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Medicaid Program - Katie Beckett Children - South Carolina

When determining a child's eligibility for Medicaid, parental income and assets are usually counted when determining financial eligibility. However, states have the option to make Medicaid benefits available to certain disabled children who would not ordinarily be eligible for SSI because their parents' income and/or resources exceed the limit. These children are generally called "Katie Beckett children".

If a child is severely disabled and meets specific medical guidelines and standards, the child's income and assets are counted and those of the parents are waived.

If the child is then eligible, Medicaid will pay for the same services it does for other children with Medicaid.

The following factors must be considered in determining the child’s eligibility:

·      must be18 years of age or younger

·      must have been disabled for at least 1 year in accordance with the SSI definition of disability

·      in need of care that is generally provided in a hospital or nursing home environment (must meet institutional level of care)

·      able to live at home if he or she can get the care needed; in some cases, a child may qualify for the Katie Beckett option even if he or she is in a residential facility

·      parents' income and resources are not counted

When applying for this program, school and medical records, verification of income for both the parents and child, and some verification of the severity of the child's disability are considered.

Katie Beckett option payments are retroactive–Medicaid will pay covered expenses from the date of application, not the date eligibility was determined.

If an application is turned down, an appeals process is available. This process is often successful in overturning a denial. Again, the eligibility will be retroactive to the date of application.

Additional Information

The local Department of Disabilities and Special Needs (DDSN) Board processes applications for the Katie Beckett Waiver. For contact information for the DSN board most convenient for you, go to http://www.state.sc.us/ddsn/delivery/boards.htm

Also see:

Medicaid Program - Optional Group Coverage

Medicaid Program - Non-Financial Eligibility

Medicaid Program - Financial Eligibility

Medicaid Program - Services

Medicaid Program - Overview

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