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If your child or dependent needs urgent services or medications, you should call your pediatrician or family medical provider immediately. Your pediatrician or provider may be able to help you get temporary Medicaid coverage through a process called “Presumptive Eligibility.”

If your pediatrician or medical provider does not offer this, you can speak with a Cover Kansas navigator for free or find an organization in your area that specializes in Presumptive Eligibility services.

What is Presumptive Eligibility?

Presumptive Eligibility is a process that allows qualified entities to determine if a person can receive short-term Medicaid coverage. It provides people with temporary Medicaid coverage while KanCare processes their application for Medicaid.

A qualified entity can assist people with the process of submitting a Medicaid application. During the application process, the qualified entity can help you understand and submit requested documents to KanCare. Qualified entities include many hospitals, clinics, health departments, schools, and community organizations such as local libraries.

Who Can Get Presumptive Eligibility?

Typically, the list includes children, low-income parents & caretakers, former foster care adults, women with breast or cervical cancer, and pregnant women who do not currently have Medicaid. You must be a U.S. citizen or qualified legal immigrant, a resident of Kansas, and meet specific income guidelines.

How Fast Can I Get Approved?

When meeting with a qualified entity, you will be asked questions to help identify the type of health benefits you and your dependents might qualify for. This typically includes questions about how many people live with you and the total income everyone in your household makes in a year. Based on the information you provide, a Presumptive Eligibility decision will be made immediately, and you can instantly start receiving medical services that are covered by Medicaid!

How Do I Find a Qualified Entity?

In Kansas, there are hundreds of qualified entities that can help you figure out what your next steps should be for securing short-term Medicaid coverage while you are waiting for KanCare to process your Medicaid or CHIP application.

Speak with a Cover Kansas Navigator for FREE, or download the PDF of qualified entities to find a service provider in your area.

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This service is provided by Cover Kansas and the Kansas Chapter of the Academy of Pediatrics. The mission of the Kansas Chapter of the American Academy of Pediatrics is the attainment by all infants, children, adolescents, and young adults of their full potential for physical, mental, emotional, and social health. Together with those who share this purpose, the Kansas Chapter pledges its efforts and expertise to a fundamental goal that all children and youth have the opportunity to grow up safe and strong, with faith in the future and in themselves.