Kansas Medicaid Office

Kansas Medicaid office (KanCare)

KanCare is the umbrella brand for every part of the Kansas Medicaid program, but three separate state agencies actually share the work. The Kansas Department of Health and Environment (KDHE) Division of Health Care Finance sets policy and pays the claims; the Kansas Department for Aging and Disability Services (KDADS) handles long-term services and behavioral health; and the Department for Children and Families (DCF) processes applications alongside the KanCare Clearinghouse.

The KanCare Clearinghouse — the single application front door

The KanCare Clearinghouse routes consumer applications, renewals, address changes, and case questions through one phone line:

• Clearinghouse — 800-792-4884; TDD/TTY 1-800-792-4292
• Managed Care Enrollment Center — 866-305-5147 (find out which MCO you're assigned to, change MCOs, or get a replacement enrollment packet)
• Premium Billing — 866-688-5009 (CHIP and Working Healthy premium questions)

Fax routing — different number depending on who's applying

KanCare uses two separate fax numbers for applications, which prevents the wrong intake team from receiving the paperwork:

• Families with children — 800-498-1255
• Elderly and persons with disabilities — 844-264-6285

Reach a specific MCO

Once enrolled, members handle plan-specific issues directly with their MCO — replacement ID cards, primary care physician changes, coverage questions, complaints, and grievances:

• Healthy Blue — 1-833-838-2593 (TTY 711)
• Sunflower Health Plan — 1-877-644-4623 (TTY 711)
• United Healthcare — 1-877-542-9238 (TTY 711)

Other Kansas Medicaid lines

• KanCare Ombudsman — 1-855-643-8180 (TTY 711); KanCare.ombudsman@ks.gov. Independent of the MCOs and the Clearinghouse; helps with applications, renewals, denials, appeals, and HCBS questions.
• KDADS — 800-432-3535 (long-term care, HCBS, behavioral health)
• DCF — 1-888-369-4777 (TTY 1-785-296-1491)
• KDHE Division of Health Care Finance — 785-296-3982; kdhe.KanCare@ks.gov
• Report eligibility fraud — Medicaid Inspector General 785-296-5050
• Report provider fraud — Medicaid Fraud Control Unit 1-866-551-6328

Who qualifies for KanCare?

Kansas has not adopted the ACA Medicaid expansion, so working-age adults without dependent children, a disability, or pregnancy generally do not qualify on income alone. KDHE's Division of Health Care Finance breaks the medical-assistance work into three programs, and an applicant qualifies for one (not all) based on age, income, family composition, and disability status.

Three medical assistance programs

• KanCare under the Medicaid plan — the largest program. Covers people with limited income, including pregnant women, children up to age 19, adult caretakers of children, persons aged out of foster care, persons with disabilities, and senior citizens.
• KanCare under the CHIP plan — the Children's Health Insurance Program; covers uninsured children up to age 19 who don't qualify for Medicaid.
• MediKan — funded entirely by state funds (not federal). Covers people who are trying to get Social Security disability benefits.

Nine covered groups

KDHE lists the only nine categories that can qualify for medical assistance. If a household doesn't fit one of these, no income test gets them coverage:

• Children up to age 19, including those in foster care or getting adoption support payments
• Persons under age 26 who were in foster care at age 18
• Pregnant women
• Persons who are blind or disabled by Social Security rules
• Persons aged 65 or older
• Persons receiving inpatient treatment for tuberculosis
• Low-income families with children under age 19
• Persons screened and diagnosed with breast or cervical cancer through the Early Detection Works program
• Persons currently receiving SSI payments

General rules that apply across all three programs

• Kansas residency — you must live in Kansas.
• Citizenship and immigrant status — citizen or qualified immigrant. Some immigrants must wait 5 years before they can get coverage. Verification of citizenship and identity is required for some individuals.
• Household composition — list every person living in your home. The eligibility worker decides who counts in the medical-assistance household.
• Other health insurance — if you have other coverage, it bills first; Medicaid bills last.
• Coverage date — coverage usually starts with the month of application, and you can request coverage for the three months before the application month.
• Reviews — medical assistance is reviewed each year. Keep your address current with the Clearinghouse or you may miss the renewal packet.

Asset (resource) rules differ by program

Each medical program has its own income standard and rules. Asset limits split sharply by population: plans for the elderly and persons with disabilities apply a resource limit on bank accounts, vehicles, property, and stocks; plans for families and children do not. Earned income (jobs) and unearned income (Social Security, child support, unemployment, VA, pensions) both count; KanCare uses gross income (before taxes) less qualifying pre-tax federal deductions.

KanCare income limits

KanCare does not publish a single consumer-facing income chart on its public pages. KDHE directs applicants to the Medical Consumer Self-Service Portal for prescreening rather than a static dollar chart, which means the most current household-by-household decision is the one the portal makes when you apply. The percentages below are stable; dollar amounts shift each January when the federal poverty level updates.

MAGI-based programs (no asset test for families and children)

Non-MAGI programs (elderly and persons with disabilities)

Plans for the elderly and persons with disabilities apply both an income limit and a resource (asset) limit. Resources include bank accounts, vehicles, property, and stocks owned by anyone in the household. Plans for families and children, by contrast, do not apply an asset test at all.

How KanCare counts income

KanCare uses gross income (before taxes) less qualifying pre-tax federal deductions. Both earned income (jobs) and unearned income (Social Security, child support, unemployment, VA, pensions) count. Households that apply at HealthCare.gov instead of the KanCare portal get screened for Medicaid and CHIP first; if eligible, the marketplace transfers the account to KDHE for a formal decision.

How to apply for KanCare

KanCare runs one consumer portal — the Medical Consumer Self-Service Portal at cssp.kees.ks.gov/apspssp/, backed by the KEES eligibility system — and one phone number, the KanCare Clearinghouse at 800-792-4884. Paper applications use one of two separate form families depending on who's applying, which determines the fax number too.

Apply online through the Self-Service Portal

The Medical Consumer Self-Service Portal accepts new applications, lets households complete annual reviews (select "Complete a KanCare Review" from the "Access my KanCare" drop-down), and shows case status. Households are notified when it's time to review. Spanish-language application content is available alongside English.

Apply by phone, fax, or mail

Call the KanCare Clearinghouse at 800-792-4884 to request a paper application or to apply over the phone. Two separate paper application families exist; pick the right one to avoid delays:

Every form has a Spanish equivalent (KC-1100S, KC-1500S, KC-1105S, KC-2700S). KanCare also publishes a multi-part "Guide to Completing the KC-1500 Application" walking through sections A–N for the disability form, which is longer than the families-with-children form.

How long does a KanCare decision take?

Federal Medicaid rules give Kansas up to 45 days to decide a non-disability application and up to 90 days for an application based on disability. Coverage usually starts with the month of application; the household can also request coverage for the three months before the application month when there are qualifying medical bills during that window.

Annual reviews

KanCare reviews medical assistance every year. The renewal packet arrives by mail unless the household opts in to electronic notices through the portal. Address changes go to the Clearinghouse at 800-792-4884; an out-of-date address is the most common reason a member's coverage ends unintentionally.

What KanCare covers

Every KanCare member picks one of three managed care organizations, and every MCO covers the same physical health, mental health, and substance-use treatment services. What differs between plans is the value-added benefits each MCO offers, plus the doctor and hospital network. KanCare's basic services cover most of what a member needs without an MCO-specific carve-out.

The three KanCare MCOs (current 2026 roster)

If a member has a doctor they want to keep seeing, the published guidance is to check each plan's network before picking — providers may be in some plans and not others.

What KanCare covers across every MCO

• Doctor's office visits, vaccines, and check-ups
• Hospital services — inpatient and outpatient
• Blood work and lab services
• Pharmacy and prescription drugs
• Eye doctor visits
• Behavioral health services (mental health and substance use)
• Dental care for children
• Dental care for adults — periodontal care, silver diamine fluoride treatments, and some restorative procedures (more limited than children's dental, but more than many non-expansion states cover)
• Transportation to medical appointments
• Home and Community Based Services (HCBS)
• Nursing facility services
• Heart and lung transplants for adults
• Weight-loss surgery
• Value-added services — each MCO offers its own additional perks; the KanCare enrollment packet includes a side-by-side comparison.

Emergencies, out-of-network specialists, and transitions of care

In an emergency, KanCare's published rule is to go to the nearest hospital emergency room. Every hospital with an ER will see anyone in an emergency situation. For non-emergency out-of-network specialty care, the MCO is required to either find another in-network specialist or authorize the out-of-network visit. New members can request Transition of Care if they're mid-treatment with a provider not in the chosen plan's network.

HCBS and long-term services run through KDADS

The Kansas Department for Aging and Disability Services (KDADS) administers the HCBS waivers — Frail Elderly (FE), Physical Disability (PD), Intellectual/Developmental Disability (I/DD), Traumatic Brain Injury (TBI), Autism, Serious Emotional Disturbance (SED), Technology Assisted (TA), and Money Follows the Person. Members enrolled in a waiver still pick a KanCare MCO for their physical and behavioral health care; KDADS sits alongside (not in place of) the MCO. Call KDADS at 800-432-3535 for waiver-specific questions.

Other state Medicaid pages