Medical Bills Details

This page is displayed because you indicated this individual is responsible for this medical bill. This page will repeat for each type of expense selected on the Medical Bills Type Selection page. If this was indicated by mistake, remove the record once you reach the Other Bills Summary page at the completion of this section of the application.

 

If the individual indicated at the top of the page does not make hospital bill payments, click the Previous button to navigate back to the Medical Bill Survey page to adjust the information entered.

Some items have an asterisk (*) next to them, indicating they are mandatory. You must fill in these items before you can continue to the next page.

 

Payment Details

 

When entering the amount the household member pays, only enter two decimal places. Special characters, such as commas, are not allowed.

 

Help with Paying

 

When entering How much do they pay? Only enter two decimal places. Special characters, such as commas, are not allowed.

 

Add Another?

 

To add another medical-related expense, select Yes to the question in this section.

 

Click the Print button to print this page for your reference.

 

If you are applying for SNAP, FITAP, and or KCSP you may click the Complete button to navigate to the end of the application where you can review the rights and responsibilities, sign, and submit the application. Please note that if you are applying for Child Support Enforcement services all required fields must be completed before you can submit your application.

 

Click the Next button to save and continue with the online application.

 

Click the Save & Exit button to exit the online application and save your progress on your application. The application is saved as Incomplete.