Cost and Coverage of Medicaid in Kansas

How much does Kansas Medicaid cost? What services are covered by Kansas Medicaid? What types of Medicaid insurance in KS can I apply for? These are common question that most people in Kansas ask.

Below, we provide information about Kansas Medicaid and cover the following:

  • How much does Medicaid cost in Kansas?

  • What services are covered by Medicaid in Kansas?

  • What does Medicaid not cover in Kansas?

  • Types of Medicaid insurance in Kansas

Kansas Medicaid coverage is funded by both the state and Federal government. The program allows eligible patients to get necessary medical services. Applicants eligible for Kansas Medicaid include children and their caretakers, persons who are blind, disabled or over 65 years or age, and pregnant women.

How Much Does Medicaid Cost in Kansas?

How much is Medicaid in Kansas? The Medicaid cost estimates vary from applicant to applicant. The state purchases health services either through a fee-for-service model or a managed care model.

The Medicaid cost estimates in Kansas are quite higher than most states. This is because Kansas is among the 19 states that have not accepted federal funding. The KS Medicaid cost estimates are usually revised from time to time. Confirm with your health care provider to know how much you are likely to pay for a service.

Before looking at what services are covered by KS Medicaid, it’s important to know the programs fall under Medicaid coverage. There are two programs under KanCare, i.e. KanCare19 and KanCare21. KanCare 19 is a medical program meant for children from birth to the age of 19 while KanCare 21 is open to children under the age of 21. The program serves families whose gross household income is above the guidelines of the Medicaid program.

If you have asked “How much is Medicaid in KS?” you have to consider the program that an individual has signed up for. The cost usually depends on the types of Medicaid insurance services covered. So, what Medicaid cost estimates should you expect when signing up for any of the programs? The Kansas Medicaid cost estimates of KanCare 19 and KanCare 21 are determined by income guidelines. Both programs are under KanCare (Medicaid) umbrella. However, to qualify for Title 21, applicants must meet additional requirements.

Some households that qualify for KanCare 21 have to pay premiums. The premiums range from zero to $50 a month. Proration in the two programs is also different.

What Services are Covered by Medicaid in Kansas?

Kansas Medicaid coverage provides the mandatory benefits provided under federal law. Apart from this, the state offers the following benefits:

  • Blood work and lab services, laboratory and x-ray services

  • Family Nurse Practitioner and Certified Pediatric services

  • Dental care for children and some preventive dental care for adults

  • Eye doctor visits and family planning benefits

  • EPSDT: Early and Periodic Screening, Diagnostic, and Treatment Services

  • Federally qualified health center services

  • Home health services, outpatient hospital care and inpatient hospital care

  • Nurse Midwife services and nursing Facility Services

  • Pharmacy and prescription drugs and physician services

  • Tobacco cessation counseling for pregnant women

What Does Medicaid not Cover in Kansas?

What is not covered by Medicaid in Kansas? Many people have this question. KS Medicaid coverage does not apply to all services. Some of the programs not covered include:

  • AIDS Drug Assistance Program (ADAP). This program provides payment for drugs required by patients being treated for AIDS.

  • Medicare Savings Plans. With these programs, Medicare out-of-pocket expenses are refunded. The payments eligible for refunds under the program include co-payments and premiums.

  • Program for All-Inclusive Care for the Elderly (PACE). This program provides long-term care to persons over the age of 55 years living in select Kansas counties. This program is not part of the KanCare network.

  • MediKan. This program is open to people with disabilities that have been approved for General Assistance. The program has limited services.

  • SOBRA. This program supports people who do not meet citizenship requirements. The program covers baby deliveries and life-threatening emergency care costs only.

Types of Medicaid Insurance in Kansas

There are various types of Medicaid insurance in Kansas you can apply for. The various types of KS Medicaid insurance will determine the extent of cover you will be eligible for. Kansas has partnered with three health plan providers, also known as managed care organizations (MCOs), to provide health care for nearly all beneficiaries. The managed care organizations contracted by the state are United Healthcare Community Plan of Kansas (United), Sunflower State Health Plan (Sunflower) and Amerigroup of Kansas, Inc. (Amerigroup).

You can apply for different Medicaid types of insurance in KS. When completing your initial KS Medicaid coverage application, you will have to choose an insurance provider. When approved for a provider, you will have 90 days to choose or change health plans.

When you enroll in a health plan, you will be eligible for cover for one year. At the end of your term, you can change to another health plan. You may want to change your KS Medicaid coverage providers for different reasons. To effect a change, a consumer is required to have a “good cause” reason to change.

Various types of KS Medicaid insurance providers offer various benefits to consumers. It’s important to find out their offerings to know the right one to choose. Some of the extra services offered by the three providers include dental care for members 21 and over, Healthy Reward programs, free cell phones, programs for pregnant women, weight management solutions, stop smoking or cessation programs, extra over the counter (OTC) drugs, and pest control programs.

Some Medicaid types of insurance also provide mental health first aid program, in-home tele-monitoring services, free home safety or other support products, provision of medical escort, if needed, yearly podiatry visits and hypoallergenic beddings for members with allergies



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