Exploring the Katie Beckett Autism Waiver Benefits
Exploring the Katie Beckett Autism Waiver Benefits
Last updated: July 2026
The Katie Beckett program is essential for families caring for children with severe disabilities or medical needs. It helps these families by allowing children to have Medicaid coverage, no matter their parents' income. This waiver program makes sure children can get important services that private insurance often does not cover. It also helps families meet strict eligibility criteria. This way, families can provide care in their own homes instead of facing the challenges of institutions. Whether they need medical equipment or therapeutic support, the Katie Beckett waiver plays a key role in making care affordable.
The rules and program names change from state to state, though — which is why so many families end up confused about whether the version they're reading about actually applies to them. Below, we walk through how the waiver works federally, what each of Blossom's five service states (Georgia, Tennessee, Virginia, North Carolina, and Maryland) actually calls it, and who qualifies. If at any point you'd rather talk this through with a person than read the whole guide, our admissions team helps families navigate this every day.
Understanding the Katie Beckett Autism Waiver
The Katie Beckett Autism Waiver is a special program for children with serious disabilities who need regular care. It provides important services that private insurance usually does not cover, like private duty nursing and speech therapy.
The waiver also helps families care for their children at home instead of sending them to institutions. This helps lessen financial stress and maintains a caring environment. Depending on the state, the program may be structured into multiple parts to serve different care needs — which makes the support flexible and personalized.
A Quick Note on the Law
The Katie Beckett Waiver was created by Congress in 1982 under the Tax Equity and Fiscal Responsibility Act (TEFRA), P.L. 97-248, which is why some states call it the TEFRA option or the Deeming Waiver. The core idea: for a child with severe disabilities who would qualify for institutional (hospital, nursing home, or ICF/IID) level of care but who is receiving that care at home instead, Medicaid can disregard parental income and count only the child's income. That single rule change is what lets a family earning above regular Medicaid income limits still get coverage for their child.
The program is named after Katie Beckett, the young girl whose case led to the law's passage in 1982.
What the Waiver Typically Covers
When a child qualifies, they generally receive full Medicaid benefits, which can include:
ABA therapy (when medically necessary)
Occupational, physical, and speech therapy
Private duty nursing and home health visits
Durable medical equipment and supplies
Prescription medications
Doctor visits, hospital care, and behavioral health
Respite care and supportive home services (varies by state)
For families already carrying private insurance, Medicaid under Katie Beckett usually becomes the secondary payer — private insurance pays first, and Medicaid covers what commercial plans don't (or won't).
Who Generally Qualifies
Katie Beckett is a level-of-care program, not a diagnosis program. Qualification is based on how much care a child needs, not what condition they have. An autism diagnosis alone typically is not enough — the child must also demonstrate a level of care that would otherwise require institutional placement. In most states, the general criteria include:
Under age 18 (age 21 in some state-run equivalents)
Documented severe disability under Social Security Administration criteria
Meets an institutional level-of-care threshold
Cost of caring for the child at home is not greater than the cost of institutional care
Not otherwise eligible for Medicaid based on the child's own income
Approximately 18 states plus Washington, D.C. have implemented the federal TEFRA/Katie Beckett State Plan Option. States that haven't may still serve similar families through §1915(c) Home and Community-Based Services (HCBS) waivers.
Katie Beckett State-by-State: Where Blossom Serves
Not every state offers a program named "Katie Beckett," and the programs that exist vary widely in structure, dollar caps, waitlists, and application steps. Here's what applies in each of Blossom's five service states — and if any of this sounds like it might apply to your child, our team can help you figure out the specifics for your state.
Georgia — Katie Beckett Deeming Waiver (TEFRA)
Georgia is one of the strongest Katie Beckett states in the country. The program is officially called the Katie Beckett Medicaid Program / TEFRA / Deeming Waiver, administered by the Georgia Department of Community Health.
Key details:
Ages 0 through 18
Disregards parental income
Level of care: institutional (hospital, nursing facility, or ICF/IID)
Centralized Katie Beckett Medicaid Team: 678-248-7449
New online portal launched April 15, 2026 at katiebeckettportal.dch.georgia.gov
No fixed waitlist cap in the way HCBS waivers have
For a deep-dive tailored to Georgia families, see our full guide: Katie Beckett Waiver in Georgia.
Tennessee — Katie Beckett Program (Parts A, B, and C)
Tennessee's program is not the federal TEFRA option. It's a §1115 demonstration authorized by Public Chapter 494 of 2019 (Tenn. Code Ann. §71-5-164), CMS-approved January 8, 2021 as part of TennCare III. It has a three-part structure unique among states:
Part A — Full TennCare Medicaid plus up to $15,000/year in HCBS wraparound services. Capped at 300 children statewide, with an acuity-prioritized waitlist. For children with the most significant disabilities or complex medical needs who meet institutional level of care.
Part B — Up to $10,000/year in flexible HCBS dollars (no Medicaid card attached). Capped at 4,700 slots with a first-come-first-served waitlist. Serves children who don't qualify for Part A but are at risk of institutionalization.
Part C — Continued Eligibility. Bridge coverage for children whose Medicaid is ending because parental income or resources increased.
Application is through TennCare Connect. The Department of Disability and Aging (DDA) handles intake and Level-of-Care assessments. Note: you must apply for Part B first — TennCare requires Part B eligibility determination before considering Part A. As of 2025, a new pathway (Public Chapter 182 of 2025) allows parents of minors to be hired by a licensed provider agency to deliver authorized services.
DDA regional offices:
West Tennessee: (866) 372-5709
Middle Tennessee: (800) 654-4839
East Tennessee: (888) 531-9876
More at the Tennessee Katie Beckett page.
Virginia — DD Waivers and CCC+ Waiver
Virginia does not offer a Katie Beckett or TEFRA program. Families instead access similar coverage through Virginia's Developmental Disability (DD) Waivers, which are §1915(c) HCBS waivers that disregard parental income. There are three:
Building Independence (BI) Waiver — for adults 18+
Family and Individual Supports (FIS) Waiver — available to children and adults
Community Living (CL) Waiver — for those needing the most intensive supports
Virginia also has the Commonwealth Coordinated Care Plus (CCC+) Waiver, which serves technology-dependent, physically disabled, and medically complex individuals.
To apply, families contact their local Community Services Board (CSB) for a screening. Virginia maintains a significant DD waiver waitlist (about 14,258 people statewide as of late 2025), with slots assigned based on priority level. The statewide DBHDS waiver hotline is 1-844-603-9248.
North Carolina — CAP/C and NC Innovations
North Carolina does not have a Katie Beckett or TEFRA program. The Autism Society of North Carolina confirms this directly. The closest equivalents for children on the spectrum are:
CAP/C (Community Alternatives Program for Children) — a §1915(c) waiver for medically fragile children ages 0–20 that disregards parental income. Provides in-home care, respite, assistive technology, and other services. Apply by calling 833-522-5429.
NC Innovations Waiver — a §1915(c) waiver for individuals with intellectual and developmental disabilities. Very long waitlist (approximately 18,000 people). Contact your LME/MCO or 855-262-1946.
1915(i) HCBS State Plan Option — an additional pathway for personal assistance services.
Because NC does not disregard parental income for standard Medicaid, families with income above the state's Medicaid threshold usually pursue CAP/C first if the child's needs qualify.
Maryland — Maryland Autism Waiver and Model Waiver
Maryland does not have a TEFRA/Katie Beckett program either, but it does have something unusual — a §1915(c) HCBS waiver specifically for children with autism, in place since 2001.
Maryland Autism Waiver — Serves children ages 1 through the end of the school semester in which they turn 21. Requires a current ASD diagnosis, an IEP or IFSP with at least 15 hours per week of special education or related services, and ICF-IID level of care eligibility. Financial eligibility is based on the child's income (up to 300% of SSI). The waiver is currently full; families must call the Autism Waiver Registry at 866-417-3480 to join the waitlist (approximately 6,200 children).
Model Waiver for Medically Fragile Children — Serves children ages 0+ who are medically fragile. Contact the Coordinating Center for Home and Community Care.
Rare and Expensive Case Management (REM) — A fee-for-service Medicaid pathway for individuals with qualifying rare and expensive conditions. Contact: 410-767-1903 or 1-800-565-8190.
The Autism Waiver waitlist is long, so families are usually advised to register as early as possible and pursue REM or standard Medicaid pathways in parallel.
What This Waiver Means for Families of Children with Autism
For most families with an autistic child, the Katie Beckett Waiver — or the state's closest equivalent — is the single biggest financial lever available. When approved, it typically pays for:
ABA therapy, when medically necessary and part of an approved plan
Occupational, physical, and speech therapy sessions private insurance capped
Home health, private duty nursing, and durable medical equipment
Respite care so parents can rest without paying out of pocket
Copays, deductibles, and premiums the family was carrying under private insurance
The financial relief is real, but so is the emotional one. Coverage removes the pressure of choosing between therapy hours and the household budget, and it lets children stay home and receive care in the environment where they're most likely to make progress.
Ready to Take the Next Step?
Whether your family lives in Georgia, Tennessee, Virginia, North Carolina, or Maryland, the Katie Beckett Waiver or its state equivalent can dramatically expand what's possible for your child's therapy plan. The paperwork can be intimidating, but you don't have to figure it out alone.
At Blossom ABA Therapy, we help families understand which Medicaid pathway their child is eligible for, coordinate documentation, and start ABA services once coverage is in place. We currently serve families across Georgia, Tennessee, Virginia, North Carolina, and Maryland.
Frequently Asked Questions
How does the Katie Beckett Waiver differ from other Medicaid waivers? Katie Beckett is an eligibility pathway that disregards parental income and counts only the child's income. Most §1915(c) HCBS waivers also disregard parental income but come with fixed slots and waitlists. In states where Katie Beckett/TEFRA exists as an entitlement (like Georgia), qualifying children must be served with no waitlist cap. In §1915(c) waiver states, families can wait years for a slot. Many families qualify for both and use them together.
Does an autism diagnosis alone qualify a child? Usually not. Katie Beckett and equivalent programs are level-of-care programs, not diagnosis programs. A child typically needs to demonstrate that they would otherwise require institutional-level care, which usually means significant adaptive, behavioral, or medical needs documented in a formal evaluation.
Can Katie Beckett benefits be used across state lines? No. Katie Beckett Medicaid is tied to enrollment in the state that approved it. If a family moves, they must reapply in the new state, and the new state may have a completely different program name and structure.
Does the Katie Beckett Waiver cover ABA therapy? In most states that offer it, yes — as long as ABA is medically necessary and included in the child's approved plan of care. Coverage terms follow the individual state's Medicaid ABA guidelines.
Can we have both private insurance and Katie Beckett? Yes. Under Katie Beckett, Medicaid typically acts as secondary insurance. Private insurance is billed first, and Medicaid covers costs the primary plan doesn't — including many services private plans routinely deny.
What happens when my child turns 18? Coverage under Katie Beckett generally ends when the child turns 18 (or in some states, at 21). Families should apply for adult Medicaid pathways — SSI-linked Medicaid, adult HCBS waivers, or Medicaid expansion — well before their child ages out. Adult waiver waitlists are usually long, so early applications matter.
Sources:
https://medicaid.georgia.gov/programs/all-programs/tefrakatie-beckett
https://www.tn.gov/tenncare/long-term-services-supports/katie-beckett-waiver.html
https://www.autismsociety-nc.org/toolkits/accessing-services-toolkit/
https://health.maryland.gov/mmcp/ltss/Pages/autism-waiver.aspx
https://ciswh.bu.edu/projects/the-tax-equity-and-fiscal-responsibility-act-tefra/
