Kan. Admin. Regs. § 129-6-72 - Medicaid determined eligibles; poverty-level children
(a) Each applicant or recipient shall meet
the general eligibility requirements of K.A.R. 129-6-50 and the specific
eligibility requirements in this regulation.
(b) For infants, each eligible infant shall
be under one year of age. Medical assistance under this regulation shall
continue according to either of the following:
(1) Through the month in which the child
reaches the age of one; or
(2) if
receiving inpatient services in the month in which the child reaches the age of
one, according to the earlier of the following:
(A) Through the calendar month in which the
inpatient care ends; or
(B) through
the calendar month following the month in which the inpatient care begins. If
the inpatient care will exceed this time period, eligibility for the child
under this regulation shall end on the last day of the calendar month in which
the child reaches the age of one.
(c) For young children, each eligible child
shall be at least one year of age, but no older than five years of age. Medical
assistance under this regulation shall continue according to either of the
following:
(1) Through the month in which the
child reaches the age of six; or
(2) if receiving inpatient services in the
month in which the child reaches the age of six, according to the earlier of
the following:
(A) Through the calendar month
in which the inpatient care ends; or
(B) through the calendar month following the
month in which the inpatient care begins. If the inpatient care will exceed
this time period, eligibility for the child under this regulation shall end on
the last day of the calendar month in which the child reaches the age of
six.
(d) For
older children, each eligible child shall be at least six years of age but
under the age of 19. A child who meets the poverty income guidelines of K.A.R.
129-6-103(a)(6) shall not currently be covered under a "group health plan" or
under "health insurance coverage" as defined in 42 U.S.C. 300gg-91. The child
shall not be considered covered if the child does not have reasonable
geographic access to care under that plan or coverage. Reasonable geographic
access to care shall mean that the child routinely does not have to travel more
than 50 miles to reach providers participating in the plan or coverage. Medical
assistance under this regulation shall continue according to any of the
following:
(1) Through the month in which the
child reaches the age of 19; or
(2)
if receiving inpatient services in the month in which the child reaches the age
of 19, according to the earlier of the following:
(A) Through the calendar month in which the
inpatient care ends; or
(B) through
the calendar month following the month in which the inpatient care begins. If
the inpatient care will exceed this time period, eligibility for the child
under this regulation shall end on the last day of the calendar month in which
the child reaches the age of 19; or
(3) through the calendar month the child who
meets the poverty-level income guidelines of K.A.R. 129-6-103(a)(6) becomes
covered under a group health plan or under health insurance coverage in
accordance with this subsection.
(e) A percentage of the federal poverty-level
income guidelines as established in K.A.R. 129-6-103(a)(4) for infants, K.A.R.
129-6-103(a)(5) for young children, and K.A.R. 129-6-103(a)(6) for older
children shall be used as the income standard for the number of persons in the
assistance plan in accordance with K.A.R. 129-6-41. The total applicable income
to be considered in the eligibility base period shall be compared against the
poverty level for the base period. To be eligible under this regulation, the
total applicable income shall not exceed the poverty level established for the
base period.
Notes
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