What Is KanCare?

Heather Braum | Updated December 13, 2024

KanCare is the state’s managed care health insurance program administering Medicaid and the Children’s Health Insurance Program (CHIP) for more than 440,000 Kansans. KanCare provides health insurance to low-income children, pregnant and postpartum women, and adult parents or caretakers of children; people with disabilities; and certain low-income seniors across the state. Different age, income, and asset limits apply for each of these populations.

Around 6 out of 10 Kansans enrolled in KanCare are under the age of 18.

What Is Medicaid?

Medicaid is the jointly financed federal-state health care program for people with very low incomes who also meet some other eligibility criteria, including age (child or elderly); condition (pregnancy); and/or disability. Each state’s Medicaid program looks different. Some covered services are mandated by Congress, and some are optional.

What Is CHIP?

The Children’s Health Insurance Program (CHIP) covers kids in families with incomes too high to qualify for Medicaid. Like Medicaid, it is jointly funded by states and the federal government, and in Kansas, it is closely aligned with the state’s Medicaid program. Some families in Kansas pay a household monthly premium for CHIP coverage, depending on household income.

How Is KanCare Financed?

KanCare is jointly funded by the federal and state governments, with federal funds covering a majority of the costs. The costs of KanCare fluctuate each year depending on how many people are enrolled and which services are accessed. The federal government sets minimum standards and requirements, yet Kansas has some level of flexibility in determining eligibility and services covered for different populations.

What Is Managed Care?

Managed care is a type of insurance company that contracts with the state Medicaid agency to deliver covered services to those enrolled in KanCare. As of January 1, 2025, three MCOs are contracted for the KanCare program: Healthy Blue, Sunflower Health Plan, and UnitedHealthcare. The state pays the MCOs a fixed amount each month (“capitation payment”) for each person enrolled in the program (“per member per month,” or PMPM), regardless of whether or how much the member uses the MCO’s services that month.

KanCare Eligibility

Right now, parents and caregivers of children can qualify for KanCare if their income is below 38% of the federal poverty level (FPL). That amount varies, depending on household size. For example, if a family of four makes more than $11,856 a year, the adult(s) cannot qualify for KanCare in Kansas.

Pregnant women and low-income children qualify for KanCare at much higher income levels. And people living with disabilities and the elderly have different age and income asset requirements.

KanCare Enrollees and Expenditures

Spending for Kansas kids, parents, and caretakers is low compared to their representation among enrollees. Investing in regular, preventative care during childhood costs much less than lifelong health issues.

 

How KanCare Helps Kansas
	KanCare helps pregnant women stay well, deliver healthy babies, and navigate the year-long postpartum period by covering services like doctor and clinic visits, labor and delivery, prenatal and postpartum care, mental health care, and prescription drugs.
	KanCare helps kids thrive by covering services like well visits, vaccines, screenings, care coordination, diagnoses and treatment, and mental health care.
	KanCare provides coverage to Kansas’ most vulnerable, including health services for children, youth in foster care, and kids with disabilities and complex medical needs.
	KanCare helps the mental and emotional wellbeing of kids and families by covering critical behavioral health services.

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