Katie Beckett Waiver

What is it? Why does it matter?

Katie Beckett is a Medicaid program for children living at home with long-term disabilities or complex medical needs, who may be eligible for Medicaid services even if their family income is above Medicaid federal poverty guidelines.

If your child is approved for the Katie Beckett program, a premium will be assessed based on your family’s income. If you are unable to pay the premium, your child’s eligibility will not be impacted.

To qualify for the Katie Beckett program your child must meet eligibility criteria for a complex medical need, a developmental disability, a physical disability, or a combination of those needs as listed below:

DEVELOPMENTAL DISABILITY CRITERIA OVERVIEW
Have one of the following chronic conditions
Autism
Intellectual disability
Seizure disorder
Cerebral palsy
Substantial limited ability to function in at least three (3) of the following major life activities:
Self care
Receptive and expressive language
Learning
Mobility
Self direction
Capacity of independent living or
Economic self sufficiency
Require services which are of lifelong or for an extended duration
COMPLEX MEDICAL NEED OR PHYSICAL DISABILITY CRITERIA OVERVIEW:

Have a chronic condition
Child has a disability which meets SSI criteria according to disability evaluation under Social Security
Child requires level of care provided in a medical institution
Child's physician has completed an evaluation identifying services necessary to maintain child at home
It is safe and appropriate to provide care to the child in the home

Requirements & Criteria

Information Required to Apply

Idaho Medicaid Application

Child's Disability Application

Child's Official Diagnosis from a licensed pediatric physician, neurologist, psychologist

Submit Application to:

Children’s DD Application Intake

823 Park Centre Way

Nampa, Idaho 83651

ChildrensDDIntake@dhw.idaho.gov

Fax: (208) 332-7331

Questions:

Phone: (208) 334-6500

Katie Beckett Eligibility Criteria

Live in Idaho
Be a child under the age of 19
Be a U.S. citizen or eligible non-citizen
Have a disability diagnosis under the Social Security Act
Be assessed to have functional impairments that qualify for the Katie Beckett program

For a child to be eligible for the Katie Beckett program, the child’s disability will be assessed. Based on the information provided by your doctor and healthcare providers, the independent assessment will determine if your child meets the level of care requirements to be eligible for Katie Beckett services. The packet will be sent to you after you apply for Medicaid.

Liberty Healthcare Corporation Idaho Independent Assessment Services Program 8850 Emerald Street

Suite 164

Boise, ID 83704

If you have any questions -please call:

208-258-7980 idahoias@libertyhealth.com

Next Steps:

After the Medicaid application is submitted and the Katie Beckett program packet is completed:

You will receive two different notices from DHW
One notice will be about Medicaid eligibility - If your child is eligible for regular Medicaid, you will receive an approval notice. The other notice will be about your child’s medical situation. A DHW representative (Liberty Healthcare) will schedule an appointment for your child's Level Care of Determination. Not all children will need an appointment.

You may need to provide additional information, but they will let you know if additional documentation is needed.
REMINDER: There is a re-evaluation process each year for the Katie Beckett program. You will receive a notice in the mail. Please read and respond to the notice. After approval - you will be sent either a Liberty Medical Letter showing approval and a budget OR you will be denied - at which point you will want to appeal the decision. If you received a budget - you will want to contact your regional disability person and find out who your case manager is, or you will be waiting a while.