Kansas Medicaid (KanCare) Eligibility for Long Term Care: Income & Asset Limits

Last updated: May 30, 2024


Kansas Medicaid Long-Term Care Definition

Medicaid is a health care program for low-income individuals of all ages. While there are varying coverage groups, the focus here is on long-term care Medicaid eligibility for elderly Kansas residents, aged 65 and over. In addition to care services in nursing homes, assisted living facilities, and adult foster care homes, KS Medicaid pays for non-medical services and supports to help frail seniors live in their homes. There are three categories of Medicaid long-term care programs for which Kansas seniors may be eligible.

1) Institutional / Nursing Home Medicaid – An entitlement; anyone who is eligible will receive assistance. Benefits are provided only in nursing home facilities.

2) Medicaid Waivers / Home and Community Based Services (HCBS) – Not an entitlement; there are a limited number of participant slots and waiting lists may exist. Intended to delay the need for nursing home admissions, services are provided at home, adult day care, adult foster care homes, or in assisted living. More on Waivers.

3) Regular Medicaid / Aged Blind and Disabled (ABD) – An entitlement; anyone who meets the requirements will receive benefits. Limited long-term care services, such as personal care assistance or adult day care, may be available.

In Kansas, the Medicaid program is called KanCare. While it is jointly funded by the state and federal government, it is administered by the state under federally set parameters. The Kansas Department of Health and Environment (KDHE) is the administering agency.

  The American Council on Aging now offers a free, quick and easy Medicaid Eligibility Test for seniors.


Income & Asset Limits for Eligibility

The three categories of Medicaid long-term care programs have differing financial and medical (functional) eligibility requirements. Further complicating eligibility is that the financial criteria changes annually, varies with marital status, and that Kansas offers several pathways towards eligibility.

 Simplified Eligibility Criteria: Single Nursing Home Applicant
Kansas seniors must be financially and medically eligible for long-term care Medicaid. In 2024, a single Nursing Home Medicaid applicant must meet the following criteria: 1) Nearly all of one’s income must go towards nursing home costs 2) Assets under $2,000 3) Require a Nursing Home Level of Care.

The table below provides a quick reference to allow seniors to determine if they might be immediately eligible for long-term care from a Kansas Medicaid program. Alternatively, one can take the Medicaid Eligibility Test. IMPORTANT: Not meeting all of the criteria does not mean one is ineligible or cannot become eligible for Medicaid in Kansas. More.

2024 Kansas Medicaid Long-Term Care Eligibility for Seniors
Type of Medicaid Single Married (both spouses applying) Married (one spouse applying)
Income Limit Asset Limit Level of Care Required Income Limit Asset Limit Level of Care Required Income Limit Asset Limit Level of Care Required
Institutional / Nursing Home Medicaid No set income limit*


$2,000 Nursing Home No set income limit*


$3,000 Nursing Home No set income limit*


$2,000 for applicant & $154,140 for non-applicant Nursing Home
Medicaid Waivers / Home and Community Based Services No set income limit† $2,000 Nursing Home No set income limit† $3,000 Nursing Home No set income limit† $2,000 for applicant & $154,140 for non-applicant Nursing Home
Regular Medicaid / Aged Blind and Disabled $475 / month‡ $2,000 Help with ADLs $475 / month‡ $3,000 Help with ADLs $475 / month‡ $3,000 Help with ADLs
*Any income over $62 / month must go towards nursing home costs as a Patient Liability. An exception may exist for paying for private health insurance and potentially a Needs Allowance for a non-applicant spouse.
†Any income over $2,829 / month must go towards care costs. An exception may exist for paying for private health insurance and potentially a Needs Allowance for a non-applicant spouse.
‡While the income limit for Regular Medicaid is quite low, seniors who receive Supplemental Security Income (SSI) payments automatically qualify for Medicaid. In 2024, this pathway to Medicaid eligibility allows a single elderly person up to $943 / month in income, while it allows married couples as much as $1,415 / month in income.


Income Definition & Exceptions

Countable vs. Non-Countable Income
Nearly any income from any source that a Medicaid applicant receives is counted towards Medicaid’s income limit. This includes cash from family and friends, Railroad Retirement benefits, employment wages, alimony payments, pension payments, annuity payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. Nationally, Holocaust restitution payments are not counted as income. Furthermore, in KS, the VA Aid & Attendance Pension, which is above and beyond the Basic VA Pension, does not count as income.

Treatment of Income for a Couple
When just one spouse of a married couple applies for Institutional Medicaid or a Medicaid Waiver, only the income of the applicant is counted. This is often called the “name on the check rule” and means that the income belongs to the person whose name is on the check. Therefore, a non-applicant spouse’s income is disregarded and does not impact the income eligibility of their applicant spouse. The non-applicant spouse, however, may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from their applicant spouse.

The MMMNA is a Spousal Impoverishment Provision and is the minimum amount of monthly income a non-applicant spouse is said to require to avoid spousal impoverishment. In KS, the MMMNA is $2,555 (eff. 7/1/24 – 6/30/25). If a non-applicant’s monthly income falls under $2,555, income can be transferred to them from their applicant spouse, bringing their income up to this level. In Kansas, a non-applicant spouse can further increase their Spousal Income Allowance if their housing and utility costs exceed a “shelter standard” of $766.50 / month (eff. 7/1/24 – 6/30/25). However, in 2024, a Spousal Income Allowance cannot push a non-applicant’s total monthly income over $3,853.50. This is the Maximum Monthly Maintenance Needs Allowance. More on how this allowance is calculated.

Income is counted differently when only one spouse applies for Regular Medicaid / Aged Blind and Disabled; both the income of the applicant spouse and non-applicant spouse is counted towards the income limit. Furthermore, there is no Monthly Maintenance Needs Allowance for a non-applicant spouse. More on how Medicaid counts income.


Asset Definition & Exceptions

Countable vs. Non-Countable Assets
Countable assets, sometimes called liquid assets, are those that can easily be converted to cash to help cover the cost of long-term care. Examples include cash, stocks, bonds, investments, bank accounts (credit union, savings, and checking), pension funds, and real estate in which one does not reside. In Kansas, an applicant’s IRA / 401K is also countable. There are also many assets that are exempt; they are not counted towards the asset limit. Exemptions include personal keepsakes and belongings, household goods and furnishings, one automobile, life insurance policies with a death benefit (also called face value) up to $1,500, burial spaces, irrevocable burial fund agreements up to $11,670 and generally one’s primary home. In KS, a non-applicant spouse’s IRA/ 401K is also exempt.

Treatment of Assets for a Couple
All assets of a married couple are considered jointly owned. This is true regardless of the long-term care Medicaid program for which one is applying and regardless of if one or both spouses are applicants. Spousal Impoverishment Rules, however, permit the non-applicant spouse of a Medicaid nursing home or Waiver applicant a Community Spouse Resource Allowance (CSRA). In 2024, the community spouse (the non-applicant spouse) can retain 50% of the couple’s assets, up to a maximum of $154,140. If the non-applicant’s share of assets is under $30,828, 100% of the assets, up to $30,828 can be retained by the non-applicant. There is no CSRA for a non-applicant spouse of a Regular Medicaid applicant.

Medicaid’s Look-Back Rule
Kansas has a 60 month (5 year) Medicaid Look-Back Period that immediately precedes the date of one’s Nursing Home Medicaid or Medicaid Waiver application. During the “look back”, Medicaid checks all past asset transfers, including asset transfers made by one’s spouse, to ensure no assets were gifted or sold under fair market value. This is done to discourage persons from gifting assets to meet Medicaid’s asset limit. Violating the Look-Back Rule, even unintentionally, results in a Penalty Period of Medicaid ineligibility.

The U.S. Federal Gift Tax Rule does not extend to Medicaid eligibility. In 2024, this rule allows one to gift up to $18,000 per recipient without filing a Gift Tax Return. Gifting under this rule violates Medicaid’s Look-Back Period.

The Look-Back Rule does not apply to Regular Medicaid applicants and their spouses.


Kansas Medicaid Home Exemption Rules

For home exemption, the Medicaid applicant or their spouse must live in the home. If there is no spouse in the home, there is a home equity interest limit of $713,000 (in 2024). Home equity is the value of the home, minus any outstanding debt against it. Equity interest is the amount of home equity owned by the applicant. Furthermore, if there is not a spouse in the home, and the Medicaid applicant does not live there, the applicant must have Intent to Return. For Regular Medicaid, there is no home equity interest limit. Other exemptions exist.

While one’s home is generally exempt from Medicaid’s asset limit, it is not exempt from Medicaid’s Estate Recovery Program. Following a long-term care Medicaid beneficiary’s death, Kansas’ Medicaid agency attempts reimbursement of care costs through whatever estate of the deceased still remains. This is often the home. Without proper planning strategies in place, the home will be used to reimburse Medicaid for providing care rather than going to family as inheritance.


Medical / Functional Need Requirements

An applicant must have a medical need for Medicaid long-term care. For Nursing Home Medicaid and Medicaid Waivers, a Nursing Home Level of Care (NHLOC) is required. Furthermore, additional criteria may need to be met for specific program benefits. As an example, for a Waiver to cover the cost of home modifications, an inability to safely and independently live at home without modifications may be required. For long-term care services via the Regular Medicaid program, a functional need with the Activities of Daily Living (ADLs) is required, but a NHLOC is not necessarily required.


Qualifying When Over the Limits

For Kansas elderly residents (aged 65 and over) who do not meet the financial eligibility requirements above, there are other ways to qualify for long-term care Medicaid.

1) Medically Needy Pathway – Kansas has a Spend Down Program for persons categorically aged, blind or disabled who have income over the Medicaid limit. This program allows persons to become income-eligible for Medicaid services by spending the majority of their income on medical bills. In 2024, the Medically Needy Income Limit (MNIL), called the Protected Income Level in KS, is $475 / month for an individual, as well as a couple. The “spend down” amount is the difference between one’s monthly income and the Protected Income Level. This can be thought of as a deductible and is calculated for a 6 month period. Once one has met their “spend down”, they are income-eligible for Medicaid benefits for the remainder of the period. The Medically Needy Asset Limit is $2,000 for an individual and $3,000 for a couple.

2) Asset Spend Down – Persons who have assets over Medicaid’s limit can “spend down” assets and become asset-eligible. This can be done by spending excess assets on non-countable ones, such as home modifications for safety and accessibility purposes. This includes installing wheelchair ramps, stair lifts, walk-in showers, and the addition of first floor bedrooms. Other ways to “spend down” assets include prepaying funeral and burial expenses and paying off debt. Remember, assets cannot be gifted or sold under fair market value, as doing so violates Medicaid’s Look-Back Rule. It is recommended one keep documentation of how assets were spent as proof this rue was not violated.

 Our Spend Down Calculator can assist persons in determining if they might have a spend down, and if so, provide an estimate of the amount.

3) Medicaid Planning – The majority of persons considering Medicaid are “over-income” and / or “over-asset”, but they still cannot afford their cost of care. For these persons, Medicaid planning exists. By working with a Medicaid Planning Professional, families can employ a variety of strategies to help them become Medicaid-eligible, as well as to protect their home from Medicaid’s Estate Recovery Program. Connect with a Medicaid Planner.


Specific Kansas Medicaid Programs

In addition to nursing home care, KanCare offers three other programs that help nursing home qualified persons live outside of nursing homes.

1) HCBS Frail Elderly (HCBS/FE) Waiver – Supportive services to promote independent living are provided. Benefits may include adult day care, assisted living services, adult foster care services, personal emergency response systems, nursing evaluation visits, and more.

2) Program of All-Inclusive Care for the Elderly (PACE) – The benefits of Medicaid, including long-term care services, and Medicare are combined into one program. Additional benefits, such as dental and eye care, may be available.

3) Money Follows the Person – This federal program helps institutionalized persons who are eligible for Medicaid to transition back home or into the community.


How to Apply for Kansas Medicaid

Elderly Kansas residents can apply for Medicaid online via the KanCare Medical Consumer Self-Service Portal or alternatively, a paper application can be requested by calling KanCare Clearinghouse at 1-800-792-4884. Completed applications can be mailed to KanCare Clearinghouse (P.O. Box 3599, Topeka, KS 66601-9738) or faxed to 1-844-264-6285. Seniors can contact their local Aging and Disability Resource Center (ADRC) for more information or for application assistance. The application process may vary based on the program for which one is applying.

Prior to applying for Kansas Medicaid / KanCare, it is vital that one is confident that the eligibility criteria discussed above are met. Seniors who are over the income and / or asset limit(s), or are unsure if they meet all the requirements, should strongly consider Medicaid Planning. Applying for long-term care Medicaid is frequently a complicated and lengthy process. Familiarizing oneself with general information about the application process can be helpful.

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