Kansas Medicaid (KanCare) Long Term Care Programs, Benefits & Eligibility Requirements

Summary
Medicaid’s rules, benefits and name can all vary by state. In Kansas, Medicaid is called KanCare. This article focuses on Kansas Medicaid Long Term Care for seniors, which will pay for care in a nursing home, a beneficiary’s home and other settings through one of three programs – Nursing Home Medicaid, HCBS Waivers or ABD Medicaid. These programs are different from regular Medicaid, which is for financially limited people of all ages.

Last Updated: Dec 29, 2023

Kansas Medicaid Long Term Care Programs Nursing Home Care Care at Home via HCBS Waivers Care at Home via ABD Medicaid Eligibility Criteria Nursing Homes HCBS Waivers ABD Medicaid How Medicaid Treats the Home Applying Choosing a Nursing Home

Kansas Medicaid Long Term Care Programs

Nursing Home / Institutional Medicaid

Kansas Medicaid, which is called KanCare, will cover the cost of long term-care in a nursing home for financially limited Kansas seniors who require a Nursing Facility Level of Care. Coverage includes payment for room and board, as well as all necessary medical and non-medical goods and services, such as:

Personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting)
Skilled nursing care
Physician’s visits
Prescription medication
Medication management
Mental health counseling
Social activities

Items not covered include a private room, specialized food, comfort items not considered routine (tobacco, sweets and cosmetics, for example) and any care services not considered medically necessary.

Kansas Nursing Home Medicaid beneficiaries are required to give most of their income to the state to help cover the nursing home expenses. They are only allowed to keep a “personal needs allowance” (PNA) of $62/month, which can be spent on personal items such as clothes, snacks, books, haircuts, flowers, etc. They can also keep enough of their income to make Medicare premium payments if they are “dual eligible,” and enough to make any Medicaid-approved spousal income allowance payments to financially needy spouses who are not Medicaid applicants or recipients.

Kansas Nursing Home Medicaid is an entitlement. This means all qualified applicants are guaranteed by law, aka “entitled,” to receive benefits without wait. However, not all nursing homes accept Medicaid, and those that do may not have any available spaces when you or your loved one needs care. So, eligible applicants are guaranteed nursing home coverage without wait, but they are not guaranteed coverage in any facility they choose.

A Nursing Home Alternative – Kansas Nursing Home Medicaid beneficiaries who want to leave their nursing home and return to living “in the community” can receive financial and functional help with that transition through Kansas’ Money Follows the Person (MFP) program. This help can include paying for moving expenses, as well as long-term care services and supports in the new residence. MFP beneficiaries must be moving from a Medicaid-approved facility and into their own home, the home of a relative or a small group home with a maximum of four unrelated residents.

Home and Community Based Services (HCBS) Waivers

Home and Community Based Services (HCBS) Waivers will pay for long-term care services and supports that help financially limited Kansas seniors who require a Nursing Facility Level of Care remain living in the community instead of residing in a nursing home. The word “waiver” means something like voucher in this instance. Think of it as a voucher that will pay for long-term care services for Kansas residents who live in their home, the home of a loved one, an assisted living facility, a boarding care home (similar to adult foster care), a home plus facility or a residential health care facility. While Kansas’s HCBS Waivers will cover some long-term care services and supports in those settings, it will not cover room and board costs.

The HCBS Waiver available to Kansas seniors is the Frail and Elderly Waiver.

Frail Elderly Waiver
Frail Elderly (FE) Waiver program participants can live in their own home, the home of a loved one, an assisted living facility, a boarding care home (similar to adult foster care), a home plus facility or a residential health care facility. While the FE Waiver will pay for some services and supports in those settings, it will not pay for room and board.

Benefits of the FE Waiver include adult day care, nursing visits, medication reminders, financial management services, oral health care and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). FE Waiver benefits will be made available depending on the needs and circumstances of each individual.

Unlike Nursing Home Medicaid, HCBS Waivers are not an entitlement. Remember, entitlement means guaranteed by law. Instead, there are a limited number of enrollment spots for each waiver program, and once those spots are full, additional eligible applicants are placed on a waitlist. There were roughly 6,300 enrollment spots for the FE Waiver in 2022.

Aged, Blind, and Disabled Medicaid

Kansas’s Aged, Blind, and Disabled (ABD) Medicaid provides healthcare coverage and long-term care services and supports to financially needy Kansas residents who are aged (age 65+), blind or disabled and live in the community. ABD Medicaid can sometimes be referred to as regular Medicaid for seniors, but it should not be confused with the regular Medicaid that is available for low-income people of all ages. ABD Medicaid is an entitlement, which means that anyone who meets the requirements is guaranteed by law to receive healthcare coverage without wait. Access to long-term care benefits via ABD Medicaid depends on the availability of funds, programs and caregivers in the beneficiary’s region.

1. ABD Long Term Care Benefits
Eligible Kansas seniors who show a medical need for long-term care services can receive those services through ABD Medicaid. These benefits can include in-home personal care, adult day care, meal delivery, home modifications and Personal Emergency Response Systems (PERS). ABD Medicaid recipients qualify for these benefits one at a time. This is different from Nursing Home Medicaid, which makes all of its benefits immediately available for anyone who qualifies. Instead, Kansas seniors will be evaluated by the state to determine what kind of long-term care benefits they need and will receive.

2. Program of All-Inclusive Care for the Elderly (PACE)
Kansas residents who are age 55 or older and have ABD Medicaid can cover their medical, social service and long-term care needs with one comprehensive plan and delivery system using the Program of All-Inclusive Care for the Elderly (PACE). PACE program participants are required to need a Nursing Facility Level of Care, but they must live in the community. Kansas’ PACE programs can be used by people who are “dual eligible” for Medicaid and Medicare, and it will coordinate the care and benefits from those two programs into one plan. PACE also administers vision and dental care, and PACE day centers provide meals, social activities, exercise programs and regular health checkups and services to program participants. Kansas PACE programs are located in McPherson (Bluestem PACE), Topeka (Midland Care PACE) and Wichita (Ascension Living HOPE). To learn more about PACE, click here.

Eligibility Criteria For Kansas Medicaid Long Term Care Programs

To be eligible for KanCare (Kansas Medicaid), a person has to meet certain financial and functional (medical) requirements. The financial requirements vary by the applicant’s marital status, if their spouse is also applying for Medicaid, and what program they are applying for – Nursing Home Medicaid, Home and Community Based Services (HCBS) Waivers or Aged, Blind, and Disabled (ABD) Medicaid.

Just For You: The easiest way to find the most current KanCare (Kansas Medicaid) eligibility criteria for your specific situation is to use our Medicaid Eligibility Requirements Finder tool.

Kansas Nursing Home Medicaid Eligibility Criteria

Financial Requirements
Kansas residents have to meet an asset limit in order to be financially eligible for nursing home coverage through KanCare (Kansas Medicaid). For a single applicant in 2024, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

For married applicants with both spouses applying for nursing home coverage through KanCare, the 2024 asset limit is $3,000 combined. And for a married applicant with just one spouse applying, the asset limit is $2,000 for the applicant spouse and $154,140 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance.

There is no set income limit for Kansas Nursing Home Medicaid in 2024, but beneficiaries must give almost all of their income to the state to offset the cost of nursing home care. They may keep $62/month as a personal needs allowance and enough to cover the cost of any private health insurance they might have. Married beneficiaries who have a financially needy spouse that is still living in the community may also keep enough income to provide their spouse a Medicaid-approved income allowance. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. COVID-19 stimulus checks and Holocaust restitution payments are not considered income.

Plan Ahead: There are alternative pathways to eligibility for Kansas Nursing Home Medicaid applicants who don’t meet their financial limits, such as Medicaid Planning. However, applicants are not allowed to simply give away their assets in order to get under the asset limit. To make sure they don’t, Kansas has a Look-Back Period of five years. This means the state will look back into the previous five years of the Nursing Home Medicaid applicant’s financial records to make sure they have not given away assets.

Functional Requirements
The functional, or medical, criteria for nursing home coverage through KanCare (Kansas Medicaid) is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is usually associated with a nursing home. To determine if Medicaid applicants require that level of care, Kansas uses the Functional Assessment Instrument. This process takes into consideration and applicant’s ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning, scheduling). Cognitive impairments such as Alzheimer’s disease and other related dementias are also considered, although a diagnoses of those impairments is not an automatic qualifier for needing a NFLOC.

Kansas Medicaid Home and Community Based Services (HCBS) Waivers Eligibility Criteria

Financial Requirements
Kansas residents have to meet an asset limit in order to be financially eligible for Home and Community Based Services (HCBS) Waivers through KanCare (Kansas Medicaid). For a single applicant in 2023, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

For married applicants with both spouses applying for HCBS Waivers through KanCare, the 2024 asset limit is $3,000 combined. And for a married applicant with just one spouse applying, the asset limit is $2,000 for the applicant spouse and $154,140 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance.

There is no set income limit for Kansas HCBS Waivers, but beneficiaries are only allowed to keep $2,829/month of their income and must give the rest to the state to offset the cost of long-term care. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. COVID-19 stimulus checks and Holocaust restitution payments are not considered income.

Plan Ahead: There are alternative pathways to eligibility for Kansas HCBS Waivers applicants who don’t meet their financial limits, such as Medicaid Planning. However, applicants are not allowed to simply give away their assets in order to get under the asset limit. To make sure they don’t, Kansas has a Look-Back Period of five years. This means the state will look back into the previous five years of the Nursing Home Medicaid applicant’s financial records to make sure they have not given away assets.

Functional Requirements
The functional, or medical, criteria for HCBS Waivers through KanCare (Kansas Medicaid) is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is normally associated with a nursing home. To determine if HCBS Waiver applicants require that level of care, Kansas uses the Functional Assessment Instrument. This process takes into consideration and applicant’s ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning, scheduling). Cognitive impairments such as Alzheimer’s disease and other related dementias are also considered, although a diagnoses of those impairments is not an automatic qualifier for needing a NFLOC.

Kansas Aged, Blind, and Disabled Medicaid Eligibility Criteria

Financial Requirements
Kansas residents have to meet an asset limit and an income limit in order to be financially eligible for Aged Blind and Disabled (ABD) Medicaid through KanCare (Kansas Medicaid). For a single applicant in 2024, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.

The 2024 income limit for a single applicant is $475/month. Almost all income is counted (IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc.) other than COVID-19 stimulus checks and Holocaust restitution payments.

For married applicants, the 2024 asset limit for KanCare ABD Medicaid is $3,000 combined, and the income limit is $475/month combined. This applies to married couples with both spouses applying or with just one spouse applying.

These are low income limits, but Kansas residents who receive Supplemental Security Income (SSI) can keep all of that income (up to $943/month for a single applicant and up to $1,415/month for married applicants, as of 2024) and still remain eligible for KanCare. Kansas seniors who do receive SSI are automatically eligible for ABD Medicaid.

Plan Ahead: There are alternative pathways to eligibility for ABD Medicaid applicants who are over the asset limit and/or the income limit, such as Medicaid Planning. While Kansas has a Look-Back Period of five years for Nursing Home Medicaid and HCBS Waivers applicants to make sure they don’t give away their assets to get under the limit, the Look-Back Period does not apply to ABD Medicaid applicants. However, ABD applicants should be cautious about giving away their assets. They might eventually need Nursing Home Medicaid, or an HCBS Waiver, and those programs will deny or penalize the applicant for giving away assets.

Functional Requirements
The only functional requirement for basic healthcare coverage through Kansas Aged, Blind, and Disabled (ABD) Medicaid is being aged (65 and over), blind or disabled. For ABD Medicaid applicants who require long-term care services and supports, KanCare will conduct an assessment of their ability to perform the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning and taking medications) to determine what kind of services the applicant needs and the state will cover.

How Kansas Medicaid Treats the Home for Eligibility Purposes

One’s home is often their most valuable asset, and if counted toward Medicaid’s asset limit, it would likely cause them to be over the limit. However, in many situations the home is not counted against the asset limit:

If the applicant lives in their home and the home equity interest (the portion of the home’s equity value that the applicant owns minus any outstanding mortgage/debt) is less than $713,000 (as of 2024) then the home is exempt.
If the applicant’s spouse, minor child, or blind or disabled child of any age lives there, the home is exempt regardless of the applicant’s home equity interest, and regardless of where the applicant lives.
If none of the above-mentioned people live in the home, the home can be exempt if the applicant/beneficiary files an “intent to return” home and the home equity interest is at or below $713,000.

These rules apply to all three types of Medicaid, with one important exception – ABD Medicaid applicants can disregard the home equity limit. Value does not matter regarding their home’s exempt status.

Kansas Medicaid applicants and recipients may also want to consider protecting their home (and other assets) from estate recovery. States are required by law to try and collect reimbursement for long-term care after the death of Medicaid recipients. They do this through their Medicaid Estate Recovery Programs (MERPs). The rules and regulations regarding estate recovery can vary greatly by state, but all states have a MERP. To learn more about the MERP in Kansas and how you can protect your home from it, click here.

Applying For Kansas Medicaid Long Term Care Programs

The first step in applying for KanCare (Kansas Medicaid) Long Term Care coverage is deciding which of the three Medicaid programs discussed above you or your loved one wants to apply for – Nursing Home Medicaid, Home and Community Based Servicez (HCBS) Waivers or Aged, Blind, and Disabled (ABD) Medicaid.

The second step is determining if the applicant meets the financial and functional criteria, also discussed above, for that Long Term Care program. Applying for KanCare when not financially eligible will result in the application, and benefits, being denied.

During the process of determining financial eligibility, it’s important to start gathering documentation that clearly details the financial situation for the KanCare applicant. These documents will be needed for the official Medicaid application. Necessary documents may include tax forms, Social Security benefits letters, deeds to the home, proof of life insurance and quarterly statements for all bank accounts, retirement accounts and investments. For a complete list of documents you might need to submit with your Medicaid Long Term Care application, go to our Medicaid Application Documents Checklist.

After financial eligibility requirements are checked and double checked, documentation is gathered, and functional eligibility is clarified, Kansas residents can apply online for many Medicaid programs at the KanCare Medical Consumer Self-Service Portal. Applicants can also call 800-264-6285 to request a paper application. Completed applications can be mailed to KanCare Clearinghouse, P.O. Box 3599, Topeka, KS 66601.

For step-by-step guides to applying for each of the 3 types of Medicaid Long Term Care, just click on the name: 1) Nursing Home Medicaid 2) HCBS Waivers 3) ABD Medicaid.

Professional Help: Many seniors need support when it comes to Medicaid Long Term Care’s rules, benefits and application process. These are all complicated, constantly changing and vary by state. The best place to get help with Medicaid Long Term Care is through a professional like a Certified Medicaid Planner or an Elder Law Attorney.

Choosing a Kansas Medicaid Nursing Home

After being approved for nursing home coverage through KanCare (Kansas Medicaid), seniors have to choose which Medicaid-accepting nursing home they will live in. Even though KanCare nursing home coverage is an entitlement, not all nursing homes accept Medicaid, and those that do might not have available space. Finding the right nursing home can be challenging, especially if you’re looking in a specific location.

There are approximately 300 nursing homes in Kansas that accept Medicaid, with the majority of them in the eastern half of the state clustered around cities. There are roughly 30 nursing homes on the Kansas side of the Kansas City area, including facilities in Overland Park, Olathe and Shawnee. Move a little further west along I-70 and you’ll find about 25 nursing homes between Topeka and Lawrence. There are 40 nursing homes within 25 miles of Wichita, but the choices thin if you move much further west than that.

Residents in some Kansas communities may cross state lines often for personal and business reasons, including healthcare. But Medicaid coverage does not cross state lines. So, a person with Kansas Medicaid will not be covered in a Kansas City, Missouri, nursing home, even if there is a better or more convenient option on that side of the border.

TOOLS: To find and compare nursing homes, Kansas residents can use Nursing Home Compare, which is a search tool administered by the Centers for Medicare & Medicaid Services (CMS) that has information on more than 15,000 nursing homes across the country. They can also use this Kansas Department for Aging and Disability Services list of facilities to search for a nursing home.

Once you’ve found nursing homes in your area that accept Medicaid, you can start comparing them, if you have multiple options. The search on Nursing Home Compare can be filtered by staffing, health inspections, quality measures and overall rating, which can be a good place to start. The healthcare professionals who work with you can be a great source of information. You can also get more information about Kansas nursing homes from your county’s Area Agency on Aging, which you can find by calling (855) 200-2372.

After doing some research, you or someone you trust should visit any nursing homes you’re considering before making a final decision. Call first to make an appointment for the visit, and arrive with a list of questions, like: Does the residence offer social activities? Does it provide transportation? How does it handle oral and eye care? What is the food like? CMS has a comprehensive “Nursing home checklist” you can use to evaluate a nursing home while visiting.

Data collected from nursing homes across the country by CMS from 2019-2022 shows that Kansas nursing homes are in line with national average when it comes to staffing, health inspections and resident satisfaction, but there is one red flag. Kansas nursing homes averaged 30.3 fire safety deficiencies from 2019-2022, which was more than twice the national average of 13.5. That doesn’t mean all Kansas nursing homes had abnormal fire safety issues, or any issues at all, but it does mean you should do your research and ask questions about fire safety before making a final choice on a Kansas nursing home.