Katie Beckett Program: A Doorway to Medicaid for Children with Disabilities
Print – English / Print – Spanish
The Katie Beckett Program, also known as Katie Beckett Medicaid, is one of the doorways into Wisconsin Medicaid coverage for children with disabilities and other special health care needs. Katie Beckett provides the same coverage as other Medicaid programs like BadgerCare Plus and SSI Medicaid.
Your child does not need to sign up with a Medicaid HMO to get the Katie Beckett benefit.
Children who would not be Medicaid eligible, because their parents’ income is too high, may qualify for Medicaid and receive a ForwardHealth card through the Katie Beckett Program. This is because the program is based on a child’s disability and not family income.
How Can the Katie Beckett Program Help My Child?
The Katie Beckett Program allows your child to get comprehensive health care coverage from Wisconsin Medicaid. Medicaid can pay for services and supplies important to children with special needs including doctor and dentist visits; annual physicals; occupational and speech therapy; prescriptions; and, medically necessary supplies and equipment.
What If We Already Have Private Insurance?
Having both private insurance and Medicaid can be very helpful! While your private insurance will be billed first, Medicaid can pay for services, supplies and costs that your private insurance may not cover. For instance, your child’s Medicaid may pay for deductibles; co-pays; additional therapy visits; and, other services that aren’t covered like personal care, diapers and transportation to medical appointments.
How Do I Know if My Child is Eligible for Katie Beckett?
To be eligible your child must be:
- Under age 19,
- A U.S. citizen and a Wisconsin resident,
- Living at home,
- Determined disabled by the Wisconsin Disability Determination Bureau,
- Not have income of more than $2,382 per month—This includes child support,
- And, 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 to answer your questions about the program.
If you decide to move ahead and apply for the Katie Beckett Program, an eligibility specialist will schedule a phone visit with you to complete the application and the functional screen together. The visit also allows the eligibility specialist to learn about your child’s needs.
Eligibility is Decided in a Two-Step Process
1st 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 a 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.
*See the Family Voices Fact Sheet Completing a Functional Screen.
2nd 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 for 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! A ForwardHealth card will be mailed to you separately.
Is There a Waiting List for the Program?
No. If your child qualifies, he/she can immediately start using Medicaid to cover the cost of medical care and other services. Remember to show your child’s providers the FowardHealth card so they know to bill Medicaid in addition to any other insurance your child may have.
Do We Have to Re-Apply?
An annual recertification is needed to keep Medicaid coverage for your child. You, or your child’s Long-Term Support service coordinator, will receive the forms to complete. Sometimes a functional screen visit and Disability Determination Review may also be needed to review your child’s level of care. It is helpful to keep each year’s recertification paperwork so you can refer back to it. If you need help with this process, contact your service coordinator or the Regional Centers.
Still Have Questions? Need Help Finding Services for Your Child?
- Regional Centers for Children and Youth with Special Health Care Needs, dhs.wisconsin.gov/cyshcn/index.htm
- Well Badger Resource Center, wellbadger.org or call 800.642.7837