010. If the applicant or his representative signs by mark, the names and addresses of two witnesses are required. Obtaining the signatures of all persons in the family group who are requesting assistance and able to act in their own behalf per 2010 is encouraged, but cannot be required.
1404.01 Filing on Behalf of a Deceased Person - An application shall be made on behalf of a deceased person in the month of death or within the three following months by the following individuals:
• A parent of the decedent where the decedent is a minor;
• The surviving spouse of the decedent;
• An adult child of the decedent;
• An adult in the decedent’s tax household; or
• An executor or administrator (including temporary) of the decedent’s estate.
1404.02 Filing for Institutionalized Individuals - When possible, all necessary information and signed forms will be obtained by institutional personnel. Parents, spouses, guardians/conservators and others who may apply on behalf of the individual per 2010 must always be given the opportunity to apply on behalf of an institutionalized person not able to act in his own behalf. If institutionalized personnel are unable to obtain the required forms from the patient or any of the above individuals, the administrator of a licensed facility may apply on behalf of the patient. General hospitals are not regarded as a licensed facility for this purpose.
Complete applications will be forwarded to the DCF office or KanCare Clearinghouse for processing.
All information pertinent to eligibility and known by institutional staff will be communicated to the local office. When the institution acts as an employer to the patient, institutional personnel will be responsible for reporting all earnings to the local DCF office.
Generally the local DCF office where the institution is located will process new applications. However, when appropriate, the local office or KanCare Clearinghouse shall determine whether the individual is currently included on an open medical case before processing. If the individual is included on a currently open case, the application shall be denied. The referral and a copy of the application shall be sent to the current county or CH where the appropriate case action will be taken to certify eligibility to the institution. (See 7300.)
For individuals who currently have an unmet spenddown, the institution should be notified as no FFP can be claimed until the spenddown is met. Medical expenses incurred at the institution shall be considered toward the unmet spenddown and eligibility certified when the spenddown is met.
1404.03 Filing for Individuals through the Federal Health Insurance Marketplace - Individuals may apply for medical assistance through the Federal Health Insurance Marketplace. The Marketplace application allows any adult member of the tax household to apply for any and all other members of the tax household. Should the agency receive an application via file transfer from the Marketplace, it shall be accepted and processed even if the individual filing the application does not meet the requirements of 2110 and subsections. The application shall be registered following standard procedures, establishing the correct individual as the primary applicant.