Federal, exists in every state
Medicaid that looks at your child’s finances (Katie Beckett)
DC’s Katie Beckett route can cover a child under 19 with substantial care needs, regardless of parents’ income.
What it is
DC’s Katie Beckett route can cover a child under 19 with substantial care needs, regardless of parents’ income.
Katie Beckett looks at your child’s own income and savings. Your child must need care usually given in an institution, while care at home is safe and no more costly. A cancer diagnosis alone does not settle that test.
Eligibility rules
- Your child must be under 19 and live in DC. DHCF must confirm the resource exclusions and whether exactly $4,000 meets its rule.
- Only your child’s own income is assessed. DHCF’s webpage and older FAQ use 300% of SSI, equivalent to $2,982 monthly in 2026. The March 2025 brochure instead refers to one annual SSI benefit, equivalent to $994 monthly. Those official statements conflict. Ask DHCF for the controlling monthly limit and effective rule; neither comparison establishes that your child is ineligible. Parents’ income does not count.
- Your child must need hospital, skilled-nursing or intermediate-care-facility care. Care at home must be safe and no more costly.
What you get
- Full DC Medicaid, which can sit behind a work plan.
Other insurance
- Other insurance pays first when your child keeps a work plan.
If you decide to apply
- Ask the hospital social worker for the DC Katie Beckett packet.
- Ask the clinical team to complete the Pediatric Level of Care form and Care Plan. Include supporting records.
Department of Health Care Finance, 202-442-5988 · Official page ↗
Decision timing
- 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.
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.
Official sources
- DHCF — Tax Equity and Fiscal Responsibility Act (TEFRA)/Katie Beckett
- DHCF — What is the Katie Beckett Eligibility Pathway to Medicaid?
- DHCF — Katie Beckett Level of Care Determination Form
- DHCF — Katie Beckett Care Plan
- DHCF — Types of Long Term Care Services
- Official source reviewed September 17, 2026 (A Q10)
- Official source reviewed September 17, 2026 (A Q10)
- Official source reviewed September 17, 2026 (A Q10)
- Official source reviewed September 17, 2026 (A Q10)
- Official source reviewed September 17, 2026 (A Q14)
- Official source reviewed September 17, 2026 (A Q21)
“Could Katie Beckett help our child, what are the benefits and drawbacks, and could you help us decide whether to complete the packet?”
Why I’m asking: We want to compare the care test and our child’s own finances with this route.
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 the application paperwork this week, gather the child's own account balances, and get it filed within two weeks with fresh signatures.
Your social worker
Gets the application paperwork, sends the level-of-care form to the right clinician, and checks the signatures are current when it goes in.
The care team
Writes the level-of-care description: every daily task, how often, and what happens without it.
- Who decides
- The state Medicaid agency's disability review
- Ask your social worker
- “Can you help me apply for Katie Beckett (TEFRA)? Who on the team writes the level-of-care application paperwork, and how soon can it go in?”
How to apply
First step: Ask the social worker for the state's Katie Beckett application paperwork this week and who on the team writes the level-of-care section.
- Get the state packet this week.
- Have the clinician describe every daily task and what happens without it.
- File in the first two weeks. Coverage reaches back to the application month.
Where it starts: State TEFRA/Katie Beckett application
What to gather
- Pathology report and oncologist's letter with diagnosis and relapse dates
- The doctor's and nurse's description of daily skilled care (line care, medicines, monitoring)
- The child's own accounts (the child's money is tested, usually at $2,000)
How long: Up to 90 days by federal rule for a disability application. File in the first two weeks so coverage reaches back to the application month.
What a yes looks like
Medicaid on the child's own record, no premium in most states, with a level-of-care end date on the letter.
What a no looks like, and the next move
“Level of care not met”: the doctor's description of daily care decides it. Ask what was missing, add the log, and appeal within the notice's period.
Watch out
- Not every state has it. TEFRA states: AK, DC, DE, GA, ID, LA, ME, MA, MI, MN, MS, NE, NV, NH, OK, RI, SC, SD, WV, WI. Texas and California use other options. The state item explains.
- The application paperwork expires: signatures usually have to be recent when it reaches the reviewer. Do not let it sit at the clinic.
- A child on maintenance can be re-reviewed at the next level-of-care date. Ask when that date is.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 7, 2026.
What it is worth
Full Medicaid on the child's own record, usually with no premium, regardless of parents' income.
Covers: Full state Medicaid benefits · EPSDT home nursing and equipment once enrolled
Legal protection: The test is disjunctive: hospital, nursing facility or ICF level of care. Any one suffices
What it costs the family: No premium in most states. Nevada charges by income.
The eligibility facts, as published
- State option required
- yes
- Child at home
- yes
- Parental income
- not counted
- Child resource limit
- usually $2,000
- Level of care
- hospital, nursing facility or ICF/IID; any one
- Disability
- SSI medical standard where applicable: documented acute leukemia meets listing 113.06A for at least 24 months from diagnosis or relapse, or at least 12 months after transplant, whichever is later; the agency still verifies evidence
Decisions this site cannot make: Disability · Institutional level of care · Cost-effectiveness (some states)
Expect friction on: Detailed medical packet with recent signatures · Re-review at the level-of-care date
The trap: The level-of-care test is separate from the disability test: the child must need the care of a hospital, a nursing facility, or an intermediate-care facility, any one of them. The doctor's description of daily care decides it, not the diagnosis.
What changes by state: Whether it exists, the name (Georgia calls it the Deeming Waiver), the premium (none in most. Nevada charges), the level-of-care form and how long a letter is valid.
Where I read this
- Medicaid Program — Centers for Medicare & Medicaid Services, read August 27, 2026
- Full List of Medicaid Waivers and Programs — Kids’ Waivers, read August 27, 2026
- 42 CFR 435.912: Timely determination of eligibility — Cornell LII (eCFR mirror), read September 7, 2026