1411.1 How to Apply - Applicable to All Programs

Application and Additional Information can be requested from the Clearinghouse or any Outstationed Worker site. An application can be filed in person, by mail, by fax, or electronically online. The following application forms are in use:

KC1500 - E&D Medical Application

KC1100 - Family Medication Application

KC1105 - E&D Supplement to KC1100

NOTE: Online applications are received through the KDHE-DHCF Customer Self-Service Portal (CSSP) .

When an application is requested, the agency shall help the household identify their medical needs and assure that the individual receives the appropriate application. The individual shall be encouraged to file the application the same day – in person, by fax, or electronically online. See 1411.2 below for the application date of an online application. An application shall be mailed to the household the same day the request is received.

If the applicant household is homeless and they have no physical street address to list, the application shall be so noted and accepted by the agency.

For ongoing recipients who have completed an application form and who subsequently request additional assistance and for situations in which an additional program is added to a pending application based on a client's request, the following provisions shall apply:

If the new program is requested within the month following the month of application or in the first month of the new review period, a new application, signature, or interview is not required. The date of application for the new program shall be the date the additional request is first received – either orally or in writing, by the agency.

Reserved

If a request is made for a new medical program on an open medical assistance case within an existing review period, additional information may be requested, but a new application is not required unless the medical program has remained active beyond the review period due to timeliness factors. If the medical program has remained active past the required review period, only submittal of a signed application form will constitute a request for coverage.

Reserved

No new application is required if the agency initiates the new program, such as, adding QMB coverage to an open Medically Needy (MN) case.