KanCare, or the State of Kansas' Medicaid program, is a government health insurance program that helps people with low income get health care services at a lower cost.

What does KanCare (Medicaid) cover?

Serving different groups of people including those who are older (age 65+), blind, or living with a disability, KanCare pays for routine and acute health care services. This includes:

• Visits to health care providers (including physicians and nurse practitioners)
• Inpatient and outpatient hospital services
• Early and periodic screening, diagnostic, and treatment services
• Preventive care (e.g., vaccinations)
• Lab tests and X-rays
• Dialysis services
• Mental health services
• Substance use treatment
• Rural health clinic services
• Medical transportation
• Long-term care (e.g., nursing facility care, home health services)

Most Medicaid programs also cover optional services such as:

• Physical, respiratory, and occupational therapy
• Home- and community-based care
• Case management
• Prescription drugs
• Dental and vision care

Since the program serves those with limited income and resources, people with KanCare pay few to no out-of-pocket costs. To get coverage once you are enrolled, you must go to health care providers that take part in the Medicaid program.

KanCare is administered by the Kansas Department of Health and Environment (KDHE) Division of Health Care Finance (DHCF). Call 1-800-792-4884 to learn more about the coverages provided.

How do I know if I qualify for KanCare (Kansas Medicaid)?

In general, to be eligible, you must:

• Be a Kansas resident
• Be a U.S. citizen or a qualified non-citizen
• Meet the income and (if applicable) resource limits for your coverage group

If you need help with your health care coverage and costs, you should apply for KanCare even if you think you are over the income limit. This is because:

• Not all types of income are counted toward the income limit.
• You may qualify for a different form of health care assistance.
• If you are over the income limit, but you have very high medical costs, you may be able to qualify through the Medically Needy Program.

What is the Medically Needy Program?

If your income is too high to qualify for KanCare, but you have high medical expenses, you may be able to qualify through the Medically Needy Program (also called the Spend-Down Program). This option works by letting you spend down your income so that you meet the program’s income limits. The spend-down amount is the amount of income that is over the KanCare limit. This amount is different for each person.

To get KanCare benefits, you must submit current paid or unpaid medical bills equal to or greater than your monthly spend-down amount. Once your medical bills reach this amount, you will get coverage for the rest of the calendar month. While using KanCare to pay for your medical expenses, you should use a health care provider who accepts Medicaid.

Some examples of medical expenses you can use to spend down your income include:

• Unpaid medical bills (that have not been used to spend down your income before)
• Health insurance premiums
• Medical bills you paid within the last three months
• Medical bills that will not be paid by health insurance (or any other source)
• Co-pays for medical bills
• Medical services prescribed by your doctor
• Transportation by ambulance, bus, or taxi to get health care services

How do Medicare and KanCare (Kansas Medicaid) work together?

KanCare (Medicaid) pays for some services not covered by Medicare. If you get Medicare, you may also be able to get help from KanCare. Millions of Americans have both Medicare and Medicaid coverage. This is called being "dual eligible."

If you have Medicare and qualify for full KanCare coverage, the state will pay your Medicare Part B (Medical Insurance) monthly premiums. Depending on the KanCare program you qualify for, the state might also pay for:

• Your share of Medicare costs, like deductibles, coinsurance, and copayments
• Part A (Hospital Insurance) premiums, if you have to pay a premium for that coverage

If you have both Medicare and KanCare, you should show both cards to your health care provider each time you receive services. In addition, if you are dual-eligible for Medicare and KanCare:

• You will automatically be signed up for the Low-Income Subsidy (LIS)/Extra Help program through Medicare Part D (prescription drug coverage). This program helps people with low income pay for their medicines.
• You can get your coverage through a Medicare Advantage Special Needs Plan (SNP) instead of having original Medicare with separate Medicaid coverage. This plan can help you manage the health care services you need. SNPs may also offer more benefits than what you already get from original Medicare. In some cases, you may have no monthly premiums and/or you may pay lower co-payments. All SNP plans are different, so check with the plans to see what they cover and if you can enroll.

Note: SNPs are not available in every community. To find out if there is an SNP in your area, visit the Medicare website or call 1-800-633-4227 or 1-877-486-2048 (TTY).

How do I prepare to apply for KanCare (Medicaid)?

When you apply for KanCare, you’ll be asked for important information to help determine if you qualify for benefits. Before you start, gather some basic information to make your application process easier: 

• A document that shows your age, such as your birth certificate or driver’s license
• Your Social Security card
• Pay stubs for anyone in your household who has earned income
• Documentation that shows any other form of income, such as letters from Veterans Affairs (VA) or the Social Security Administration (SSA)
• Information about your financial assets, such as bank account or investment account statements

How do I apply for KanCare (Medicaid)?

There are a couple of different ways you can apply for KanCare. Read below to learn more about which option might be right for you.

The quickest and easiest way to apply for KanCare is online through the KanCare Medical Consumer Self-Service Portal. All your personal information is kept 100% confidential and protected by special security technology. 

Apply on the KanCare Portal