Coverage gap: Kansas has not expanded Medicaid. Adults earning below $15,960/year (100% FPL) who don't fit traditional categories may have no affordable coverage option. Those above 100% FPL qualify for marketplace subsidies.
Kansas Medicaid Income Limits 2026
The following table shows the key income thresholds for Kansas in 2026:
| Household Size | 100% FPL | 138% FPL | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,960 | N/A | $63,840 |
| 2 | $21,640 | N/A | $86,560 |
| 3 | $27,320 | N/A | $109,280 |
| 4 | $33,000 | N/A | $132,000 |
| 5 | $38,680 | N/A | $154,720 |
| 6 | $44,360 | N/A | $177,440 |
Because Kansas has not expanded Medicaid, the 138% FPL threshold does not apply for adult eligibility. Adults earning between 0-100% FPL may fall into the coverage gap. Those earning between 100-400% FPL can access marketplace subsidies.
About KanCare
Who Qualifies in Kansas
If you're a Kansas resident trying to understand your healthcare options, it's important to know that Kansas has not expanded its Medicaid program, called KanCare. This means that unlike many other states, most low-income adults without children or a qualifying disability will not be eligible for KanCare, creating a "coverage gap." Currently, KanCare primarily covers children, pregnant women, parents with very low incomes, seniors, and individuals with disabilities. For example, children up to age 1 are covered with family income up to 166% of the Federal Poverty Level (FPL), children ages 1 to 5 up to 149% FPL, and children ages 6 to 18 up to 133% FPL. Pregnant women can qualify with family incomes up to 166% FPL, with coverage extending for 12 months postpartum. Parents with dependent children must have household incomes up to a very low 33% of FPL to be eligible. If you are a childless adult and your income falls below 100% of the FPL, you are likely in the coverage gap and won't qualify for either KanCare or marketplace subsidies.
If You're Near the Income Line
If your income is near the Medicaid cutoff, you might transition to marketplace coverage on HealthCare.gov. For those with incomes above 100% FPL, subsidies become available to help make marketplace plans affordable. For instance, with a benchmark Silver plan costing around $568 per month in Kansas, subsidies can significantly reduce your out-of-pocket premium. It's crucial to report any changes in your income or household size, as this can affect your eligibility for either KanCare or marketplace subsidies. Kansas saw a decrease in Medicaid enrollment in 2024, with 392,500 people covered by Medicaid, a 14.6% drop from its 2023 peak, partly due to the end of continuous enrollment provisions from the pandemic. If you lost coverage during this "unwinding" period, you can reapply at any time if you believe you now meet the eligibility criteria.
What KanCare Covers
KanCare provides comprehensive benefits with little to no cost-sharing for eligible residents. This includes doctor visits, primary care, specialist referrals, hospital stays, emergency care, laboratory tests, prescription medications, and behavioral health services like counseling and substance use disorder treatment. Dental and vision care are also covered, especially for children. Kansas does have income and asset tests for seniors and individuals with disabilities seeking long-term care Medicaid, with individual assets generally needing to be under $2,000. For others, there is generally no asset test for Medicaid eligibility.
Options in the Coverage Gap
If you find yourself in the coverage gap, meaning your income is too high for KanCare but too low for marketplace subsidies (below 100% FPL), there are still practical alternatives in Kansas. Community health centers, often called Federally Qualified Health Centers (FQHCs), offer services on a sliding-scale fee based on your income, and many provide free care for those below the federal poverty guidelines. Examples include Health Partnership Clinic in Johnson County and Hunter Health Clinic in Wichita. Hospitals like North Central Kansas Medical Center and The University of Kansas Health System also offer charity care or financial assistance programs for uninsured or underinsured patients, often with discounts for those at or below 200-300% of the FPL. Additionally, free clinics like JayDoc Free Clinic in Kansas City and Guadalupe Clinic in Wichita provide no-cost medical care to uninsured and low-income individuals. Remember to recheck your eligibility for marketplace subsidies if your income increases above 100% FPL, as financial assistance will then become available to help you afford a plan.
Marketplace Insurance in Kansas
Kansas residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Kansas costs approximately $568/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Kansas might pay for a Silver plan after subsidies, based on the $568/month benchmark:
| Income Level | Annual Income | Your Cost | Monthly Subsidy |
|---|---|---|---|
| 150% FPL | $23,940 | ~$80/mo | $488/mo |
| 200% FPL | $31,920 | ~$173/mo | $395/mo |
| 250% FPL | $39,900 | ~$277/mo | $291/mo |
| 300% FPL | $47,880 | ~$392/mo | $176/mo |
| 400% FPL | $63,840 | ~$523/mo | $45/mo |
These estimates are for a 40-year-old individual on a benchmark Silver plan in Kansas. Actual premiums depend on your age, household size, tobacco use, and plan choice. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays. Kansas uses the federal marketplace at HealthCare.gov.
How to Get Coverage in Kansas
Your path depends on your income:
- Income above $15,960/year (100% FPL): You qualify for marketplace subsidies. Apply through HealthCare.gov during open enrollment (Nov 1 – Jan 15) or after a qualifying life event.
- Income below $15,960/year: Check if you qualify for traditional Medicaid (children, pregnant women, disabled). Apply through KanCare.
- Children: Kansas's CHIP program covers kids in families up to 200-300% FPL regardless of expansion status.
Calculate Your Subsidy in Kansas
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Kansas.
Frequently Asked Questions
What are Kansas's Medicaid eligibility requirements?
Kansas has not expanded Medicaid, so there is no standard income limit for adults. Traditional Medicaid covers specific groups (children, pregnant women, disabled, very low-income parents). Income limits for these groups vary. Children are generally covered up to 200-300% FPL through CHIP.
Has Kansas expanded Medicaid under the ACA?
No, Kansas has not expanded Medicaid. This creates a coverage gap for adults earning below 100% FPL who do not qualify for traditional Medicaid categories.
How do I get help paying for health insurance in Kansas?
Kansas residents with household income between 100% and 400% FPL ($15,960 to $63,840 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through HealthCare.gov.
What is the Kansas Medicaid program called?
Kansas's Medicaid program is known as KanCare. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and certain other qualifying groups.
What happens if I lose Medicaid coverage in Kansas?
If your KanCare coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through HealthCare.gov. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
What are my options if I'm in Kansas's Medicaid coverage gap?
If you're in the coverage gap (earning below $15,960/year but not qualifying for traditional Medicaid), look into community health centers in Kansas that offer sliding-scale fees based on income. Many hospitals have charity care programs for uninsured patients. Free clinics and the 211 helpline can connect you with local resources. If your income changes, reapply — even small income increases could qualify you for marketplace subsidies.
What's stopping Medicaid expansion in Kansas?
Medicaid expansion has been a politically contentious issue in Kansas. The state legislature has not passed expansion legislation, leaving an estimated coverage gap for adults earning below 100% FPL. Advocacy groups continue to push for expansion, and several neighboring states have recently adopted it. Check with Kansas's legislative updates for the latest status.