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Frequently Asked Questions

Long-Term Care and Institutional Services

What are the specific long-term care and institutional services offered?

Nursing Home
This category of coverage is for persons residing in a nursing home or similar facility for a long term stay. Based on income level, some individuals are responsible for a portion of the cost of their care in the facility.

HCBS (Home and Community Based Services)
This program is for persons who have a medical need for services in the community which can keep them out of an institution. There are currently 7 different HCBS programs, each with a different set of rules. Based on income level, some individuals are responsible for a portion of the cost of their care.

PACE (Program of All-Inclusive Care for the Elderly)
This program is for disabled persons (age 55 years or older) and persons age 65 or older residing in selected counties within the state.

Sedgwick

Shawnee

Douglas

Jackson

Jefferson

Osage

Pottawatomie

Wabaunsee

Individuals receive long term care coverage through a managed care network. HCBS guidelines apply to individuals living in the community and institutional guidelines apply to those living in a facility. Based on income level, some individuals are responsible for a portion of the cost of their care.

WORK (Work Opportunities Reward Kansans)
This program is for disabled or blind persons between the ages of 16 to 64 who are working. It will provide personal care and other services to help people stay employed. Based on income level, some individuals are responsible for a portion of the cost of their care.

Other Institutional Care
Coverage for other types of Institutional Care is also available. For example:

State Hospitals

Psychiatric Residential Treatment Facilities

Swing Bed Hospitals

Head Injury/Rehabilitation Facilities

Intermediate Care Facilities for People with intellectual Disablities/Mental Retardation

Persons seeking payment for coverage in one of these facilities will need to meet level of care requirements. Based on income level, some individuals are responsible for a portion of the cost of their care.

Status of applications and coverage

What am I eligible for?

You can use our self-assessment to see what you might be eligible for. To begin the self-assessment process, click here . We will not be able to give you a final answer until after you apply. If you wish to bypass the self-assessment and apply now, click here to begin your application process.

How long will this take?

The self-assessment takes only a few minutes. It will take you about 15 minutes if you want to fill out the online application.

What will I need to provide?

Once you have completed your application and hit "submit," a list of possibly needed items will appear.

When will I hear from someone?

Within a few days you may be asked to send documents. The sooner you can provide these, the sooner a decision can be made. If you have not heard from us within 45 days please call us. Phone numbers are listed on the link "Contact Information". This link is on the left hand side of the page.

How long will it be before my application is processed?

Applications should not take longer than 45 days to process. In most cases you should hear from us much sooner than that.

How do I find out the status of my application?

You can use the link on the home page that reads 'Check the status of my application'. This link will not be visible until you sign in. If you have not heard from us within 45 days please call us. Phone numbers are listed on the link " Contact Information ". This link is on the left hand side of the page.

My application was denied and I think an error was made. How do I get this fixed?

In many cases if you contact us and let us know that you feel an error was made, we can review the processing of your application. If any errors are found, they will be corrected. You can also file an appeal. Appeals must be made in writing and sent to:

Office of Administrative Hearings
1020 S. Kansas Ave.
Topeka, KS 66612.

The fax number is 785-296-4848.

Elderly and Disabled

If I am age 65 or older what can I qualify for?

If you are on Medicare, you may qualify for help to pay your Medicare premium. If you need nursing home care, you may qualify for Medicaid to help pay for it. We also have a program of in-home care called Home and Community Based Services (HCBS). This may help you remain in your home. Click on " Program Information " to read more about these programs.

What benefits do I get if I am disabled?

If you are not yet age 65, your disability must be determined by Social Security rules. If you are getting Social Security Disability benefits, this was already done. You may qualify for Medicaid if your income is within certain limits. You may also qualify for Home and Community Based Services (HCBS). This program may provide some in-home help to you. If you receive Medicare, you may also qualify for help with your premiums. Click on " Program Information "to read more about this.

What is the difference between Medicare and Medicaid?

While Medicaid and Medicare sound similar, they are in fact very different programs. One of the biggest differences is Medicaid is a state governed program and Medicare is a federal governed program. Here are some other differences:
Medicaid is for low income:

Pregnant women

Children under the age of 19

People 65 and over

People who are blind

People who are disabled

People who need nursing home care

Application for Medicaid is made at the State's Medicaid agency.

Medicare is for:

People 65 and over

People of any age who have kidney failure or long term kidney disease

People who are permanently disabled and cannot work

Medicare is applied for at the local Social Security office.
Some people qualify for both Medicaid and Medicare. Medicaid is sometimes used to help pay for Medicare premiums.People who qualify for both programs are called 'dual eligible'.

Documents, Notices, and Messages

I received a notice in the mail but I don't understand it, who can I talk to about it?

The notice will have a phone number that you can call. Phone numbers and address are also listed on the link " Contact Information ". This link is on the left hand side of the page.

I received a notice in the mail saying I have to send in documents and I need help understanding what documents I can send, who can help me?

The notice will have a phone number that you can call. Phone numbers and address are also listed on the link " Contact Information ". This link is on the left hand side of the page.

I received a notice in the mail saying I have to send in documents but I'm not sure how to send them.

If you are logged in to the Customer Self-Service Portal you can upload documents there. Click the "Maximize" button on the Message Center. Select "Compose". On the right hand side of that window will be the option to Add Attachments. Click here to go there now.

You can also check the notice you received for a fax number or address to send them to. Phone numbers and address are also listed on the link "Contact Information". This link is on the left hand side of the page.

I received an email or text that said I had a message but it didn't say anything else?

The email or text message we sent is only to alert you that a new message has been sent to the message center. You need to be signed on to see your messages, they can be read here.

How do I view my notices?

Click on the 'View notices' link in the Access my benefits section of the home page. The link is only visible if you are signed in. Notices from the last 14 months are available.

Viewing information about your case

I created an account but can't get any information about my case?

If you already had a case with us when you created your account on the portal you will need to take one more step to link the two together. On the left hand side of the page, look for the link 'Request Case Access'. Once you click on that link follow the instructions on screen. The linking is currently a manual process and may take some time to be processed.

Can I see the documents I've sent in?

We are not able to show you the documents you have sent us. We are only able to show you a list of the documents we have received. To see the list click the link 'View my documents' in the Access my benefits section of the home page. The link is only visible if you are signed in.

How do I view my notices?

Click on the 'View notices' link in the Access my benefits section of the home page. The link is only visible if you are signed in. Notices from the last 14 months are available.

Why can't I see any information about my food assistance, or TANF case?

This site can only provide you to information about your low or no-cost health insurance. Programs that are handled by the Department for Children and Families (DCF) like food assistance or TANF can be viewed at their self-service portal. Please note that a link is always available to their site in the column to the left of the page. Click here to go there now.

Changes to your current coverage, income, or family

How do I report a change?

Changes can be reported in the Self-Service Portal. You must be logged in to report a change to your case. Click here to report your change. You may also report changes over the phone or submit a change in writing to your local office. To see contact information for your local office, click here.

I got married. Will this affect my current coverage?

Getting married does not affect current coverage for many of our programs, although changes may occur at your next review. If your coverage is through a program for the elderly or disabled current coverage might be affected, but we would have to look at your individual case to know.
Everyone with an open case should report this change to us.

Can my new husband or wife receive coverage?

In some cases, yes they can. You will need to contact us and make a request to add your spouse to your case. You may be asked to provide verification of citizenship, identity, and income.

I just had a baby. Can they be added to my current coverage?

In most cases, yes they can. You will need to contact us and make a request to add your baby to your case. You may be asked to provide verification of citizenship, identity, and income.

A child who was not listed on my application is now living with me. Can they be added to my current coverage?

In most cases, yes they can. You will need to contact us and make a request to add your child to your case. You may be asked to provide verification of citizenship, identity, and income.

Can my premiums be reduced?

In some cases premiums can be reduced or even removed. Events such as the loss of a job or the birth of a child can change how your premium is calculated. If you feel that your circumstances have changed since you applied (or since your last review), then you should contact us for more information.

I lost my job. Can I be covered now?

In some cases, yes you can. If you were the sole source of income for your household and you have no other source of income, then it is likely that you could receive coverage. If you contact us and request coverage for yourself, a new determination can be made to see if you are eligible for coverage.

I found a job. Will I or my children lose our coverage?

Getting a job does not affect current coverage for many of our programs, although changes may occur at your next review. If you coverage is through a program for the elderly or disabled current coverage might be affected but we would have to look at your individual case to know. Changes should be reported within 10 days of the change.

I'm pregnant. Can I be covered now?

Income guidelines are higher for pregnant women, than for other non-pregnant adults. In order to be considered for coverage you will need to contact us and request coverage.

I've gotten health insurance through my job. Does this mean I, or my children, will lose coverage?

Health Insurance through an employer will not cause you, or your children, to lose your current coverage. You do need to let us know about this change. Your insurance through your job will become your primary insurance. Changes do sometimes happen at the review.

Technical Support

On-line Help doesn't work.

To see on-line help, you may need to change the pop-up blocker settings on your computer. In some cases this may be as simple as clicking on a bar near the top of this page that displays a message similar to "a pop-up was blocked, click here to allow pop-ups." If you don't see a bar like this you may need to edit the internet settings for your browser under the tools menu. Many browsers have a help option that will show you step-by-step instructions.

How do I upload documents?

If you are logged in to the Customer Self-Service Portal you can upload documents there. Click the "Maximize" button on the Message Center. Select "Compose". On the right hand side of that window will be the option to Add Attachments. Click here to go there now.

How do I see my messages?

You need to log into the Customer Self-Service Portal. Once you have done that, click the "Maximize" button on the Message Center. This will be located on the upper left hand part of your screen.

What do I do if I forgot my user ID and/or password?

Below the area where you would type in your password is a link reading 'Forgot Password'. This will always be located at the top right hand side of the page. In some cases it may also be located in the center of your screen. Once you click on the words 'Forgot Password' just follow the on-screen instructions. If you need additional help you can call 1-877-782-7358.

What do I do if I forgot my user name?

You will need to call 1-877-782-7358.

How Do I Open an E-mail Account?

Having an e-mail address has become a necessity in our society. You need to have an e-mail address if you want to create an account for this site. You also need e-mail for using some public library services, purchasing online, and contacting prospective employers. There are many free e-mail services for you to choose from. Your chosen free email service should offer plenty of storage, effective spam filtering, a fast and productive interface, desktop e-mail program as well as mobile access, and more. Each of the services has different strengths and weaknesses. You may find that one serves your needs better than another. In all cases, print out a copy of your information (including password, exactly as entered) and keep it securely with you.

To find free e-mail services, search for "free e-mail" using your computer's Web browser. In addition, your local public library can help you set up an e-mail account.

Facilitators and Representatives

What is the difference between a facilitator and a representative?

A facilitator is someone who has very limited access to your case information. They may be able to help you with your application, check on the status of your application, and find out if you are currently receiving coverage.
A representative on the other hand has more access to your case and may in fact be able to make requests for coverage on your behalf and sign your application for you.
In order for anyone to be designated as either a representative or facilitator, the proper releases and forms must be completed and copies provided to us.

What is a role?

A role is used on this site to indicate if you are looking at your own case, if you a looking at a case on which you are the facilitator, or if you are looking at a case on which you are a representative. In each of these roles, the information that can be seen, and the options you can see, will differ.

How do I change roles?

There is a drop-down selection box in the upper right hand corner of the screen, above the sign on box, for all of the cases you are associated with. When you select a case from that list you will automatically assume the role that you are assigned on that case. If you are only associated with one case, you will not see the drop-down selection box.

Why do I see different information and different options on some cases than I do on others?

Each role has access to different information and different options. You may have been assigned different roles on some cases than others. Please see the FAQ above about the difference between facilitators and representatives, and the FAQ on roles.

How do I change my own information?

You will need to choose your own case from the drop-down selector in the upper right hand corner above the sign in box and choose 'Report a change to my case'.

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