Written by a parent, not a doctor. Nothing here is medical advice.

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Alaska program

Medicaid that leaves out parents' income (Disabled Children at Home)

Alaska Medicaid for a disabled child living at home. This route leaves out parents' income and savings.

What it is

Alaska Medicaid for a disabled child living at home. This route leaves out parents' income and savings.

High household income does not close every Medicaid route. Disabled Children at Home can cover a child who needs an institutional level of care at home. The state must approve both the disability and the care needs.

Eligibility rules
  • Your child must live in Alaska, be found disabled and meet the required level of care.
  • The financial review uses your child's own income and resources, not the parents'.
  • Under 7 AAC 100.424, the care test includes hospital, long-term-care, intermediate-care-facility or inpatient-psychiatric care. It is not limited to skilled nursing.
  • Disabled Children at Home is for a child under 19 who meets Social Security’s disability rules and lives with a parent or legal guardian. Alaska also applies institutional financial and care tests and must approve a suitable care plan and cost comparison. The child’s countable resources have a $2,000 individual standard. Public Assistance confirms the child-income calculation; family wages are not the test.
What you get
  • Full Alaska Medicaid if your child qualifies.
  • Parents’ earnings and savings are left out of this financial test.
  • Access to separate reviews for home nursing and travel help.
What the help includes
  • Approved coverage includes the same core hospital care, chemotherapy and medicines as other Alaska Medicaid coverage.
  • Home nursing, personal care and travel still have their own approval requirements.
  • Disabled Children at Home is a Medicaid eligibility route, separate from the working-disabled buy-in. Public Assistance confirms any premium or lawful family charge for this exact category. The counselor can also check the child’s ordinary Medicaid billing protections.
If you decide to apply
  1. Talk with the hospital social worker about whether Disabled Children at Home is worth assessing. If you decide to pursue it, ask for the category by name through Public Assistance.
  2. If you decide to proceed, have the oncology team describe the care your child needs through the day and night. Gather medical records and accounts in your child’s name.

Alaska Division of Public Assistance, with a disability and level-of-care assessment — 800-478-7778 · Official page ↗

After you ask
  • The Division of Public Assistance handles the financial decision, with a separate disability and care-level assessment.
  • A refusal letter should distinguish financial, disability and care-level reasons. Its appeal deadline governs a challenge.
  • If you decide to pursue this route, the social worker can obtain the current disability and care-assessment packet from Public Assistance. The medical team describes your child’s needs and proposed home plan. The application-notice standard is up to 90 days when disability must be decided; a notice can request information. The office confirms the complete forms checklist, assessment status and expected wait.
  • Alaska Medicaid generally requires a written fair-hearing request within 30 days of the notice date, with a good-cause route for late requests. The ordinary final-decision standard is 90 days after receipt. For an existing service being cut, the social worker can help request continued care before the effective cut date. Continuation or reinstatement has conditions, and Medicaid may seek repayment if its decision is upheld. The clinical team can support urgent review; the hearing office confirms the applicable expedited process.
Good to know

A cancer diagnosis does not settle the care-level test. The counselor can compare ordinary coverage and Disabled Children at Home without waiting for one route to be refused.

Other details
  • Elsewhere this route is often called TEFRA or Katie Beckett. Alaska calls it Disabled Children at Home.
  • Relevant Alaska rules: 7 AAC 100.424 (Disabled Children at Home), 7 AAC 100.018 (application notice), and 7 AAC 49.030, .180 and .190 (hearings).

Federal background: A Medicaid option you may hear called Katie Beckett.

Official sources
Ask your social worker

“Could the Medicaid route that leaves out our income fit our child's care needs? What would the assessment and any costs involve, and would you help us ask if it makes sense?”

Why I’m asking: I want to understand whether our child's care needs open Medicaid even if our household income is too high.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for it by name and hand over the medical records and the care team's letter.

Your social worker

The hospital social worker gathers the records and chases the assessment.

The care team

The oncology team writes what the child cannot do and what care is needed at home.

Who decides
The Division of Public Assistance decides the money side; an assessor decides the level of care.
Ask your social worker
“We are over the income line. Can we ask for Disabled Children at Home in this same application, and can you help with the level-of-care letter?”

How to apply

First step: Write to the Division of Public Assistance asking for Disabled Children at Home in the same application, and ask the oncology team for a letter about care at home.

  1. Ask for Disabled Children at Home by name in the same application, in writing.
  2. Ask the oncology team for a letter describing the care your child needs at home, day and night.
  3. Disabled Children at Home is for a child under 19. The controlling rule allows acute hospital, long-term-care, intermediate-care-facility or qualifying inpatient psychiatric care. Public Assistance confirms current child-income rules, forms and any lawful premium; the $2,000 individual resource standard also applies.

Official application / program page ↗

Where it starts: Ask for Disabled Children at Home by name in the Medicaid application, on Alaska Connect or by phone.

What to gather

  • The oncology team's letter about care at home, day and night
  • Medical records since diagnosis
  • Any account in the child's own name

How long: The disability-related application notice is due within 90 days, but can request missing information. Public Assistance confirms the assessment packet and current wait; this is not a promised assessment appointment.

What a yes looks like

An Alaska Medicaid card for your child with the parents' income left out of it.

What a no looks like, and the next move

Read whether the no was about disability, the level of care, or the child's own money, and appeal by the date on the letter.

Watch out

  • Ask for it by name. A refusal on ordinary income is not a refusal of this category.
  • Disabled Children at Home is for a child under 19. The controlling rule allows acute hospital, long-term-care, intermediate-care-facility or qualifying inpatient psychiatric care. Public Assistance confirms current child-income rules, forms and any lawful premium; the $2,000 individual resource standard also applies.
  • Public Assistance confirms the child-income calculation, current assessment packet and any lawful premium. The individual resource standard is $2,000. A disability-related application notice is due within 90 days, but that is not a guaranteed assessment appointment or measured wait.

Dates that change this

2026-09-11: The controlling rule, 7 AAC 100.424, uses broader institutional care settings than the handbook glossary. It requires a child under 19, disability, the child’s own financial eligibility, an approved care plan and a cost comparison.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Full Alaska Medicaid for a disabled child at home, decided on the child's own income and resources rather than the parents'.

Covers: Everything ordinary Alaska Medicaid covers, including chemotherapy, medicines and hospital care · The door to private duty nursing and personal care at home · The door to Alaska Medicaid travel for care out of town or out of state

Legal protection: Parents' income and savings are left out of the decision

What it costs the family: unknown: whether Alaska charges a premium or cost share for this category was NOT FOUND.

The eligibility facts, as published

Age
under 19
Income
The child’s own finances are tested, not parents’ income or savings. The individual countable-resource standard is $2,000; Public Assistance confirms the current category-specific income calculation.
Level of care
Under 7 AAC 100.424: acute hospital, long-term care, intermediate care for intellectual disability or qualifying inpatient psychiatric care; an approved care plan and cost comparison also apply.
Residency
Alaska; the child lives with a parent or legal guardian
Disability
the child must be found disabled

Decisions this site cannot make: Disability decision · Assessment under 7 AAC 100.424 of the applicable institutional level of care, approved plan and cost comparison

Expect friction on: Public Assistance confirms the child-income calculation, current assessment packet and any lawful premium. The individual resource standard is $2,000. A disability-related application notice is due within 90 days, but that is not a guaranteed assessment appointment or measured wait.

The trap: Ask for it by name, in the same application. The office will not offer it because the ordinary income test failed.

Where I read this

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