Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 9/1/2024
02210
2211 Categorically Needy - Those persons who are eligible for a cash benefit under the SSI program or who meet Family Medical guidelines comprise a good portion of the categorically needy. Children and pregnant women who have incomes that fall below certain poverty level guidelines also are classified within this group.
The categorically needy receive medical assistance either because their income falls within poverty or Family Medical income guidelines or as a result of SSI eligibility. Within the categorically needy segment are also those persons who are "deemed" to be receiving an SSI cash benefit or Family Medical although ineligible for one due to certain financial or non-financial factors. For Family Medical, this would include persons who become ineligible due to increased earnings or hours of employment. For SSI, this would include persons qualifying based on the Pickle Amendment provisions and persons who qualify for 1619(b) status under the SSI program benefits because they are working but who retain disability.
Coverage of the categorically needy is largely mandated by federal law with some limited options.
2211.01 - The mandatory groups include:
(1) - Persons meeting Caretaker Medical criteria whose countable income does not exceed 38% of the federal poverty level.
(2) - SSI recipients, including those deemed to be receiving SSI.
(3) - Pregnant women and children under the age of 1 whose countable income does not exceed 171% of the federal poverty level.
(4) - Children ages 1 through 5 whose countable income does not exceed 149% of the federal poverty level.
(5) - Children ages 6 through 18 whose countable income does not exceed 133% of the federal poverty level.
(6) - Persons meeting TransMed and Extended Medical criteria.