Resource Information

KanCare Ombudsman Resources

Note: To accommodate people with disabilities, auxiliary aides, services and modifications to policies will be provided on request. Please call Robert Stevens, KanCare Ombudsman Specialist, at 785-296-1492 or 711 (Relay) to make request at least five working days prior to training session.
KanCare Programs and Fact Sheets
  1. KDHE Fact Sheets - Investigate KanCare/Medicaid programs and eligibility for each.
  2. KanCare Ombudsman General Information Fact Sheets  - General Medicaid related topics
  3. Home and Community Based Service (HCBS) Waiver Programs
  4. Grievances, Appeals and Fair Hearings
  5. Client Obligation-Patient Liability Calculation Fact Sheet 2022
  6. KanCare Ombudsman Brochure
  7. PACE Brochure and Service Map
KanCare Applications and Assistance
  1. Children and Families Applications (scroll to bottom of web page)
  2. Elderly and Disabled Applications (scroll to bottom of web page)
  3. Medicare Savings Program Application (scroll to bottom of web page)
  4. Application Assistance Guide Jan 2022 - Where to Find Help with Medicaid Applications
  5. Application Assistance Folder

General Health and Disability Resources

  1. Who Should I Call - Consumers & Helpful Numbers: Information sheet with important KanCare and related agency contact numbers. English  Spanish
  2. Who Should I Call Providers: Information sheet with important KanCare and related contact information for Providers
  3. Assistance for people who are Uninsured August 2021 : Medical, Prescription, Vision and Dental -- Clinics in Kansas that take low income patients based on eligibility and a sliding scale. It also includes pharmacy assistance.
  4. Marketplace. Enroll with the Marketplace. Find help from a Navigator.  www.getcoveredkansas.org. NEW coverage information!   
  5. KCDC Disability Services Maps 2021
  6. Directory of Mental Health Resources in Kansas, September 2021
  7. 2022 Federal Poverty Guidelines
  8. Cultural Awareness and Trauma Informed Care Training
  9. Accessibility Guidelines for Word and PowerPoint
  10. How to make Accessible Videos
  11. State ADA Coordinator and Grievance Process

Additional Resources

Forms

  1. Authorization for Release of Protected Health Information: for an individual to get release of information for organizations, providers, or a class of persons (like a targeted case manager or care coordinator). The person or organization listed on line 1 and/or line 2 does not act on behalf of the member. The person or organization listed on line 1 and/or line 2 cannot request services for the beneficiary.                                                                                                                           

  2. Medical Representative Form: for persons on Medicaid to authorize (allow) another person to help them with medical calls, paperwork, turn in your renewal each year, use your medical card for you, etc. If the person assisting is a DPOA or Guardian, the do not need to complete the Medical Representative form in order to act on behalf of the individual. The Financial DPOA paperwork or Guardianship paperwork must be provided to the KanCare Clearinghouse.  English   Spanish

  3. Facilitator Authorization Form:  A facilitator is a person who can help fill out an application and help with the application process.  Eligibility people will be able to share information with this person.  This person will get copies of letters sent to the applicant about the application.  After the application is processed, the facilitator is not connected to your case.  A facilitator can be someone such as a relative, neighbor, friend, medical office staff, or community organization employee. English    Spanish

  4. Authorized Representative Designation Form for Grievances, Appeals and Fair Hearings
    Authorized Representative Designation Form for Grievances, Appeals and Fair Hearings Large Print

  5. Submitting a Change to KanCare Clearinghouse Form:  It is important to provide current income, address and household composition changes to the KanCare Clearinghouse while eligible for KanCare. English    Spanish