Katie Beckett insurance provides a pathway for children with significant medical needs, such as autism, to qualify for Medicaid benefits regardless of parental income. Katie Beckett Medicaid is a last resort for families seeking Medicaid coverage for their children with disabilities. It's an essential option for families who require financial assistance for significant medical expenses for their children when they have no other means of qualifying for Medicaid.
What is Katie Beckett Insurance?
The Katie Beckett program is a Medicaid eligibility option under Section 134 of the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA). It allows states to extend Medicaid benefits to children under 19 who have disabilities and need a level of care typically provided in a hospital or an intermediate care facility but are living at home.
To be eligible for Katie Beckett in Nevada, a child must:
1. Be under 19 years old.
2. Require a level of care typically provided in a hospital or intermediate care facility. This includes both medical and therapeutic services that are otherwise available in more restrictive settings.
3. Not qualify for Supplemental Security Income (SSI) because of parental income. The child’s eligibility is based solely on their own needs and conditions, not on family income.
ICF/ID Qualification
Children with ASD require frequent therapies to address developmental delays, cognitive impairment, or intellectual disability. For Medicaid purposes, this is called an ICF/ID level of care. It means the patient needs a high frequency of therapies, and caregivers prefer to provide that level of care at home. Parents often apply for Medicaid under this category (Deaton, 2023).
Steps to Apply for Katie Beckett Medicaid in Nevada
Initial Eligibility Check and Application Submission:
Apply for Supplemental Security Income (SSI). If the child is denied due to parental income, this paves the way for Katie Beckett eligibility.
Complete the Medical Assistance to the Aged, Blind, and Disabled (MAABD) application. Ensure all sections are filled accurately, marking each page with "KATIE BECKETT" at the top.
Submit the completed application along with the SSI denial letter to the Division of Welfare and Supportive Services (DWSS) at the specified address, using certified mail to ensure you have proof of the date the application was received:
DWSS Attn:
KB Intake
3223 W. Craig Rd. #140
Las Vegas, NV 89032
Documentation Gathering:
Gather all necessary documentation, including medical records from the past 36 months, Individualized Education Program (IEP) documents, and any relevant assessments or reports.
A Health Care Coordinator will be assigned to your case after DWSS verifies financial eligibility and forwards your case to the Nevada Medicaid District Office for a Katie Beckett eligibility evaluation.
Home Visit Packet and Preparation:
You will receive a home visit packet containing important forms such as the Katie Beckett Home Visit Questionnaire, Consent for Release of Information, Physician Statement, and a Teacher Questionnaire.
Complete these forms and gather additional medical records as required. This preparation is crucial as it forms the basis for the home assessment.
Home Assessment:
A home visit is scheduled, during which a Health Care Coordinator assesses whether the child meets the required Level of Care (LOC) provided through an Aging and Disability Services Division (ADSD) Regional Center.
This evaluation confirms that the child’s medical and care needs align with those of a hospital, nursing facility (NF), or ICF/ID.
Review and Decision:
If the LOC criteria are met and all paperwork is in order, your case will be reviewed by a Nevada Medicaid-contracted physician who will decide whether the child's disability aligns with the Social Security Administration’s (SSA) disability criteria.
The disability approval can last from 1 to 3 years, after which reevaluation is necessary.
Notification and Coverage Start:
DWSS will notify you by mail if the application is approved, providing the Medicaid card.
Eligibility starts on the initial application date, and you may request up to 3 months of retroactive coverage if necessary.
Important Considerations:
The process typically takes 60 to 90 days due to the detailed review required by multiple offices.
Your child cannot be denied based on your income or resources but may be denied if they do not meet the required LOC or if the disability criteria as per SSA guidelines are not substantiated.
Coverage Under Katie Beckett Insurance:
Doctor visits and hospital care: Covers both inpatient and outpatient services.
Prescription drugs: Includes medications prescribed by a physician.
Therapeutic services: These are crucial for children with autism and include therapies such as behavioral therapy (including ABA), physical therapy, speech therapy, and occupational therapy.
Tips for a Smooth Application Process:
Begin gathering all required documents well in advance of your application. Keeping thorough records can expedite the process.
Utilize the support offered by state coordinators who are there to guide families through the application process. They can provide direct contact information, assistance with forms, and answer any queries you may have.
After submitting your application, contact the Medicaid office to check on its status and respond promptly to any requests for additional information.
Conclusion:
Navigating the Katie Beckett application process in Nevada can be daunting, but understanding the steps involved can make it manageable. This program is vital for families of children with autism, providing them with necessary medical coverage without the financial strain of traditional Medicaid eligibility criteria. By following this guide, caregivers can effectively advocate for and secure the benefits their children need to thrive at home and in their communities.
Resources:
Medicaid:
Carson District Office: (775) 684-3651
Elko District Office: (775) 753-1191
Las Vegas: (702) 668-4200
Reno District Office: (775) 687-1900
Welfare (DWSS):
Carson Office: (775) 684-0800
Elko Office: (775) 753-1233
Las Vegas Office: (702) 631-3386
Reno Office: (775) 684-7200
Sparks Office: (775) 824-7400
Aging and Disability Services Division:
Desert Regional Center: (702) 486-6200
Rural Regional Center: (775) 687-5162
Sierra Regional Center: (775) 688-1930
This post was written using information gathered primarily from Laurie Bauers' presentation found on YouTube. It is a great resource and I recommend watching for more in-depth information:
Additionally, here is the PowerPoint used in the video:
References:
Bauer, L., & Blochowiak, T. (2019, December 31). Katie Beckett Eligibility Option Division of Health Care Financing and Policy.
Deaton, G. (2023, April 5). QUALIFICATIONS GUIDE FOR KATIE BECKETT. ginadeaton.com. https://ginadeaton.com/katie-beckett-guide/how-to-qualify/
YouTube. (2022, August 11). Katie Beckett. YouTube. https://www.youtube.com/watch?v=HjT9L8-_358&list=PLjNIC7nVgWKRypaQBI4kUuilPWgCk89AT&index=4&ab_channel=NevadaCenterforExcellenceinDisabilities
