KanCare Medicare Savings Program Denial — How to Appeal in 33 Days

A KanCare denial for a Medicare Savings Program doesn't mean your parent is ineligible. It means the Clearinghouse made a determination — and that determination can be wrong. The most common MSP denial reasons are fixable: income miscalculated because the $20 general income disregard was not applied to gross Social Security, a missing document that was actually submitted, or a resource count that included an exempt asset.

The 33-Day Deadline

The request for a state fair hearing must reach the Kansas Office of Administrative Hearings within 33 calendar days from the date printed on the Notice of Action. Not 33 business days — calendar days. If the notice is dated October 1, the deadline is November 3.

This deadline is firm. Miss it, and your parent loses the right to appeal that specific denial. They can reapply, but the appeal window is gone.

How to Request a Fair Hearing

Three ways to file:

1. Written request — mail to the Kansas Office of Administrative Hearings, with a copy to KanCare Clearinghouse. Include your parent's name, case number (on the Notice of Action), the date of the denial, and a sentence explaining why the decision is wrong.
2. Phone — call the KanCare Clearinghouse at 1-800-792-4884 and ask to file a fair hearing request. They record it, but follow up in writing to create a paper trail.
3. Fax — send to 1-844-264-6285 with the same information.

If an adult child is handling case communications with the Clearinghouse, have a signed KC-6100 (Medical Representative Authorization) on file so staff can discuss the case records with them.

Aid Paid Pending

If your parent was already receiving MSP benefits and the denial is a termination (not a first-time denial), submit the hearing request before the effective date of the action or within 15 calendar days of the notice date, whichever is later, to continue benefits while the appeal is pending. This timing rule is separate from the 33-day appeal deadline.

For first-time applications that were denied, aid paid pending doesn't apply because there was no prior benefit to continue.

Common Denial Reasons and How to Fight Them

Income over the limit: Check whether the Clearinghouse used gross Social Security correctly. They should use the gross entitlement from the SSA-1099 or benefit verification letter, then subtract the $20 general income disregard. If they counted gross benefits without applying the $20 disregard, countable income is too high under Kansas rules.

Resources over the limit: Look at what was counted. The primary home, one vehicle, household goods, and burial plots are all excluded. A joint bank account with an adult child may have been counted in full — if so, prepare documentation showing the child's independent deposits and that the account is shared for convenience.

Missing verification: If the Clearinghouse says documents weren't received, check your records. Fax confirmations, mailing receipts, or online portal upload timestamps can prove submission. If documents were genuinely never sent, you can submit them at the hearing.

What Happens at the Hearing

The hearing is conducted by an Administrative Law Judge from the Kansas Office of Administrative Hearings. It can be held by phone. You'll present your side, the Clearinghouse presents theirs, and the judge issues a written decision.

Kansas Legal Services (1-800-723-6953) provides free legal representation for MSP fair hearings if your parent is income-eligible. An attorney can make a significant difference — they know which KFMAM policy provisions to cite and how to frame income and resource calculations.

For a complete timeline planner, notice response tracker, and hearing preparation checklist, see the Kansas Medicare Savings Programs & Extra Help Guide.

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