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

Childhood Cancer Lantern
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Kentucky program

Medicaid routes based on your child’s care needs

Some Medicaid routes look at your child’s disability and care needs under different financial rules.

What it is

Some Medicaid routes look at your child’s disability and care needs under different financial rules.

A qualifying waiver can use different financial rules from ordinary child Medicaid. The oncology team describes your child’s actual care needs. The benefits office checks the route, finances and access to a place.

Routes to discuss
  • A child admitted to an applicable home and community based waiver can be assessed under its institutional financial rules. The child’s own income and resources still matter. Asking for a place does not itself exclude parents’ income.
  • Home and Community Based uses nursing-facility-level criteria. Model II uses ventilator and permanent-tracheostomy criteria. The waiver team confirms all clinical and age rules for the current program.
  • Michelle P. and Supports for Community Living serve qualifying intellectual or developmental disability. CHILD serves its specified under-21 institutional-care group. A cancer diagnosis alone does not establish any of these tests.
  • The waiver team confirms the exact program, financial rules, start of any parental-income treatment and available funded place. Approved annual capacity is not a count of open places.
What you get
  • An assessment of whether a waiver or hospital-stay rule could open Medicaid.
A hospital stay and financial rules
  • If your child is in hospital for a long stay and qualifies under a disability category, from the month after admission the state can count only your child’s own income, not yours. Ask the hospital benefits specialist to check this before the first month ends.
  • Beginning the following month, the child’s own finances and actual continuing contributions are considered under that rule. MS 1820 does not state a 30-day admission minimum.
  • A long stay alone does not qualify; your child also needs to fit a disability category, which the office checks.
  • Discharge home requires another review of the living arrangement and category. It does not promise either permanent exclusion of parents’ income or automatic loss of all Medicaid.
If you decide to apply
  1. Ask the oncology social worker to help write to the Department for Medicaid Services about the available routes.
  2. Have any income denial and a note describing your child’s daily care needs ready.

Medicaid without counting parents' income: 877-315-0589 · Official page ↗

If you request an assessment
  • The hospital benefits specialist can ask DCBS to name the category, explain whose money counts and calculate the first covered date in writing.
  • The waiver team checks the care-level evidence and access to a place. Existing Medicaid members can also seek medically necessary home services through their present coverage without assuming a waiver wait is required.
Good to know

A waiver can involve a waiting list. A child already on Medicaid can still need a separate home-care assessment.

Questions for the Medicaid office
  • For an at-home Katie Beckett/TEFRA or Family Opportunity Act route, ask DMS for the current approved state-plan provision, if any. The office can explain its age, care-level, financial, cost and application rules.
  • Waiver help: 877-315-0589 for Home and Community Based; 844-784-5614 for Model II and the under-21 route; 502-564-7700 for Michelle P. and Supports for Community Living.
Official sources
Ask your social worker

“Our income is over the child Medicaid line. Is there a way for our child to get Medicaid based on how much care they need or a long hospital stay, and could you help us ask?”

Why I’m asking: I want to know whether another Medicaid route fits our child’s actual care needs.

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

Send one written question and keep the dated reply.

Your social worker

The oncology social worker knows which Kentucky families have got in this way and can send the letter with you.

The care team

If a waiver is in play the team documents the level of care; for leukaemia alone that is rarely reached.

Who decides
The Department for Medicaid Services answers the election question; the waiver teams decide level of care.
Ask the agency
“Does Kentucky have a category that covers a disabled child at home without counting the parents' income? Please answer in writing, and please treat this as a request for a spend-down assessment too.”

How to apply

First step: Write to the Department for Medicaid Services with the question, and ask for a spend-down assessment in the same letter.

  1. Ask the state in writing whether Kentucky has a category that covers a disabled child at home without counting the parents' income.
  2. Ask for a spend-down assessment in the same letter, so the certain route is running while you wait.
  3. If your child is in hospital for a long stay, ask whether the rule that stops counting parents' income after the month of separation applies.

Official application / program page ↗

Where it starts: Put the question in writing to the Department for Medicaid Services and ask the same office for a spend-down assessment. Waiver enquiries go to the numbers above.

What to gather

  • The notice saying the income was too high
  • A short note from the oncology team about the care your child needs at home

How long: Kentucky publishes no clock for this question. The spend-down request travels on the 30-day Medicaid standard.

What a yes looks like

A written answer naming a category, or naming the waiver to apply to.

What a no looks like, and the next move

A written no is still useful: it is the document an appeal starts from, and it settles a question this page could not.

Watch out

  • A waiver's published capacity is not a count of free places. Both big waivers say entry is by application date from a waiting list.
  • Do not let anyone tell you Kentucky definitely has no such category. The document that would prove it either way would not open.

The numbers and the rules

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

What it is worth

No Kentucky category that ignores parents' income for a child at home was verified. The waivers that exist need a level of care leukaemia does not usually reach, and the spend-down is the route that is certain.

  • $17,800/year — Home and community based waiver, approved maximum people a year (not a count of free places)
  • $100/year — Model II waiver, approved maximum people a waiver year
  • $12 — Model II waiver, hours a day of ventilator dependence required

Covers: A written answer from the state about the Katie Beckett question · Waiver help lines: 877-315-0589 for the home and community based waiver, 844-784-5614 for the Model II and under-21 waivers, 502-564-7700 for the Michelle P. and community living waivers

Legal protection: The manual stops counting parents' income after the month a disabled child is separated from the family by an acute-hospital stay

What it costs the family: Nothing to ask.

The eligibility facts, as published

Age
under 19 for the child categories; under 21 for the newer waiver
Income
the point of these routes is that the parents' income is left out; whether Kentucky has such a category for a child at home was not established
Level of care
nursing facility for the home and community based waiver; ventilator and permanent tracheostomy for Model II; intellectual or developmental disability for Michelle P. and community living; psychiatric or intellectual-disability facility for the under-21 waiver
Residency
Kentucky

Decisions this site cannot make: A written answer from the Department for Medicaid Services about the state plan election

Expect friction on: The state plan page that would settle the question returned an error on every attempt

The trap: A waiver's published capacity is not a count of free places. The home and community based waiver's approved application lists 17,800 people a year and its own page says there is a waiting list picked by application date; the Michelle P. waiver page says the same. Do not read a big number as a short wait.

Where I read this

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