Updated August 27, 2026. Quick answer: Kansas answers a question most manuals leave open. An expense you paid with a loan or a card is not spent: “This provision includes instances in which the individual has taken out a loan to pay the expense or charged the expense on a credit card.” and “The unpaid portion of the loan or credit card balance attributable to the original medical expense shall be regarded as a due and owing expense which can be applied to spenddown.”
What Kansas requires
| What the state sets out | What it says |
|---|---|
| Kansas’s name for it | spenddown, Medically Needy Program (KFMAM 6512) |
| The test | “Financial eligibility exists if allowable incurred medical expenses, as specified in this section, equal or exceed the spenddown for the base period.” |
| Expenses from outside the base period | Allowable expenses incurred outside of the current eligibility base are only allowable if the individual is still legally obligated to pay the expense and such expenses have not been previously applied to spenddown in any other base period in which the person became eligible. |
| How much of an old expense counts | “The amount of these expenses applied to spenddown within a particular base period shall be the amount due and owing as of the first day of that base period.” |
| Loans and credit cards | “This provision includes instances in which the individual has taken out a loan to pay the expense or charged the expense on a credit card.” |
| What is left owing | “The unpaid portion of the loan or credit card balance attributable to the original medical expense shall be regarded as a due and owing expense which can be applied to spenddown.” |
How it works in practice
- The credit-card provision is genuinely useful and easy to miss. The unpaid balance attributable to the original medical expense is treated as due and owing, so financing a bill does not forfeit it for spenddown purposes.
- The measurement date is the first day of the base period, not the date of service. That is what decides how much of an older bill still counts.
- An expense used once cannot be used again: it is allowable only if it has “not been previously applied to spenddown in any other base period in which the person became eligible”.
The mechanism itself — why an income cap exists and what the trust must contain — is explained on the income-cap and Miller trust page. This page is the record for Kansas.
What this page does not settle
- The spenddown amount is set elsewhere. Section 6512 governs which expenses count against it; the amount itself is established under a different section of the same manual.
- This page reads one source: Kansas Family Medical Assistance Manual (KFMAM) Eligibility Policy, Section 6512. It is the state’s own publication on this rule, but no state puts its whole treatment of excess income in a single document, and a detail that decides your case may sit in one this page did not read.
- A spend-down fixes an income problem and nothing else. The resource test, the level-of-care test and the transfer-of-assets look-back are separate hurdles, each decided on your own file, and meeting this rule does not clear any of them.
- Every quotation here was read against the source on August 27, 2026. States revise these rules, and a figure or a section number can move without the page around it changing. Open the source before you rely on a detail.
Eligibility is decided by the state agency on the whole file, not by one rule on one page. Nothing here is legal advice, and no one should move, retitle or assign income on the strength of a web page.
Sources
The source above was retrieved and read against the state text on August 27, 2026. Every quotation on this page was checked against those bytes.
Spending down to the income limit is only half of what Kansas Medicaid can do for a household that is already providing the care itself, and getting paid as a family caregiver in Kansas names the Kansas program that pays one and answers the family-member and the spouse question separately.
Related: Kansas’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.