TEFRA / Katie Beckett Medicaid Option

Medicaid state plan option allowing children with institutional-level-of-care needs who live at home to qualify for Medicaid based only on the child's own income and assets — not the parents' income. Available in 18 states and DC as a state-plan option. The primary federal funding door for parents caregiving medically complex children who exceed income limits for regular Medicaid. Gateway to home nursing, medical equipment, therapy, and EPSDT services.

Medicaid coverage for medically complex children (under 18 or 19) living at home when institutional-level care is needed: (1) Home nursing care (skilled nursing, LPN, home health aide visits); (2) Medical equipment and supplies (wheelchairs, ventilators, feeding tubes); (3) Therapy services (physical, occupational, speech); (4) EPSDT (Early and Periodic Screening, Diagnosis, and Treatment) — comprehensive preventive and treatment services for Medicaid-eligible children. For caregiving families: the parent's income is not counted, so higher-income families who would otherwise be over Medicaid income limits can access comprehensive in-home medical services. This substantially reduces out-of-pocket cost for complex care. Available in approximately 18 states + DC as a state plan option. Separate 1915(c) 'Katie Beckett' HCBS waivers exist in some states with different scope — verify your state's pathway.

Some details for this program are still being verified. Check the official source for the most current information.

Eligibility

• Care recipient age: under 18

Services

Medicaid coverage for medically complex children (under 18 or 19) living at home when institutional-level care is needed: (1) Home nursing care (skilled nursing, LPN, home health aide visits); (2) Medical equipment and supplies (wheelchairs, ventilators, feeding tubes); (3) Therapy services (physical, occupational, speech); (4) EPSDT (Early and Periodic Screening, Diagnosis, and Treatment) — comprehensive preventive and treatment services for Medicaid-eligible children. For caregiving families: the parent's income is not counted, so higher-income families who would otherwise be over Medicaid income limits can access comprehensive in-home medical services. This substantially reduces out-of-pocket cost for complex care. Available in approximately 18 states + DC as a state plan option. Separate 1915(c) 'Katie Beckett' HCBS waivers exist in some states with different scope — verify your state's pathway.

How to apply

Apply online or find more information at the official program page.