Federal, exists in every state
A Medicaid option you may hear called Katie Beckett
Some states offer Medicaid without counting parents’ income for a child with heavy care needs. In Texas, the enrollment specialist can explain MBIC, SSI-linked coverage and MDCP.
What it is
Some states offer Medicaid without counting parents’ income for a child with heavy care needs. In Texas, the enrollment specialist can explain MBIC, SSI-linked coverage and MDCP.
Texas does not offer the Katie Beckett option; a child with heavy care needs is reached through the MDCP waiver, which has its own card. There is nothing to apply for under this name here.
Eligibility rules
- A disability finding and an institutional level-of-care finding are different tests.
- MBIC counts family income. MDCP uses a child-only financial budget or existing Medicaid eligibility.
What you get
- Background to help identify the Texas application someone means.
What coverage includes
- MDCP can provide respite, equipment and home changes after interest-list release and approval.
If you decide to apply
- Ask the hospital enrollment specialist whether the person means MBIC or the MDCP waiver.
Hospital enrollment specialist
After you apply
- Ask the specialist to name the Texas category and explain its application.
Good to know
Joining the MDCP interest list does not arrange immediate home nursing. Regular Medicaid home services have their own assessment.
Other details
- A benefit comparison is not a recommendation to move states.
Official sources
“We have heard the name Katie Beckett. Is there a Texas route that checks our child’s finances separately from ours, and what is it actually called?”
Why I’m asking: We want to avoid chasing a program that does not exist here.
More background and detailed requirements
How this works
MBIC considers family income and disability. MDCP requires nursing-facility-level care and release from its interest list. The enrollment specialist can confirm which Texas route someone means by Katie Beckett and explain its financial and care tests.
- Background to help identify the Texas application someone means.
- Ask the hospital enrollment specialist whether the person means MBIC or the MDCP waiver.
Eligibility rules
- A disability finding and an institutional level-of-care finding are different tests.
- MBIC counts family income. MDCP uses a child-only financial budget or existing Medicaid eligibility.
What coverage includes
- MDCP can provide respite, equipment and home changes after interest-list release and approval.
After you apply
- Ask the specialist to name the Texas category and explain its application.
Other details
- A benefit comparison is not a recommendation to move states.
A disability finding is different from meeting an institutional level-of-care requirement.
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