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

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Maine program

Coverage based on your child’s needs (Katie Beckett)

MaineCare for a child living at home with a disability. Your income does not decide eligibility.

What it is

MaineCare for a child living at home with a disability. Your income does not decide eligibility.

Katie Beckett can help when household income is above ordinary MaineCare limits. It looks at your child’s own income and assets. Two medical reviews decide whether your child qualifies, so a cancer diagnosis alone is not enough.

Eligibility rules
  • Your child must be under 19, live at home in Maine and meet Social Security disability standards.
  • The disability must meet Social Security’s duration rule: expected to last at least 12 months or result in death. The agency, not the diagnosis label alone, makes that determination.
  • For 2026, the controlling Katie Beckett rule allows the child’s countable gross income up to $2,982 a month and requires countable assets below $2,000. Parent income and assets do not determine financial eligibility, but parent income can affect the premium. OFI checks ownership and exclusions rather than treating every account balance as countable.
  • Your child must need a covered institutional level of care: hospital, nursing-facility, psychiatric-hospital or qualifying intermediate-care-facility care. Supervision or a generic group-home placement alone does not establish this test.
  • Annual care costs at home cannot exceed the institutional care your child would need.
What you get
  • Full MaineCare coverage if your child qualifies. A premium depends on parent income.
  • Nursing, personal care and rides when the service rules are met.
What the help includes
  • A monthly premium based on parent income is billed every three months.
  • The monthly family premium depends on parent income and private insurance. At 150%–200% of poverty it is $11 with private insurance or $30 without it. Above 2,500% it is $263 or $750. The guide describes quarterly billing. Tribal exemptions and good-cause rules can matter. OFI confirms the charge below the first listed band and how nonpayment affects current continuous coverage.
  • One premium covers the whole family, however many children are on Katie Beckett, and it is billed every three months.
  • The family premium rises with income: $11 a month with private insurance or $30 without at 150% to 200% of poverty, about $18 or $50 at 300%, about $35 or $100 at 500%, and at most $263 or $750 at the very top. Ask OFI for the figure for your income. (replaces items [1] to [6])
  • 701–800% of poverty: $61 / $175 monthly; 801–900% of poverty: $72 / $205 monthly; 901–1000% of poverty: $84 / $240 monthly; 1001–1200% of poverty: $96 / $275 monthly; 1201–1400% of poverty: $117 / $335 monthly.
  • 1401–1600% of poverty: $138 / $395 monthly; 1601–1800% of poverty: $159 / $455 monthly; 1801–2000% of poverty: $182 / $520 monthly; 2001–2500% of poverty: $207 / $590 monthly; 2501+% of poverty: $263 / $750 monthly.
If you decide to apply
  1. Ask the hospital social worker to help you request Katie Beckett on the MaineCare application.
  2. Complete the disability packet with your oncology team. Include your child’s own income and asset information.

Acentra assessment questions: 1-866-521-0027, option 2 · Official page ↗

After you ask
  • The disability review comes before the separate level-of-care assessment.
  • The oncology team supplies records for both reviews. Medical offices are given 30 days to provide records.
Good to know

The application still asks about your income. It checks easier coverage categories and sets the premium.

Other details
  • OFI checks which assets your child owns and which exclusions apply. A gift account needs that ownership review; a family savings range does not establish your child’s resources.

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

Official sources
Ask your social worker

“Could my child meet Katie Beckett’s disability and care tests? What would the premium and other drawbacks be, and would you help us apply if it fits?”

Why I’m asking: I want to understand whether my child can get MaineCare when 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

File the MaineCare application, name Katie Beckett, and send the Disability Determination packet.

Your social worker

The oncology team writes what the child cannot do and sends records; providers are given 30 days for that.

The care team

The oncology team supplies the medical evidence for both the disability review and the level-of-care assessment.

Who decides
The Office for Family Independence decides, after a medical review of Social Security disability standards and a separate level-of-care assessment.
Ask your social worker
“We are over the income line. Can we apply for Katie Beckett, which counts only my child's own income, and get the disability packet moving?”

How to apply

First step: File the MaineCare application, write Katie Beckett on it, and ask the oncology team for the Disability Determination packet.

  1. File the MaineCare application and name Katie Beckett on it.
  2. Ask the oncology team for the records the Disability Determination packet needs; they have 30 days to send them.
  3. Expect two steps: the disability review first, the level-of-care assessment after.

Official application / program page ↗

Where it starts: File the MaineCare application and add the Disability Determination packet. Call Acentra on 1-866-521-0027, option 2, with questions about the assessment.

What to gather

  • The Disability Determination packet
  • Clinic notes and the diagnosis date
  • What the child cannot do day to day
  • Any account in the child's own name

How long: The state works to 45 days on MaineCare applications and says to expect contact in that time. The wait for the two assessments is not published.

What a yes looks like

Full MaineCare for the child plus a quarterly premium bill set on your income.

What a no looks like, and the next move

Check which of the three tests failed: disability, level of care, or the child's own money. Appeal by the date on the notice.

Watch out

  • You will be asked for your own income. It does not decide eligibility; it sets a premium and checks easier categories first.
  • There are two separate reviews, a disability one and a level-of-care one, and the second only starts after the first.
  • Money in the child's own name counts. A gift account over $2,000 in the child's name is a problem worth raising early.

Dates that change this

2026-03-01: The state guide names the University of Massachusetts for the disability review and Acentra for the level-of-care assessment. Neither contract start date was published, so check the current name when you call. (not yet confirmed against the final rule)

2026-03-01: Monthly family premiums, with private insurance / without private insurance: 150–200% FPL $11/$30; 201–250% FPL $14/$40; 251–300% FPL $18/$50; 301–350% FPL $21/$60; 351–400% FPL $25/$70; 401–450% FPL $30/$85; 451–500% FPL $35/$100; 501–550% FPL $40/$115; 551–600% FPL $46/$130; 601–700% FPL $51/$145; 701–800% FPL $61/$175; 801–900% FPL $72/$205; 901–1000% FPL $84/$240; 1001–1200% FPL $96/$275; 1201–1400% FPL $117/$335; 1401–1600% FPL $138/$395; 1601–1800% FPL $159/$455; 1801–2000% FPL $182/$520; 2001–2500% FPL $207/$590; 2501+% FPL $263/$750. Chart effective January 1, 2020, retained in April 29, 2025 amendment; guide describes quarterly billing. OFI confirms treatment below 150%, exemptions, and current nonpayment rules in light of continuous eligibility.

The numbers and the rules

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

What it is worth

Full MaineCare after clinical and financial review: child countable income up to $2,982 monthly in 2026, countable assets below $2,000, and a family premium.

  • $2,982/month — The child's own monthly income standard
  • $2,000 — The child's own asset limit

Covers: Everything MaineCare covers for a child under 21 · Home nursing and personal care when approved · Rides to appointments

Legal protection: Parents' income and assets are not counted for eligibility

What it costs the family: Monthly family premiums, with private insurance / without private insurance: 150–200% FPL $11/$30; 201–250% FPL $14/$40; 251–300% FPL $18/$50; 301–350% FPL $21/$60; 351–400% FPL $25/$70; 401–450% FPL $30/$85; 451–500% FPL $35/$100; 501–550% FPL $40/$115; 551–600% FPL $46/$130; 601–700% FPL $51/$145; 701–800% FPL $61/$175; 801–900% FPL $72/$205; 901–1000% FPL $84/$240; 1001–1200% FPL $96/$275; 1201–1400% FPL $117/$335; 1401–1600% FPL $138/$395; 1601–1800% FPL $159/$455; 1801–2000% FPL $182/$520; 2001–2500% FPL $207/$590; 2501+% FPL $263/$750. Chart effective January 1, 2020, retained in April 29, 2025 amendment; guide describes quarterly billing. OFI confirms treatment below 150%, exemptions, and current nonpayment rules in light of continuous eligibility.

The eligibility facts, as published

Age
under 19
Age max exclusive
19
Income
Child countable gross income at or below $2,982 monthly in 2026; parents’ income is not an eligibility limit.
Assets
the child's own assets under $2,000
Medical
Social Security disability standards, including expected duration of at least 12 months or death.
Level of care
A covered hospital, nursing-facility, psychiatric-hospital or qualifying intermediate-care-facility level of care, assessed separately from the diagnosis.
Cost test
the cost of care at home must not exceed the annual cost of the institutional care the child would need
Residency
Maine; the child must live at home

Decisions this site cannot make: Medical review of Social Security disability standards · Level-of-care assessment

Expect friction on: Gathering medical records · A premium set on parent income

The trap: Parents' income is still asked for, and that frightens families into thinking it counts. It does not count for eligibility. It is used to check whether the child fits an easier category first, and to set a monthly premium billed every three months. The premium drops if the child has other insurance, unless the state is already paying for that insurance.

Where I read this

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