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

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Tennessee program

TennCare without counting parents' income (Katie Beckett)

Katie Beckett offers coverage or home services for children with substantial care needs, without counting parents’ income for eligibility.

What it is

Katie Beckett offers coverage or home services for children with substantial care needs, without counting parents’ income for eligibility.

A family can earn too much for ordinary TennCare and still have this conversation. Your child’s own income, resources and care needs decide eligibility. Places are limited, and Part B is assessed before Part A.

Eligibility rules
  • Your child must be under 18, with their own monthly income at or below $2,982 and resources at or below $2,000 in 2026. Parents’ income is not counted for eligibility.
  • Part A requires an institutional level of care. Part B also includes children at risk of institutional placement.
  • Eligibility for Part B comes before consideration for Part A. A diagnosis alone does not establish the care test.
What you get
  • Part A offers full TennCare plus up to $15,000 a year in home services.
  • Part B offers up to $10,000 a year in home services, without full TennCare.
What the help covers
  • Part A supplements private insurance. Part B is a home-services budget, not a replacement health plan.
  • Under the January 5, 2026 policy, monthly Part A base premiums are $0 through 150% of poverty; $25 above 150% through 250%; $75 above 250% through 300%; $125 above 300% through 400%; and $225 above 400% through 500%. Above 500%, the schedule starts at $350 plus $70 for each further 100 percentage points. TennCare confirms how partial increments apply.
  • Part B is assessed before Part A. Help while waiting for Part A requires a Part B place and is not guaranteed. Part C continues TennCare only for certain already-enrolled children losing ordinary coverage because of parental finances who meet Part A care requirements but lack a Part A place.
  • The child’s private-insurance premium, and necessary parent coverage when required, can reduce the Part A premium to $0. Family income sets the premium even though parents’ income is not counted for the child’s financial eligibility.
  • If your child has no private insurance when they join Part A, hardship help can buy it when the premium would be over 5% of family income, or when income is under 400% of poverty and no employer plan is offered. The help is capped at about $466 a month.
If you decide to apply
  1. If you decide to seek an assessment, the oncology social worker can help with TennCare Connect.
  2. Your child’s income, savings and daily-care records help explain the request.
  3. The oncologist can supply medical certification, and the specialist can explain the care assessment and waiting list.

TennCare Connect: 1-855-259-0701 · Official page ↗

After you ask
  • When a Part A premium is actually owed, the first payment and automatic-payment setup are due within 60 days of the mailed notice. Private-insurance costs can reduce the premium to $0, so the counselor should check the actual obligation and coverage start before the family pays. Separate deadlines govern obtaining or replacing required private insurance.
  • Funded places are limited, with a waiting list. The social worker can ask where your child stands.
  • You must show proof of private insurance by a date the specialist gives you, usually the February after enrollment, and replace lost coverage within 60 days.
Good to know

Part A can charge a monthly premium, and it usually expects your child to have private insurance as well; if there is none, hardship help can sometimes buy it after enrollment. The counselor can explain deadlines and premium offsets.

Other details
  • This is part of the TennCare III demonstration under section 1115, rather than Tennessee’s state-plan option for children living at home.
  • Other coverage routes include ordinary child TennCare, Medicaid linked to SSI, and medical-bill spend-down. These have different income and eligibility tests.

Federal background: disability-related Medicaid includes SSI-linked TennCare and other coverage categories as well as Katie Beckett. Those routes have different eligibility rules.

Official sources
Ask your social worker

“Could our child’s care needs qualify for Katie Beckett? How do the home services, premiums and waiting list compare with what we have, and could you help with the assessment if it is worthwhile?”

Why I’m asking: I want to know whether our child’s care needs open a route that does not depend on our earnings.

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 Katie Beckett by name, hand over anything the state asks for, and keep the appointment for the assessment.

Your social worker

The oncology social worker starts the application, gathers the medical paperwork, and asks where the waiting list stands.

The care team

The oncologist signs the certification of medical necessity and writes what the child cannot do day to day.

Who decides
TennCare decides the money side on the child’s own income; an assessment decides the level of care.
Ask your social worker
“Can you start a Katie Beckett application for us and get the physician certification signed? Where does the waiting list stand today, and does Part C help while we wait?”

How to apply

First step: Call TennCare Connect on 1-855-259-0701 and say Katie Beckett by name, or start at tenncareconnect.tn.gov. Ask what the Part B assessment needs.

  1. Call TennCare Connect and ask for Katie Beckett by name in the first weeks.
  2. Ask the oncologist for the physician certification of medical necessity and a current picture of what your child cannot do.
  3. Ask where the waiting list stands today and whether Part C applies while you wait.

Official application / program page ↗

Where it starts: Start on TennCare Connect or call 1-855-259-0701 and say Katie Beckett by name. The Part B assessment comes first.

What to gather

  • Child’s Social Security number and birth certificate
  • Any income or savings in the child’s own name
  • The physician certification of medical necessity
  • A current letter from the oncologist about what your child cannot do
  • Your private insurance card, if there is one

How long: Tennessee gives itself 90 days on an application that turns on disability. No published figure was found for how long the assessment or a place takes, so ask where the list stands.

What a yes looks like

A notice naming Part A or Part B, a start date, and, for Part A, a premium amount and a request to set up automatic payment within 60 days.

What a no looks like, and the next move

Ask which test failed: the child’s own income, the level of care, or a free place. If it was a place, ask to go on the list and whether Part C applies.

Watch out

  • Tennessee does not use the open state-plan route. This runs inside the state’s demonstration, with a fixed number of funded places and a published waiting list.
  • You have to be found eligible for Part B first. Part B is a pot of home services, not full TennCare.
  • Part A charges a monthly premium once family income passes 150 percent of the poverty line, and the first month plus an automatic payment arrangement are due before enrollment.
  • Part A also requires your child to have private or employer insurance. Ask about the hardship help if the cost bites.

If they say no, quote this: The Katie Beckett policy manual, section on eligibility: parent to child deeming is waived so that parents’ income and resources are not counted in determining the child’s eligibility.

Dates that change this

2026-03-01: Two official documents disagree about how many Part B places are funded: a January 2026 report says 4,700 and a March 2026 questions page says up to 4,000. The current funded number is unknown. (not yet confirmed against the final rule)

2025-12-29: On December 29, 2025 there were 27 children waiting for Part A and 898 waiting for Part B. The same report also says every child who applied for Part A and qualified is being served. Ask where the list stands the day you apply.

The numbers and the rules

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

What it is worth

Part A: full TennCare plus up to $15,000 a year of home services, for a child whose own income is at or under $2,982 a month. Part B: up to $10,000 a year of home services, without full TennCare.

  • $2,982/month (the child’s own income only; parents’ income is not counted) — Child’s own monthly income ceiling (three times the federal disability payment rate)
  • $2,000 — Child’s own resource ceiling
  • $15,000/year — Part A home and community services, yearly cap
  • $10,000/year — Part B home and community services, yearly cap
  • $25/month — Part A monthly premium, family income above 150 up to 250 percent of poverty
  • $125/month — Part A monthly premium, family income above 300 up to 400 percent of poverty
  • $350/month (plus $70 for each further 100 percent of poverty) — Part A monthly premium, family income above 500 percent of poverty

Covers: Full TennCare benefits in Part A · Home and community services up to the yearly cap · Private-duty nursing and personal care through the health plan, when approved

Legal protection: Parents’ income and resources are not counted in deciding the child’s eligibility · Part C keeps an enrolled child covered when a Part A place is not free

What it costs the family: Free below 150 percent of the poverty line. Above it, Part A charges a monthly premium from $25 to $350 and more, reduced by what you already pay for the child’s share of private insurance.

The eligibility facts, as published

Age max exclusive
18
Parental income
waived: not counted in the child’s eligibility
Child income
at or below $2,982 a month, three times the federal disability payment rate
Resources
the child’s own resources at or below $2,000
Level of care
Part A: care in a medical institution. Part B: care in a medical institution or at risk of institutional placement
Insurance
Part A requires the child to have or obtain private or employer coverage, with hardship help
Order
apply for Part B and be found eligible before Part A is considered
Premium due
the first month’s premium and an automatic payment arrangement, due 60 days from the date of the notice
Statutory route
section 1115 demonstration (TennCare III), not the state-plan option for disabled children living at home, which Tennessee leaves unchecked

Decisions this site cannot make: TennCare Connect financial review of the child’s own income and resources · Level-of-care assessment; the state names a contractor for the Part A review · Physician certification of medical necessity

Expect friction on: You have to be found eligible for Part B before Part A is considered · Places are funded in fixed numbers and a waiting list is published · Part A charges a monthly premium above 150 percent of the poverty line and requires private insurance

The trap: This is not the open state-plan option some states use. Tennessee leaves that box unchecked in its own Medicaid plan and runs Katie Beckett inside its demonstration instead, with a fixed number of funded places and a published waiting list. You have to be found eligible for Part B before Part A is considered, and Part A charges a monthly premium once family income passes 150 percent of the poverty line.

Where I read this

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