Katie Beckett & TEFRA Pathways by State
Katie Beckett and TEFRA are special Medicaid pathways that can help children with significant disabilities qualify for Medicaid coverage regardless of parental income. Each state implements these programs differently — use this page to find your state's approach.
Key takeaways
- Katie Beckett-style programs evaluate the child's disability needs separately from parental income in most states.
- Not every state uses the "Katie Beckett" name — look for TEFRA, TEFRA Medicaid, or child-specific waiver pathways.
- These programs are designed to keep children at home rather than in hospitals or institutions.
- Some states have waitlists for these programs — apply as soon as possible.
- Program names, rules, and income thresholds vary significantly by state.
What is Katie Beckett?
Katie Beckett was a child with a serious disability whose case in the 1980s led to a federal rule change allowing states to evaluate a child's Medicaid eligibility independently from parental income. Before this change, many children with significant care needs could only access Medicaid if they lived in an institution. The "Katie Beckett" provision allows states to cover children at home, recognizing that home-based care is both more humane and often less expensive than institutional care.
Today, different states have implemented this concept in different ways — through TEFRA state plan elections, HCBS waivers, or other child-focused Medicaid categories. The Katie Beckett guide on this site explains more.
Browse states for pathway information
Frequently asked questions
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