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

Childhood Cancer Lantern
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Delaware program

Medicaid without counting parents’ income (Children’s Community Alternative Disability Program)

Medicaid for a child with substantial disability-related care needs, without counting parents’ income or savings.

What it is

Medicaid for a child with substantial disability-related care needs, without counting parents’ income or savings.

This route can help when parents earn too much for ordinary child Medicaid. The Medical Review Team checks the child’s level of care. A cancer diagnosis alone does not establish that level.

Eligibility rules
  • The approved state-plan group is for children under 19.
  • Hospital-level care requires at least daily physician intervention and access to professional nursing around the clock. An institutional level of care is an alternative.
  • Beyond the care level, the team checks disability, that care at home is safe, and that it costs no more than institutional care.
What you get
  • Full Medicaid coverage when your child meets the financial, disability, care, home-safety and cost rules.
  • Parents’ income, parents’ savings and other insurance do not block this disability route.
What the help includes
  • Both ordinary CCADP and the separate at-risk demonstration test the child’s finances. In 2026, the published monthly income limit is $2,485 and the resource limit is $2,000. Parents’ income and resources are excluded. Central Intake identifies the appropriate route.
  • The ordinary route is Delaware’s TEFRA/Katie Beckett option under section 1902(e)(3) and 42 CFR 435.225.
  • There is also an "at-risk" route for a child who does not yet need institutional-level care but is close to it; Central Intake decides which route to assess.
If you decide to apply
  1. Ask Central Intake about the Children’s Community Alternative Disability Program.
  2. Ask the oncology social worker to complete the Primary Caregiver Assessment for the Medical Review Team.
  3. Have the treatment plan, a description of daily care, your child’s Social Security number and child-owned account details ready.

Central Intake · 1-866-940-8963 · Official page ↗

What happens next
  • Central Intake takes the referral. The Medical Review Team decides the care level.
  • The team’s written decision can help you understand which daily-care evidence mattered.
  • Disability-based Medicaid decisions ordinarily have a 90-day standard, with limited exceptions. Central Intake confirms the assessment appointment, any separate at-risk application and the child’s financial tests. The team explains approved services and any remaining costs before you rely on the result.
Good to know

Parents’ income and savings do not count, but your child’s own income and savings do. The team also checks disability, care needs, safe care at home and costs.

Other details
  • The oncologist’s description of physician contact, nursing needs, lines, medicines and care time supports the review.

Federal background: Medicaid without counting parents’ income (Katie Beckett).

Official sources
Ask your social worker

“Could our child’s daily care needs qualify for Medicaid without counting our income? What are the benefits and drawbacks, and could you help with the assessment if it is worth pursuing?”

Why I’m asking: I want the care team’s assessment to guide this decision, rather than assuming a diagnosis qualifies.

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

Call Central Intake, ask for the programme by name, and gather the treatment record.

Your social worker

The oncology social worker fills in the Primary Caregiver Assessment and sends it to the Medical Review Team.

The care team

The oncologist describes the daily care: physician contact, nursing needs, lines, medicines and how much of the day care takes.

Who decides
Central Intake takes the referral; the Medical Review Team decides the level of care.
Ask your social worker
“We are over the ordinary Medicaid line. Can you start the Children’s Community Alternative Disability Program and fill in the caregiver assessment for the Medical Review Team?”

How to apply

First step: Call the Division of Medicaid and Medical Assistance Central Intake Unit on 1-866-940-8963 and ask for the Children’s Community Alternative Disability Program.

  1. Call Central Intake on 1-866-940-8963 and name the programme.
  2. Ask the oncology social worker to complete the Primary Caregiver Assessment while your child is at the hardest point of treatment.
  3. Ask the oncologist to write what the daily care looks like: nursing, lines, medicines, monitoring, who does it and for how long each day.

Official application / program page ↗

Where it starts: Call Central Intake and ask for the Children’s Community Alternative Disability Program. Your social worker sends the Primary Caregiver Assessment to the Medical Review Team.

What to gather

  • The diagnosis letter and the treatment plan
  • A written description of the daily care at home
  • Your child’s Social Security number and any accounts in their name

How long: The disability-based decision standard is ordinarily 90 days with limited exceptions. Central Intake confirms the assessment appointment and operational steps.

What a yes looks like

A Medicaid card for your child alone, with a health plan to choose. Parental income is not on the notice.

What a no looks like, and the next move

The written notice identifies the financial, disability, care, home-safety or cost test not met and the available review route.

Watch out

  • The old belief that Delaware has no Katie Beckett option is wrong; the current federal approval lists it. Ask for the programme by name.
  • The test is the level of daily care, not the word leukemia. Apply while the care is at its heaviest and have the oncologist describe a day.
  • Ordinary CCADP and the separate at-risk route both have child financial tests. Central Intake confirms which care assessment applies; the at-risk route does not automatically include every DSHP Plus home-care service.

If they say no, quote this: The state manual: "In general, any child whose disability profile meets a designated level of care may be eligible for Medicaid without regard to parental income, resources, or other health insurance."

Dates that change this

2024-07-01: The approved federal document describes the demonstration’s at-risk route once as "children under age 18" and once as "children, ages 18 or younger". How age 18 is treated is unresolved; ask Central Intake if your child is 18.

2014-08-05: The caregiver assessment the state links is the August 5, 2014 edition; no newer form was found on September 10, 2026. Ask the social worker whether a newer version exists before filling it in.

The numbers and the rules

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

What it is worth

Ordinary CCADP excludes parents’ income and resources but tests the child’s own income and resources: published 2026 limits are $2,485 monthly and $2,000. Disability, level-of-care, safe-home-care and cost rules also apply.

  • $2,485/month — Child monthly income limit for ordinary CCADP and the at-risk route in 2026 (250% of the SSI standard)
  • $2,000 — Child resource limit for ordinary CCADP and the at-risk route
  • $19 — Age ceiling in the approved state plan group

Covers: Hospital and clinic care · Chemotherapy and prescriptions · Private duty nursing and personal care at home once approved · Rides to appointments

Legal protection: Parental income, parental savings and other health insurance are left out of the eligibility decision

What it costs the family: Central Intake confirms any premium, family cost or uncovered service. Child copay protections do not guarantee approval of every requested home-care service.

The eligibility facts, as published

Age
under 19 in the approved state plan group
Age max exclusive
19
Income
Parents’ income and resources are excluded. Ordinary CCADP tests the child’s own countable income up to 250% of SSI ($2,485 monthly in 2026) and resources up to $2,000. Disability, level-of-care, safe-home-care and cost criteria also apply.
Level of care
hospital level of care means at least daily physician intervention and the availability of around-the-clock professional nursing care; an institutional level of care is the alternative
Statute
42 CFR 435.225; section 1902(e)(3) of the Social Security Act
Processing standard
Disability-based Medicaid decisions ordinarily have a 90-day standard with permitted exceptions. Central Intake confirms assessment timing, any family cost and the ordinary or separate at-risk route.

Decisions this site cannot make: Medical Review Team decision on the level of care, from the Primary Caregiver Assessment the social worker sends in

Expect friction on: The level-of-care test is about daily care, not the diagnosis; a child in ordinary maintenance may not meet it

The trap: Families are told Delaware has no Katie Beckett programme. The current approved federal document lists "TEFRA Children (Katie Beckett)" among Delaware’s state plan groups. Ask for the Children’s Community Alternative Disability Program by name at Central Intake.

Where I read this

← Back to your options