The Katie Beckett Program is a special eligibility process that allows certain children with long-term disabilities, mental illness, or complex medical needs, living at home with their families, to obtain a Wisconsin Medicaid card. Children who are not eligible for other Medicaid programs because the income or assets of their parents are too high, may be eligible for Medicaid through the Katie Beckett Program. A child may be eligible for this source of Medicaid even if they are currently covered under a private insurance policy.

In order to be eligible for Wisconsin Medicaid through the Katie Beckett Program, a child must meet ALL of the following criteria:
1. Be under 19 years of age;
2. Be disabled by standards in the Social Security Act;
3. Be a United States citizen or have acceptable immigration status;
4. Be a Wisconsin resident;
5. Live at home with their family;
6. Require a level of care at home that is typically provided in a hospital or nursing facility;
7. Be provided safe and appropriate care in the family home;
8. Not have income or assets in their name in excess of the current standards for a child
living in an institution; and
9. Not incur a cost of care at home to the Wisconsin Medicaid Program that exceeds the cost
Medicaid would pay if the child was in an institution.

If the child meets the Katie Beckett Program eligibility criteria, which is determined through the application review process, then the child will receive a FORWARD Medicaid card. This card can be used to pay for medically necessary services and equipment allowed under the Wisconsin Medicaid Program. Information about how to use the card and covered services will be sent to the child’s parent(s) with the approval letter. This information is also available at the following website: dhs.wisconsin.gov/Medicaid.

All rules and benefits for card-covered services for the Wisconsin Medicaid Program apply to children who receive their card through the Katie Beckett Program. The Division of Health Care Financing administers the Medicaid Program and is responsible for ongoing assistance to families regarding coverage and benefit questions. Their toll free number is: 800-362-3002.

Parent(s) contact the Katie Beckett Consultant located in the region where the family and child live. Additional information is available on the web at dhs.wisconsin.gov/kbp.

The Katie Beckett Consultant explains the program and assists the family in deciding whether or not the Katie Beckett Program is the best Medicaid option for their child. If a parent decides to apply, the consultant will send an application packet. The eligibility specialist will set up a meeting with the parents to review the application materials, verify certain documentation, answer questions, and complete the functional screen. The screen gives the eligibility specialist a picture of a day in the child’s life and determines if a child is functionally and financially eligible for Katie Beckett Medicaid.

Eligibility determination for the Katie Beckett Program is a two-part process. The Disability Determination Bureau first makes the disability determination using Social Security Act standards. After that decision, the Katie Beckett Program staff assess all other eligibility criteria.

A re-certification of eligibility is required every year after the initial approval or whenever significant changes in the child’s condition occur.

Contact:

Phone: 888-786-3246