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To fill out this form, begin by gathering the required information related to your case. Ensure that all sections are completed thoroughly, especially the signature and date fields. Double-check for accuracy before submission.

How to fill out the KanCare Renewals and Discontinuances FAQs?
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Gather all required personal and case information.
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Complete each section of the form accurately.
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Sign and date the form in the provided spaces.
4
Review the form for any missed information or errors.
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Who needs the KanCare Renewals and Discontinuances FAQs?
1
Individuals renewing their KanCare benefits seek guidance on the process.
2
Guardians or conservators submitting for applicants require specific instructions.
3
KanCare members whose coverage ended need to understand their reinstatement options.
4
Users needing to edit their renewal form benefit from clear editing instructions.
5
New applicants looking for information on eligibility requirements find this file essential.
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What are the instructions for submitting this form?
To submit your KanCare renewal form, please send it to the KanCare Clearinghouse by mail or fax. The preferred mailing address is KanCare Clearinghouse, PO Box 3599, Topeka, KS 66601-3599. Alternatively, you can fax your renewal to 1-844-264-6285. Make sure your form is signed and dated before submission.
What are the important dates for this form in 2024 and 2025?
Deadlines for KanCare renewals occur on the 15th of every month. Ensure your renewal form is submitted to avoid any lapse in coverage. Mark your calendar for annual renewal periods to stay on top of your eligibility.

What is the purpose of this form?
The purpose of this form is to facilitate the renewal process for KanCare members. It serves as a comprehensive guide for users to understand what is required for successful submission. Additionally, it outlines the actions to take if a renewal is submitted late or if there are issues with eligibility.

Tell me about this form and its components and fields line-by-line.

- 1. Name: The full legal name of the applicant.
- 2. Date of Birth: The applicant's date of birth.
- 3. Address: The current residential address of the applicant.
- 4. Signature: Space for the primary applicant's signature.
- 5. Date Signed: The date the form is signed.
What happens if I fail to submit this form?
Failing to submit this form by the due date can result in automatic closure of your KanCare coverage. You may experience a gap in healthcare coverage until your renewal is processed. It is critical to ensure timely submission to maintain eligibility.
- Loss of Coverage: Failure to submit can lead to loss of health benefits.
- Processing Delays: Late submissions may cause significant delays in processing.
- Ineligibility Risks: Not submitting on time could risk being deemed ineligible for further assistance.
How do I know when to use this form?

- 1. Annual Renewal: To renew your KanCare benefits on an annual basis.
- 2. Change in Household: When there are changes in your household that impact eligibility.
- 3. Reinstatement Requests: To request reinstatement if your coverage was closed inadvertently.
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