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

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Federal, exists in every state

Medicaid without parents’ income (Katie Beckett option)

New Hampshire’s Home Care for Children With Severe Disabilities can cover a child without counting parents’ income.

What it is

New Hampshire’s Home Care for Children With Severe Disabilities can cover a child without counting parents’ income.

This route can help when parents’ income is over the ordinary Medicaid line. Your child must need an institutional level of care while living at home. The state checks the child’s own finances and compares home-care costs with institutional care.

Eligibility rules
  • Your child must be under 19 and need hospital, psychiatric-hospital, nursing-facility or intermediate-care-facility care.
  • Parents’ income is left out, but the child’s own income and resources still matter. DHHS must confirm the current child-only limits, income calculation and excluded accounts or property. A broad family-savings answer does not decide this test.
  • Estimated home-care costs cannot exceed the Medicaid cost of the appropriate institutional care.
What you get
  • Full NH Medicaid when your child meets the program’s rules.
What coverage includes
  • This is New Hampshire’s section 1902(e)(3) option; its state card explains the application.
If you decide to apply
  1. Ask NH DHHS or the hospital enrollment specialist for Home Care for Children With Severe Disabilities.
  2. Ask the oncology team to describe your child’s daily care, and bring your child’s income and savings records.

NH DHHS, 1-844-275-3447 · Official page ↗

After you apply
  • The social worker can ask NH DHHS for the current Home Care for Children With Severe Disabilities application and the joint medical review team’s assessment instructions. The treating team supplies the clinical certification and home-care plan. DHHS must confirm the current processing estimate, any premium and whether anything beyond the eligibility review affects when coverage can start; a different waiver’s waiting list does not answer that question.
Good to know

Parents’ income is left out, but your child’s own money still counts.

Official sources
Ask your social worker

“Could our child’s daily care qualify for Home Care for Children With Severe Disabilities, and what would applying involve?”

Why I’m asking: I want to know whether our child can get Medicaid without our income blocking it.

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.

  1. Get the state packet this week.
  2. Have the clinician describe every daily task and what happens without it.
  3. 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

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