Florida · Katie Beckett / TEFRA

Florida Katie Beckett waiver for children

Florida's Katie Beckett program — a federal TEFRA state plan option — gives Medicaid to children under 18 with significant medical needs without counting parents' income or assets. It is administered by the Florida Agency for Health Care Administration (AHCA) and is not a capped waiver with a waitlist, unlike the APD iBudget waiver for individuals with developmental disabilities.

Parent income is not counted

Under TEFRA, parental income and assets are "deemed" unavailable for eligibility purposes. Only the child's own income and assets are reviewed. This allows children from higher-income families to qualify if their medical needs meet the institutional level-of-care standard.

No waitlist

Unlike Florida's APD iBudget waiver, Katie Beckett is an entitlement program for eligible children — not a capped waiver with limited slots. Children who meet the level-of-care and financial criteria are enrolled without joining a waiting list. Confirm current enrollment status with AHCA.

Level-of-care threshold

Eligibility requires meeting the standard for nursing facility, ICF, or hospital care — the child must need significant medical or personal care supports that justify the institutional threshold. AHCA conducts a level-of-care review using the family's submitted medical documentation.

How to apply — 6 steps

Step 1: Confirm the child meets the level-of-care requirement. Florida's Katie Beckett program requires that the child's medical needs equal a nursing facility, intermediate care facility, or hospital level of care — meaning, without ongoing home supports, institutional care would be needed. Begin by discussing this threshold with the child's primary care physician or specialist. Ask the doctor to document the functional limitations and medical complexity in writing before you start the application — this documentation drives the AHCA level-of-care determination.
Step 2: Verify Medicaid enrollment status or begin enrollment simultaneously. Katie Beckett requires active Florida Medicaid enrollment. Check the child's current Medicaid status through the ACCESS Florida portal (myflorida.com/accessflorida) or by calling 1-877-711-3662. If the child is not enrolled, apply for Medicaid at the same time you begin gathering documents for the level-of-care review. Under TEFRA rules, parent income is not used in the eligibility determination, so do not assume the family's income disqualifies the child.
Step 3: Gather medical documentation before contacting AHCA. Assemble medical records before your first contact: the child's diagnosis documentation from specialists, current physician notes describing daily functional limitations, any therapy or rehabilitation reports, IQ or adaptive behavior assessments if applicable, school or early intervention records documenting support needs, and a physician letter stating the child's need for ongoing home medical supports. Having these ready at intake prevents weeks of back-and-forth.
Step 4: Apply through ACCESS Florida or contact AHCA Medicaid directly. Submit a Medicaid application through ACCESS Florida (myflorida.com/accessflorida) and indicate in the application that you are requesting Katie Beckett / TEFRA coverage for a child with complex medical needs. Alternatively, call the AHCA Medicaid helpline at 1-877-711-3662 to be connected with the unit handling TEFRA level-of-care reviews. Record the date you called, the representative's name, and the reference or case number provided.
Step 5: Attend the level-of-care assessment and submit supporting records. AHCA or its contracted review organization will conduct a level-of-care determination. This involves reviewing medical documentation and may include an in-person or telephone assessment. Present the child's real daily support needs accurately and completely — include supports currently provided by family members that might not appear on formal records. Incomplete assessments that understate daily needs can result in a denial that requires appeal.
Step 6: Follow up with AHCA and confirm enrollment once approved. After the level-of-care determination, AHCA sends a written notice. If approved, confirm Medicaid enrollment is active and Katie Beckett services have been authorized. Note the coverage start date, review period, and renewal date — Katie Beckett coverage requires periodic renewal, and missing a renewal notice can interrupt coverage. Log all correspondence dates and keep copies of every document submitted and received.

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Documents to gather

Assemble these before your first AHCA contact to avoid delays. The agency will confirm the exact list for your child's situation.

Child's birth certificate or proof of ageRequired to confirm the child is under 18.
Proof of Florida residencyCurrent lease, utility bill, or official mail showing the child's Florida address.
Child's Social Security numberRequired for Medicaid enrollment — not the parent's SSN.
Physician's statementLetter from the treating physician documenting the qualifying diagnosis, functional limitations, and need for ongoing home medical supports.
Specialist medical recordsNotes from specialists (neurologists, developmental pediatricians, therapists) that document the condition and its impact on daily functioning.
Functional or psychological assessmentsAny existing assessments of the child's adaptive behavior, IQ, or daily living skills — especially important for developmental disabilities.
School or early intervention recordsIEP, 504 plan, or early intervention records documenting the child's support needs in educational settings.
Previous Medicaid correspondenceIf the child has applied for Medicaid before, include any prior determination letters or case numbers.

Florida Katie Beckett FAQ

Is Florida Katie Beckett Medicaid based on parent income?

No. Florida's Katie Beckett program uses the federal TEFRA rule, which 'deems' parental income and assets unavailable. Only the child's own income and assets are evaluated. This means children with complex medical needs can qualify for Medicaid even when the family's household income would normally exceed Florida Medicaid limits. Confirm current financial criteria with the Florida Agency for Health Care Administration (AHCA).

Is there a waitlist for Florida Katie Beckett?

Florida's Katie Beckett program is a TEFRA state plan option — not a capped 1915(c) HCBS waiver — so eligible children are entitled to coverage without a waitlist. This is different from the Florida APD iBudget waiver, which has a waiting list for individuals with developmental disabilities. Confirm current program capacity and enrollment status with AHCA Medicaid.

Who qualifies for Florida Katie Beckett Medicaid?

A child under 18 who: (1) has a medical condition that would require care in a nursing facility, intermediate care facility, or hospital without home supports; (2) can be served cost-effectively in a home or community setting; and (3) meets the child's own income and asset rules. Parent income is not counted. The determination is made by AHCA through a level-of-care review.

What is the difference between Katie Beckett and the Florida APD iBudget waiver?

They serve different populations through different mechanisms. Katie Beckett (TEFRA) is a Medicaid state plan option for any child with a nursing-facility-level need, regardless of diagnosis — it disregards parent income and has no waitlist. The APD iBudget waiver is a 1915(c) HCBS waiver specifically for Floridians with developmental disabilities (autism, intellectual disability, cerebral palsy, Prader-Willi syndrome, spina bifida) and does have a waitlist. Many children qualify for one or the other, not both at the same time. Confirm eligibility for each program with the administering agency.

How does a family apply for Katie Beckett Medicaid in Florida?

Apply through ACCESS Florida (myflorida.com/accessflorida) by submitting a Medicaid application and noting the child's complex medical needs. You can also call the Florida Medicaid helpline at 1-877-711-3662 to request a level-of-care review directly. A physician's statement and medical records are central to the application. Once submitted, AHCA or its contracted review organization conducts the level-of-care determination.

What documents does Florida AHCA need for a Katie Beckett application?

Generally: the child's birth certificate or proof of age, proof of Florida residency, Social Security number for the child, a physician's statement documenting the qualifying diagnosis and functional needs, current medical records (specialist notes, therapy records, test results), and any existing functional or psychological assessments. The specific document list is confirmed by AHCA during the intake process — gather records before your initial call to avoid delays.

How long does the Florida Katie Beckett approval process take?

Timelines vary based on the completeness of medical records and AHCA's current review volume. The level-of-care review can take several weeks to months. Submitting complete documentation upfront — without missing physician signatures or gaps in records — is the most effective way to avoid delays. WaiverPath helps organize documents and contacts so nothing falls through the cracks.

Can a child receive Katie Beckett Medicaid and also access other Florida waiver services?

A child with Katie Beckett (TEFRA) Medicaid may be able to access additional waiver services depending on diagnosis, age, and the specific programs available. Children with developmental disabilities may separately be placed on the APD iBudget waiting list. Services received through Katie Beckett Medicaid and those funded through an HCBS waiver are separate — confirm with AHCA and APD what can be combined and what cannot. Always verify current program rules directly with the administering agencies.

Looking at the national Katie Beckett picture? See the Katie Beckett waiver national guide. For Florida's APD iBudget waiver for individuals with developmental disabilities, see the Florida iBudget waiver overview. Families tracking eligibility steps can also use the HCBS waiver eligibility guide.

WaiverPath is not a government agency, law firm, Medicaid provider, or benefits advisor. We help you organize information, documents, and follow-up tasks. Always verify requirements with the official agency or a qualified professional.