Katie Beckett / TEFRA
The Katie Beckett waiver — formally the TEFRA Medicaid option — lets children with significant medical needs get Medicaid at home without counting their parents' income or assets. Here is how it works, who qualifies, and how to start in your state.
Katie Beckett was an Iowa child who needed ventilator care that Medicaid would cover in a hospital but not at home, because at home her parents' income counted against her. In 1981 the federal government created a pathway for children like her, made a formal state option by the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) — which is why the program carries both her name and the TEFRA label.
States electing the TEFRA option treat a qualifying child as a household of one: parents' income and assets are "deemed" unavailable. The child must be under 18, meet an institutional level of care, and be cared for at home cost-effectively.
Unlike capped HCBS waivers with waitlists, TEFRA is a state-plan option: children who meet the criteria are entitled to coverage. If your child qualifies, there is no slot to wait for.
Not every state adopted TEFRA, and states that did use their own forms, physician paperwork, and review contractors. Always start from your own state Medicaid agency's current instructions.
Georgia's Katie Beckett program (locally, the "Deeming Waiver") is one of the best-known TEFRA programs — and one of the most paperwork-heavy. Families assemble a packet built around the Form 94 Medicaid application plus three physician forms (DMA-6(A), DMA-706 level of care, DMA-704 cost-effectiveness), mail or fax it to a centralized team in Norcross, and send medical documentation to Alliant Health Solutions for the level-of-care review. A physician-signed DMA-6(A) is valid only 90 days, and a new DCH portal launched April 15, 2026 for uploads and status tracking.
Technically no. It is a TEFRA state-plan option, not an HCBS 1915(c) waiver. Because parents' income and assets are 'deemed' unavailable, many states — Georgia especially — call it the Deeming Waiver, and 'Katie Beckett waiver' stuck as the everyday name.
No. That is the defining feature: only the child's own income and assets are counted. A family can earn too much for regular child Medicaid and still qualify a medically complex child through Katie Beckett.
In general: a child under 18 who meets an institutional level of care (such as nursing facility or ICF level) and whose care at home is cost-effective compared with institutional care. Exact process and forms vary by state.
In states that adopted the TEFRA option, eligible children are entitled to coverage — there is no enrollment cap or waitlist like capped HCBS waivers. Georgia's Katie Beckett program, for example, has no waitlist.
Start with your state Medicaid agency. In Georgia, the Department of Community Health runs a mail/fax packet (Form 94 plus physician forms) with a new online portal launched in April 2026. Other states use different forms and intake routes.
Last reviewed by WaiverPath: July 2, 2026.
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.
