Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 11/21/2024
02000 >>> 02270
02260
02270 Medicaid Poverty Level -
2271 Medicaid Poverty Level Eligibiles - Children under age 19 and pregnant women (including pregnant minors) shall be eligible for medical assistance without a spenddown if countable income (per 2280) does not exceed the following applicable limit:
2271.01 - For pregnant women and children under the age of 1, 171% of the appropriate federal Poverty Income Guidelines;
2271.02 - For children ages 1 through 5, 149% of the appropriate federal Poverty Income Guidelines; or
2271.03 - For children ages 6 through 18, 133% of the appropriate federal Poverty Income Guidelines. Children in this age group with an FPL between 113-133% without other health insurance are part of a special M-CHIP expansion group that follows Medicaid policies but receives CHIP funding. Children in this age group with an FPL between 113-133% with other health insurance are part of the special M-CHIP group that follows Medicaid policies and receives Medicaid funding.
However, persons convicted of medical assistance fraud shall not be eligible in accordance with 8420.
The poverty level programs are intended to cover children and pregnant women who are not financially eligible for SSI or Caretaker Medical, as eligibility is considered for these groups first. Persons ineligible under the financial criteria of these programs may meet the eligibility provisions of CHIP as well as the spenddown programs. See 2400 and 2350 and respectively.
NOTE: Persons under the age 19 who are pregnant shall first be determined under the Medicaid or CHIP program. If ineligible under these provisions, eligibility shall then be determined as a child under the pregnant woman provisions.
2272 General Eligibility Requirements - The general eligibility requirements of acting in own behalf 2010 (including the caretaker requirements), cooperation 2020, social security number 2030, citizenship and alienage 2040, and residence contained in 2050 must be met.
2273 Age/Pregnancy Determination - The child must be under the age of 19. Coverage may be provided through the end of the month of the individual's 19th birthday unless she is a pregnant woman. See 2300 for pregnant woman standards.