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

Childhood Cancer Lantern
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District of Columbia program

Medicaid that ignores what the parents earn (Katie Beckett)

A Medicaid route for children under 19 with substantial care needs [Katie Beckett]. Parents' earnings and savings do not count.

What it is

A Medicaid route for children under 19 with substantial care needs [Katie Beckett]. Parents' earnings and savings do not count.

Katie Beckett can open Medicaid when parents earn too much for ordinary children's coverage. Your child's care needs must meet an institutional level of care. Home care must be safe and no more costly than institutional care.

Eligibility rules
  • Your child must be under 19.
  • Only your child's own income counts, under $2,982 a month in 2026 on the current webpage; an older leaflet gives a lower figure, so ask DHCF which applies. Parents' income does not count.
  • Your child's own savings must be under about $4,000.
  • Care typically given in a hospital, skilled nursing facility or intermediate care facility, with home care safe and no more costly than an institution.
  • There is no insurance bar: a child may hold other insurance, which is billed first.
  • District of Columbia.
  • 60 calendar days from a complete packet.
What you get
  • Full DC Medicaid, including approved nursing at home.
  • Medicaid alongside private insurance, which is billed first.
If you decide to apply
  1. Ask the oncology social worker for the DHCF Katie Beckett packet.
  2. Ask the clinical team to complete the Pediatric Level of Care form and Care Plan.
  3. Gather your child's own financial information and supporting medical records for the packet.

The Department of Health Care Finance: 202-442-5988 · Official page ↗

The clinical and financial review
  • DHCF publishes a 60-day review standard. Ask when the agency considers your application received and complete, what is missing and the written decision deadline. This is a review standard, not a guarantee of a decision on a particular day.
  • The Katie Beckett worker can confirm in writing whether any premium, copay or other family charge applies, including for a child who is 18.
Good to know

DHCF publishes a 60-day review standard. The agency can confirm the receipt date, missing documents and deadline; a cancer diagnosis alone does not establish the care test.

Federal background: Medicaid that looks at your child’s finances (Katie Beckett).

Official sources
Ask your social worker

“Could our child qualify through Katie Beckett even if our income is too high for ordinary Medicaid? What would the care assessment involve, and could you help us weigh that route?”

Why I’m asking: I want to know whether our child's care needs qualify even if our earnings are 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

Collect the packet, chase the two clinical forms and send everything in one go.

Your social worker

The oncology social worker gathers the records; the team completes the level-of-care form and the care plan.

The care team

The oncologist or nurse practitioner completes the Pediatric Level of Care Determination Form and the Care Plan, describing what the child needs day to day.

Who decides
The Department of Health Care Finance, on a level-of-care determination and the child's own finances.
Ask your social worker
“Our income is over the DC Medicaid line. Can we start a Katie Beckett packet, and can the team complete the pediatric level-of-care form and the care plan this week?”

How to apply

First step: Ask the oncology social worker this week for the Pediatric Level of Care Determination Form and the Care Plan, and call 202-442-5988 for the application.

  1. Ask the oncology team this week for the Pediatric Level of Care Determination Form and the Care Plan.
  2. Send the whole packet together: an incomplete one does not start the 60-day clock.
  3. Ask DHCF on 202-442-5988 which income figure it applies to the child, because its own two sources disagree.

Official application / program page ↗

Where it starts: Send the TEFRA/Katie Beckett application with the Pediatric Level of Care Determination Form, the Care Plan form and the supporting clinical records. DHCF's listed number is 202-442-5988.

What to gather

  • The child's own income and savings, if any
  • Clinical records describing the care the child needs
  • The completed level-of-care form
  • The completed care plan

How long: Sixty calendar days from the day DHCF has the complete packet.

What a yes looks like

A Medicaid card for the child alone, working behind your work plan for what that plan will not cover.

What a no looks like, and the next move

Ask whether the no was on the level of care or on the child's own money, and appeal by the date on the notice. Ask about Spend Down in the same call.

Watch out

  • The 60-day clock starts at a complete packet, not at your first phone call.
  • The child's own income limit is unsettled: DHCF's page and its own brochure say different things. Ask on 202-442-5988 which applies.
  • Your child keeps the work plan. That plan is billed first and Medicaid wraps around it.

If they say no, quote this: DHCF: "Under TEFRA/Katie Beckett, only the child’s income and resources are considered (not those of the parents)."

Dates that change this

2026-09-10: The child's income limit is unsettled: the live DHCF page says less than 300% of SSI, while the March 2025 brochure says below the SSI annual benefit rate. They are far apart and nothing reconciles them, so no figure is printed. Ask DHCF on 202-442-5988 which one it applies. (not yet confirmed against the final rule)

The numbers and the rules

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

What it is worth

Full DC Medicaid decided on the child's own money. Child savings must be below $4,000, and DHCF decides within 60 calendar days of a complete packet.

  • $4,000 — Limit on the child's own countable resources
  • $60 — Decision time from a complete application packet

Covers: Everything DC Medicaid covers, including home nursing hours · Wrap-around behind a private plan for what that plan will not pay

Legal protection: The parents' income and savings are not counted

What it costs the family: No premium or cost share was published for this route; it was searched for and not found. Ask DHCF before assuming there is none.

The eligibility facts, as published

Age
under 19
Age max exclusive
19
Income
Child-owned income only; parental income excluded. Current webpage and December 2019 FAQ say 300% of SSI ($2,982 monthly using 2026 SSI), while March 2025 brochure says annual SSI rate ($994 monthly equivalent). No reconciled controlling current standard or endpoint verified; do not use either for an automatic exclusion.
Resources
Child-owned resources around $4,000; strict versus inclusive endpoint differs between the live page and FAQ. DHCF must confirm exact-boundary treatment and exclusions.
Level of care
Care typically given in a hospital, skilled nursing facility or intermediate care facility, with home care safe and no more costly than an institution
Insurance status condition
none: a child may hold other insurance, which is billed first
Residency
District of Columbia
Processing standard
60 calendar days from a complete packet

Decisions this site cannot make: Pediatric level-of-care determination · Care plan review · Child-only financial determination

Expect friction on: The packet needs the oncology team to write the level-of-care form and the care plan

The trap: The 60-day clock starts when DHCF has the complete packet, not when you first ring. Get the level-of-care form and the care plan from the oncology team before you send anything.

Where I read this

← Back to your options