Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 11/22/2024
2442
2443 Impact on Eligibility for Former Recipients - For new applicants, a child who continues to live in the family unit upon which the premium was assigned (i.e., the case number in which the premium was assigned) cannot re-qualify for CHIP until all delinquent premiums are paid or a penalty has been served for the time period in question. This includes children who would be eligible for CHIP coverage without a premium obligation. However, as Medicaid eligibility is not affected by non-payment of premiums, any Medicaid eligible child in the family would still qualify even if there were premiums due and owing from a period in which they were CHIP eligible.
When processing a new request for CHIP, whether a new application or adding a person to an existing program, if the account meets the definition of delinquent, CHIP ineligibility exists. Prior to denial for a premium delinquency, staff must send a notice to the applicant informing them of the requirement to pay. The applicant is given the standard 12-day pending timeframe to pay the outstanding balance. If payment is not made, coverage is denied and a three-month penalty is applied. The penalty is established beginning with the month the application is processed.
2443.01 Impacts of Payments on the Penalty - If payment of the delinquent amount is made at some point during the penalty period, the penalty is ‘Shortened’. A new request for coverage is required and a new determination is made. If the request is received during the Reactivation period, per 1410.02 a verbal request is allowed. After that time, a new application is required, which would include a verbal request for coverage as allowed per 1402.