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As a Medicare beneficiary, the state where you live can have a significant impact on the care that you receive and how you pay for that care during your golden years. This page explains how Kansas’s regulations and policies may help you pay for Medicare and discusses potential Medicaid coverage for long-term care needs.
Many Medicare beneficiaries are eligible for help paying for coverage through a Medicare Savings Program (MSP). MSPs helps eligible Kansans pay for Medicare Part B premiums, Medicare Part A and B cost-sharing, and – in some cases – Part A premiums.
MSP asset limits: Kansas uses the federal asset limit for QMB, SLMB and QI, which is $7,860 if single and $11,800 if married. The asset limit for QDWI is $4,000 if living alone and $6,000 if living with others.
Medicare covers many services, but can leave enrollees with significant out-of-pocket costs (i.e., deductibles, co-pays, and coinsurance). Original Medicare also does not cover important services like vision and dental benefits, although Medicare Advantage plans sometimes do offer this coverage.
[mro_survey align ="right"]Some beneficiaries – those whose incomes make them eligible for Medicaid – can receive coverage for Medicare cost sharing and additional services covered by Medicaid if they’re enrolled in Medicaid for the aged, blind and disabled (ABD).
In Kansas, Medicaid ABD covers “some preventable dental care” for adults. Medicaid ABD may also cover eye exams and eyeglasses. More extensive vision coverage is usually available only to enrollees with medical conditions impacting the eye.
Income eligibility: The income limit is $475 a month for both single and married applicants.*
Asset limits: The asset limit is $2,000 if single and $3,000 if married.
*The income limit for Medicaid for the aged, blind and disabled in Kansas is very low. However, Supplemental Security Income (SSI) enrollees receive full Medicaid benefits in Kansas, which effectively increases Medicaid’s income limit to the SSI eligibility level.
In 2020, individuals who are 65 or older, blind or disabled can qualify for SSI with incomes up to $783 a month for individuals and $1,175 a month for spouses. The SSI program provides cash payments to enrollees with few resources. Most enrollees receive a monthly payment equal to the SSI income limit.
SSI has the same asset limits – $2,000 for singles and $3,000 for spouses – as Medicaid ABD in Kansas.
Medicare beneficiaries who are enrolled in Medicaid, an MSP, or SSI also receive Extra Help – a federal program that lowers prescription costs under Medicare Part D. Enrollees who don’t automatically receive this program can apply for it themselves. The income limit is $1,615 a month for singles and $2,175 a month for couples, and the asset limit is $14,610 for individuals and $29,160 for spouses.
Medicare beneficiaries increasingly rely on long-term services and supports (LTSS) – or long-term care – which is mostly not covered by Medicare. Twenty percent of Medicare beneficiaries who were living at home received some assistance with LTSS in 2015, and even more seniors will need these services as the population ages.
Medicaid fills this gap in Medicare coverage for long-term care, but its complex eligibility rules can make qualifying for benefits difficult. What’s more – eligibility rules vary significantly from state to state.
Medicaid long-term care applicants must undergo a level of care assessment.
Most seniors used to receive long-term care in nursing homes. Today, many receive these services in their homes. But some seniors have medical or living situations that make nursing home care a better choice.
Income limits: There is no income limit for nursing home benefits in Kansas, but nursing home residents must pay all their income above $62 a month toward their care.
Assets limits: The asset limit is $2,000 if single and $3,000 if married and both spouses are applying. If only one spouse needs Medicaid, the other spouse can keep up to $128,640. (Note that certain assets like a car and many household furnishings do not count against this limit.)
Medicaid programs that cover long-term care in the community are called Home and Community Based Services (HCBS) waivers. Enrollees continue living in the community, rather than entering a nursing home.
Income limits: There is no income limit for HCBS services in Kansas, but enrollees pay all their income above $1,157 a month toward their care. When both spouses receive HCBS, income $2,304 a month is paid toward that care.
Asset limits: The asset limit is $2,000 if single and $3,000 if married (and both spouses are applying). If only one spouse needs Medicaid, the other spouse can keep up to $128,640.
Spousal impoverishment rules enable the spouse (the “community spouse”) not receiving Medicaid LTSS to afford living expenses and home maintenance costs.
In Kansas in 2020, these spousal impoverishment rules allow community spouses to keep:
Federal law requires states to limit eligibility for Medicaid nursing home and HCBS to applicants with a home equity interest below a specific dollar amount. In 2020, states set this home equity level based on a federal minimum of $595,000 and maximum of $893,000.
Kansas uses the most restrictive home equity limit allowed – meaning that applicants for nursing home care or HCBS must have less than $595,000 in home equity.
Because long-term care is expensive, individuals sometimes have an incentive to give away or transfer assets to others to become eligible for Medicaid LTSS benefits. As deterrent, states — in accordance with federal law — have a penalty period during which Medicaid will not pay for nursing home care for applicants who have transferred assets. States can also have a penalty period for HCBS.
Kansas chooses to have an asset transfer penalty for nursing home care and HCBS. This penalty is based on a 60 month lookback period where asset transfers and gifts are prohibited. The penalty’s length is determined by dividing the amount of money transferred or given away by the monthly cost of nursing home care.
State Medicaid agencies are required to attempt to “claw back” what they paid for long-term care related costs for enrollees who were 55 or older. State have the option of going further – and recovering the cost of all other Medicaid benefits.
Kansas has chosen to pursue estate recovery against for all Medicaid benefits received beginning at age 55. The state also recovers from the estates of younger enrollees who were permanently institutionalized.
When a deceased beneficiary’s Medicaid coverage was administered by an insurer, the state will attempt to recover what it paid that insurer. That amount could differ the actual cost of the Medicaid services received.
Kansas will not pursue estate recovery if an enrollee is survived by children who are under 21, blind or disabled. The state will delay its estate recovery for enrollees who are survived by their spouse, and will file its claim against the spouse’s estate after their death.
Congress exempted Medicare premiums and cost sharing from Medicaid estate recovery starting with benefits paid after December 31, 2009, but Medicaid will attempt to recover MSP benefits paid through that date.
Free volunteer Medicare counseling is available by contacting Senior Health Insurance Counseling for Kansas (SHICK) at 1-800-860-5260. This is the State’s Health Insurance Assistance Program (SHIP). Visit the SHICK website for information about the services it offers.
Elder law attorneys can help individuals explore Medicaid long-term care benefits. You can use the National Academy of Elder Law Attorneys (NAELA) search feature to find an elder attorney locally.
Medicare beneficiaries in Kansas can also receive assistance from one of the state’s Aging and Disability Resource Centers (ADRCs). These centers can provide information and counseling about services that help with aging or living with a disability. You can contact the Kansas ADRC call center at 855-200-ADRC (2372).
This website has more information about ADRC services in Kansas.
Medicaid is administered by the Kansas Department of Health and the Environment. You can request an application for Medicaid ABD or an MSP by calling call 800-792-4884. This website contains more information about applying for Medicaid in Kansas.
Josh Schultz has a strong background in Medicare and the Affordable Care Act. He coordinated a Medicare technical assistance contract at the Medicare Rights Center in New York City, where he represented clients in extensive Medicare claims and appeals. In addition to advocacy work, Josh helped implement health insurance exchanges at the technology firm hCentive. He has also held consulting roles, including at Sachs Policy Group, where he worked with hospital, insurer and technology clients.
