Federal, exists in every state
A Medicaid option you may hear called Katie Beckett
A name used for Medicaid routes that can leave out parents' income for children with substantial care needs.
What it is
A name used for Medicaid routes that can leave out parents' income for children with substantial care needs.
New Jersey does not offer the Katie Beckett option; a child with heavy care needs is assessed for pediatric MLTSS, which the enrollment specialist can explain. There is nothing to apply for under this name here.
Eligibility rules
- From birth through age 20, MLTSS requires the state’s pediatric clinical test. It includes complex skilled-nursing needs around the clock beyond ordinary parenting, or the specified life-sustaining technology and ongoing nursing needs. Parents’ income and resources are excluded for a child who meets the test. DDS assesses the complete criteria; financial approval, approved hours and an available nurse are separate decisions.
- New Jersey’s documented comparable route is pediatric MLTSS, which can disregard parents’ income and resources when the child meets its stringent clinical test. That is not proof of a separate, generally available Katie Beckett or TEFRA option. DDS confirms any other applicable waiver, pediatric capacity or wait, the child’s resource ceiling and category-specific costs. DDS and the plan need to identify the exact Medicaid authority and requirements before the family relies on this route.
What you get
- A possible route to full NJ FamilyCare and nursing at home when the clinical test is met.
If you decide to apply
- Ask the oncology team whether your child needs a pediatric MLTSS assessment.
- Contact the Division of Disability Services at 1-888-285-3036; an enrolled child starts with the NJ FamilyCare plan.
Division of Disability Services, 1-888-285-3036 · Official page ↗
Good to know
The actual nursing tasks and their frequency matter more than the label someone uses for the program.
Official sources
“When someone says Katie Beckett, do they mean the New Jersey nursing route, and would an assessment help us?”
Why I’m asking: I want to understand the actual nursing test and whether parents' income would be left out.
More background and detailed requirements
How this works
A name used for Medicaid routes that can leave out parents' income for children with substantial care needs.
The first question is whether your child’s existing coverage includes the nursing and other services needed. Ordinary Medicaid may already cover nursing. Pediatric MLTSS has separate financial rules and a strict clinical test. DDS or the plan can explain whether it adds anything for your child.
- A possible route to full NJ FamilyCare and nursing at home when the clinical test is met.
- Ask the oncology team whether your child needs a pediatric MLTSS assessment.
- Contact the Division of Disability Services at 1-888-285-3036; an enrolled child starts with the NJ FamilyCare plan.
Eligibility rules
- From birth through age 20, MLTSS requires the state’s pediatric clinical test. It includes complex skilled-nursing needs around the clock beyond ordinary parenting, or the specified life-sustaining technology and ongoing nursing needs. Parents’ income and resources are excluded for a child who meets the test. DDS assesses the complete criteria; financial approval, approved hours and an available nurse are separate decisions.
- New Jersey’s documented comparable route is pediatric MLTSS, which can disregard parents’ income and resources when the child meets its stringent clinical test. That is not proof of a separate, generally available Katie Beckett or TEFRA option. DDS confirms any other applicable waiver, pediatric capacity or wait, the child’s resource ceiling and category-specific costs. DDS and the plan need to identify the exact Medicaid authority and requirements before the family relies on this route.
The actual nursing tasks and their frequency matter more than the label someone uses for the program.
From birth through age 20, MLTSS requires the state’s pediatric clinical test. It includes complex skilled-nursing needs around the clock beyond ordinary parenting, or the specified life-sustaining technology and ongoing nursing needs. Parents’ income and resources are excluded for a child who meets the test. DDS assesses the complete criteria; financial approval, approved hours and an available nurse are separate decisions.
New Jersey’s documented comparable route is pediatric MLTSS, which can disregard parents’ income and resources when the child meets its stringent clinical test. That is not proof of a separate, generally available Katie Beckett or TEFRA option. DDS confirms any other applicable waiver, pediatric capacity or wait, the child’s resource ceiling and category-specific costs. DDS and the plan need to identify the exact Medicaid authority and requirements before the family relies on this route.
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