Federal, exists in every state
The Virginia route behind the name Katie Beckett
Several Medicaid routes use care needs, disability or medical bills as well as income.
What it is
Several Medicaid routes use care needs, disability or medical bills as well as income.
Virginia does not offer the Katie Beckett option; a child with heavy care needs is reached through the CCC Plus waiver, which has its own card. There is nothing to apply for under this name here.
Eligibility rules
- The eligibility worker can confirm which state-plan disability options are available. CCC Plus is a separate waiver assessment.
- CCC Plus needs a hospital or nursing-facility level-of-care screening. The child’s own income limit is $2,982 monthly in 2026, with no savings test under 18.
- A disability award does not automatically open Medicaid in Virginia. A separate Medicaid application and financial review are required.
What you get
- A review of routes beyond the ordinary income-based application.
Other options
- The spend-down route is another conversation for a child under 18 with large medical bills.
- Ordinary Medicaid comes first when income fits. A disability finding and a care-level screening are different tests.
- Developmental-disability waivers need a developmental disability; cancer alone does not establish that.
- Medicaid Works is a separate working-disabled route for ages 16–64. Developmental-disability waivers have different clinical tests. These are distinct routes, not a general child buy-in.
If you decide to apply
- Ask the hospital enrollment specialist to compare ordinary Medicaid, CCC Plus and spend-down using your child’s care needs and bills.
Hospital enrollment specialist or local Department of Social Services · Official page ↗
Good to know
An SSI award does not open Medicaid automatically in Virginia. Medicaid needs a separate application.
Official sources
“Could you explain whether CCC Plus or spend-down fits our child, and help us decide which application is worthwhile?”
Why I’m asking: I want to understand which coverage could help and what the application involves.
More background and detailed requirements
How this works
Virginia’s CCC Plus waiver can leave parents’ income out when a child needs hospital-level care at home.
The eligibility worker can confirm which state-plan disability options are available. CCC Plus is a separate waiver assessment.
CCC Plus needs a hospital or nursing-facility level-of-care screening. The child’s own income limit is $2,982 monthly in 2026, with no savings test under 18.
A disability award does not automatically open Medicaid in Virginia. A separate Medicaid application and financial review are required.
- The spend-down route is another conversation for a child under 18 with large medical bills.
- Ordinary Medicaid comes first when income fits. A disability finding and a care-level screening are different tests.
- Developmental-disability waivers need a developmental disability; cancer alone does not establish that.
- Ask the hospital social worker to review the Virginia program with you.
Ordinary Medicaid comes first when income fits. A disability finding and a care-level screening are different tests.
Developmental-disability waivers need a developmental disability; cancer alone does not establish that.
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