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

Childhood Cancer Lantern
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Federal, exists in every state

The Medicaid option called Katie Beckett

Some states cover children with heavy care needs without counting parents’ income under a Katie Beckett option.

What it is

Some states cover children with heavy care needs without counting parents’ income under a Katie Beckett option.

New Mexico does not offer the Katie Beckett option; a child with heavy care needs is reached through the Medically Fragile Waiver, which has its own card. There is nothing to apply for under this name here.

New Mexico availability
  • The enrollment specialist confirms whether a standalone Katie Beckett option is available. The Medically Fragile Waiver is a separate route with a care-needs test and allocation process. Under the rule effective July 1, 2024, parents’ income and resources count through the allocation month. Starting the next month, only the child’s attributable available finances count, with a $2,000 resource ceiling. The specialist confirms the current income limit and paperwork.
What you get
  • Medicaid without counting parents’ income where the state offers the option and your child meets its rules.
Federal background
  • The institutional-care test can be hospital, nursing-facility or intermediate-care-facility level; a disability finding is separate.
If you decide to apply
  1. Ask the hospital enrollment specialist whether New Mexico offers Katie Beckett and what application it uses.
  2. Ask the oncology team to describe daily care, how often it is needed and the risks without it.

Hospital enrollment specialist

Good to know

The Medically Fragile Waiver is a separate named New Mexico route with its own clinical test.

Official sources
Ask your social worker

“Does New Mexico offer Katie Beckett, or would the Medically Fragile Waiver be the relevant route? What are the benefits and drawbacks, and could you help with the right application?”

Why I’m asking: I want to understand which program can assess our child’s daily 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

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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