The Katie Beckett Program, also known as Katie Beckett Medicaid, is one of the doorways into Wisconsin Medicaid for children with disabilities and special health care needs.

Katie Beckett provides the same coverage as other Medicaid programs like BadgerCare Plus and SSI-Related Medicaid. Once your child enrolls, you will receive a Wisconsin ForwardHealth insurance card. 

The Katie Beckett Program bases a child’s eligibility on his/her disability and income and not on their family’s income. This allows children who would not be Medicaid eligible, because their parents’ income is too high, to qualify for Medicaid.

What If We Already Have Private Insurance?

Having both private insurance and Medicaid coverage can be very useful, especially for children who need a higher level of medical care. Medicaid is the payer of last resort, meaning it is billed after your primary insurance has paid its share. Medicaid can still pay for services, supplies and costs that private insurance may not cover. For example, your child’s Medicaid card may pay for deductibles, co-pays, additional therapy visits, and other services that are not covered by most private insurance plans like personal care, diapers or transportation to medical appointments.

How Do I Know if My Child is Eligible for Katie Beckett Medicaid?  

To be eligible your child must be:

• • • Under the age of 19,
    • a U.S. citizen and Wisconsin resident,
    • living at home or other qualifying location,
    • determined disabled by the Wisconsin Disability Determination Bureau,
    • not have income in their name of more than $2,382 per month (this includes child support),
    • require a level of care typically provided in a hospital or nursing facility for at least one year.

How Do I Apply? 

Contact a Katie Beckett eligibility specialist

Email: DHSKatieBeckett@DHSwisconsin.gov

Phone: (888) 786-3246

Online: Katie Beckett Medicaid: How to Apply | Wisconsin Department of Health Services 

To apply for the Katie Beckett Program, an eligibility specialist will schedule a phone visit with you to complete the application and screen together. The visit also allows the eligibility specialist to learn about your child’s needs.

NEW: Those covered by Katie Beckett Medicaid can now use the Access website to manage your child’s benefits as well as find and submit renewal documents. To learn more visit Access.wi.gov and download the Access app to make it convenient to login anywhere. Keep in mind that applying for the program and renewals for Katie Beckett Medicaid cannot be done using this website or app.

Eligibility is Decided in a Two-Step Process

1^st: Eligibility specialists meet with your family, help you with application materials, verify that your child is financially eligible, and complete a functional screen. The eligibility specialist uses the DHS functional screen tool* that collects information about your child’s health, need for supports and interactions with other children and adults. It’s important that you give your input on your child’s limitations, care needs and challenges during the functional screen to help the specialist see the full picture that might not be captured in a single visit.

       *Read the Family Voices Fact Sheet Completing a Functional Screen.

2^nd: The Department of Health Services (DHS), Disability Determination Bureau, reviews your child’s medical records and other documents to decide if your child meets the Social Security standards of a disability. You will receive a letter from DHS letting you know if your child is eligible for the Katie Beckett Program. KEEP THIS LETTER IN A SAFE PLACE!

If your child is eligible, a ForwardHealth card will be mailed to you separately.

Is There a Waitlist for the Program?

No. If your child qualifies, you can immediately start using their ForwardHealth card. Remember to show all your child’s providers and pharmacy this card so they know to bill Medicaid in addition to any other insurance your child may have.

How Often is Eligibility Reviewed?

An annual renewal is needed to keep Medicaid coverage for the upcoming year for every child. See Katie Beckett Medicaid Renewal Flyer for Members | Wisconsin Department of Health Services

You, or your child’s Children’s Long-Term Support (CLTS) service coordinator will receive the needed forms for their renewal. A functional screening visit and Disability Determination review may be needed to assess changes in your child’s level of care needs.