Tip for State-specific

Katie Beckett/TEFRA allows children with significant disabilities to qualify for Medicaid based on THEIR disability — not family income

Tip for State-specific

Not all states participate — check if your state has a Katie Beckett or TEFRA option

Tip for State-specific

Some states charge a monthly parental fee based on income — this is typically much less than private insurance

MedicaidhardDoctor signature required

Katie Beckett / TEFRA Application

State-specific · State Medicaid Agencies

Application for children with severe disabilities to qualify for Medicaid based solely on the child's income/resources. No enrollment cap or waitlist. Requires medical Level of Care determination.

Form Details

Total fields: 70
Auto-fillable: 35 (50%)
Time without BeneFill: 60 minutes
Time with BeneFill: 18 minutes
Time saved: 42 minutes
Filled by: caregiver
Frequency: annual
State-specific: Yes — form may vary by state

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Where to Submit This Form

🏢

At your state's Medicaid office or children's services division

Not all states offer Katie Beckett/TEFRA programs — check with your state Medicaid agency.

📬

Mail to your state Medicaid agency's children's services division

🌐

Some states accept applications through their Medicaid portal

Required Attachments

📎 Child's medical records documenting the qualifying disability or chronic condition
📎 Physician certification that the child requires an institutional level of care
📎 Proof of the child's age and identity (birth certificate)
📎 Parent/guardian income and resource documentation
📎 Functional assessment of the child's care needs

Processing Time

30-90 days depending on the state. A medical eligibility determination is required.

What Happens Next

A state assessor will evaluate whether the child meets the institutional level of care criteria. If approved, the child receives Medicaid coverage regardless of parental income (though some states require a parental fee).

Tips for This Form

✓ Katie Beckett/TEFRA allows children with significant disabilities to qualify for Medicaid based on THEIR disability — not family income
✓ Not all states participate — check if your state has a Katie Beckett or TEFRA option
✓ Some states charge a monthly parental fee based on income — this is typically much less than private insurance
✓ Coverage can include services not typically covered by private insurance, such as personal care and home health

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Federal marketplace application that also screens for Medicaid/CHIP eligibility and refers to state agencies when the applicant qualifies.

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State-specific (e.g., Form 520) · State Medicaid Agencies

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Presumptive Eligibility Determination

State-specific PE form · State Medicaid Agencies / Qualified Entities

Temporary Medicaid coverage granted by qualified entities (hospitals, clinics) based on preliminary income assessment. Covers services until full application is processed.

Medicaid Renewal / Redetermination

State-specific (e.g., CA MC 210 RV) · State Medicaid Agencies

Annual renewal verifying continued Medicaid eligibility. Includes income, expenses, and household composition. Failure to complete results in disenrollment.

Medicaid Spend-Down Documentation

State-specific · State Medicaid Agencies

Documents medical expenses applied toward meeting the spend-down amount. Once the difference between income and the medically needy income level is met, Medicaid covers remaining expenses.

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Disclaimer: BeneFill™ provides form-filling assistance and informational guidance only. It is not affiliated with, endorsed by, or sponsored by the State Medicaid Agencies or any government agency. The information provided is for general informational purposes and does not constitute legal, medical, financial, or tax advice. Always verify form requirements and submission details directly with the issuing agency.