Kansas Medicaid coverage helps pay the costs for medically necessary services. The types of Medicaid insurance available in KS are intended primarily for low-income families and applicants who have incomes less than the federal poverty line. It is important for all applicants to understand how much does Medicaid cost since they will be responsible for their share of costs. Likewise knowing what services are covered by Medicaid and what does Medicaid not cover can help prevent unexpected costs. Finding answers to basic questions about Medicaid coverage can help families prepare for what to anticipate after approval. For instance, knowing the services covered by Medicaid, such as ambulatory services or physician visits, can make a difference in many emergency situations. Kansas Medicaid cost estimates remain low cost since it is a state and federal funded program. Even if there are copayments, deductibles and premiums involved, Medicaid coverage is one of the most affordable medical insurance programs in the country. Each state differs in terms of the services covered by Medicaid, so it is important for all Kansas Medicaid applicants to understand what to expect in advance. To find out more about Medicaid coverages, including the services Medicaid does not cover in Kansas, continue reviewing the outlined information below.
What services are covered by Medicaid in Kansas?
Kansas has a few different types of Medicaid insurance options available for approved applicants. Each Medicaid insurance type can contain different Medicaid coverages, or different services covered by the program. However, all Medicaid insurance must cover the federally mandated services. Kansas can elect to have option benefits covered by Medicaid as well. It is important for applicants to know the types of services covered by Medicaid in Kansas so that they can avoid unnecessary surprises should they arise. Medicaid covered services in Kansas include but are not limited to:
- Doctor’s office visits and hospital services
- Transportation to medical appointments
- Vaccines and immunizations
- Nursing facility and behavioral health services
- Blood work and laboratory services
- Prescription drugs
- Weight loss surgery
Some covered services will depend on the Medicaid eligibility and age of the participant. For instance, Medicaid will cover dental care for children but only preventative dental care for adults. Likewise, heart and lung transplants are available for adults.
For comprehensive details about Medicaid covered services, download our free guide.
What services are not covered by Medicaid in Kansas?
Understanding the services Medicaid does not cover in Kansas is equally as important as learning the services covered by Medicaid. The variety of Medicaid insurance options can also provide different services available. More often than not, Medicaid coverage in Kansas does not include services that are not deemed medically necessary by a medical professional. This includes services elected by the patient. For instance, Medicaid will not cover services involving cosmetic services or surgeries since the majority of these cosmetic procedures are by choice rather than necessity. More services Medicaid will not cover in Kansas include but are not limited to:
- Experimental services and treatments
- Private nursing duties
- Medical equipment not prescribed
- Infertility diagnosis and treatment
Medicaid coverage oftentimes has very specific requirements surrounding the services deemed covered. For example, dental visits for adults are services covered by Medicaid, but this is not all inclusive. Dental care for adults approved for Medicaid include a visit every six months or two cleanings a year. Medicaid for children will cover hearing aids, but will not cover hearing aids for adults. It is important to understand that while it may seem Medicaid does not cover a service, there may be exceptions that need approval on a case-by-case basis.
Another way to determine if a service is covered by Medicaid is to find out if the doctor is a Medicaid provider. Anyone outside of the Medicaid network will not be covered. This also includes health services provided by relatives or friends.
How much does Medicaid cost in Kansas?
Medicaid cost estimates in Kansas can vary due to a few different factors. Most applicants incorrectly assume that all Medicaid coverage is without cost. However, different types of Medicaid insurance can carry different costs. For instance, copayments and monthly premiums still play a huge role in accessing Medicaid coverage. While inexpensive, families and applicants in certain income categories may need to pay more than others do. Monthly premiums can range for applying families depending on the Medicaid income limits for the number of household members.
Applicants wondering, “How much is Medicaid in Kansas?” will receive an exact answer until they are approved into the program. Even then, Medicaid cost estimates can differ for a magnitude of reasons such as the number of services rendered. Medicaid coverage costs always remain as low as possible, since the bulk of the cost for Medicaid is covered on a federal and state level. Copayments usually remain minimal. The costs for Medicaid tend to become higher only when a service is not covered by Medicaid. Applicants should stay on top of their Medicaid costs that are not covered by the program, as a medical provider can refuse treatment if the cost differences are not paid or cannot be paid.
Download our comprehensive guide for details on the Medicaid program.