Paying for care
Medicaid and EPSDT, coverage whatever the family's income, waivers, Title V programs, private insurance, appeals, SSISupplemental Security Income: monthly payments from Social Security for people with disabilities who have low income and few savings. and ABLE accounts.
Medicaid and EPSDT
Medicaid pays for most long-term care for children with medical complexity. For children under 21, the EPSDT benefit means Medicaid must cover any medically necessary service that federal law lets Medicaid cover, even if the state does not cover it for adults. That includes nursing, equipment and therapies when they are medically necessary.
Separate CHIP plans do not have to follow EPSDT. Ask whether your child's coverage is Medicaid or CHIP.
Medicaid whatever the family's income
Most states have a way for children with significant disabilities who live at home to get Medicaid whatever their parents earn. It goes by names like Katie BeckettA Medicaid option for children with significant disabilities that looks at the child's own income, not the parents'. Also called TEFRA., TEFRAA Medicaid option for children with significant disabilities that looks at the child's own income, not the parents'. Also called Katie Beckett., or a waiver for medically fragile children. Some have wait lists, so apply early.
| State | Medicaid for children | Coverage whatever the income | CHIP |
|---|---|---|---|
| Alabama | Alabama Medicaid | yes (KFF 2026: state plan option or comparable waiver) | ALL Kids |
| Alaska | Denali KidCare (Alaska Medicaid for children and pregnant women) | yes: TEFRA (state plan option) | Denali KidCare |
| Arizona | AHCCCS (Arizona Medicaid) | yes (KFF 2026: state plan option or comparable waiver) | KidsCare |
| Arkansas | ARKids First A (Medicaid) | yes: TEFRA (ARKids TEFRA, income-based premium) | ARKids First B |
| California | Medi-Cal | yes (KFF 2026: state plan option or comparable waiver) | Medi-Cal (CHIP is part of Medi-Cal); Medi-Cal Access Program (MCAP) fo |
| Colorado | Health First Colorado | yes: Health First Colorado Buy-In Program for Children with Disabilities | Child Health Plan Plus (CHP+) |
| Connecticut | HUSKY Health (HUSKY A) | yes: Katie Beckett Waiver (1915(c)) | HUSKY B |
| Delaware | Delaware Medicaid (Diamond State Health Plan) | yes: Children's Community Alternative Disability Program (TEFRA) | Delaware Healthy Children Program |
| District of Columbia | DC Medicaid | yes: TEFRA/Katie Beckett option | DC Healthy Families (CHIP is part of DC Medicaid) |
| Florida | Florida Medicaid (Florida KidCare Medicaid) | yes (KFF 2026: state plan option or comparable waiver) | Florida KidCare (MediKids, Florida Healthy Kids, Children's Medical Se |
| Georgia | Georgia Medicaid | yes: TEFRA/Katie Beckett | PeachCare for Kids |
| Hawaii | Med-QUEST (Hawaii QUEST Integration) | yes (KFF 2026: state plan option or comparable waiver) | Med-QUEST (CHIP is part of QUEST) |
| Idaho | Idaho Medicaid | yes: Katie Beckett (TEFRA), Home Care for Certain Disabled Children | Idaho CHIP (part of Idaho Medicaid) |
| Illinois | Illinois Medicaid (All Kids) | yes (KFF 2026: state plan option or comparable waiver) | All Kids |
| Indiana | Hoosier Healthwise | yes (KFF 2026: state plan option or comparable waiver) | Hoosier Healthwise (CHIP package) |
| Iowa | Iowa Medicaid (IA Health Link) | yes: Iowa HCBSHome and community based services: help at home, at work, and in the community, paid for by Medicaid. children's waivers (Iowa was the first Katie Beckett waiver state per Catal | Hawki |
| Kansas | KanCare | yes (KFF 2026: state plan option or comparable waiver) | KanCare (CHIP is part of KanCare) |
| Kentucky | Kentucky Medicaid | yes (KFF 2026: state plan option or comparable waiver) | KCHIP |
| Louisiana | Healthy Louisiana (Louisiana Medicaid) | yes: Children's Medicaid Option (TEFRA) | LaCHIP |
| Maine | MaineCare | yes: Katie Beckett (TEFRA | CubCare |
| Maryland | Maryland Medicaid (HealthChoice) | yes (KFF 2026: state plan option or comparable waiver) | Maryland Children's Health Program (MCHP) |
| Massachusetts | MassHealth | yes: Kaileigh Mulligan Program (TEFRA) | MassHealth (CHIP is part of MassHealth) |
| Michigan | Healthy Kids (Michigan Medicaid) | yes: Home Care Children's/TEFRA Program | MIChild |
| Minnesota | Medical Assistance (Minnesota Medicaid) | yes: MA-TEFRA | Medical Assistance (CHIP is part of MA); MinnesotaCare |
| Mississippi | Mississippi Medicaid | yes: Disabled Children Living at Home (TEFRA) | Mississippi CHIP |
| Missouri | MO HealthNet for Kids | yes (KFF 2026: state plan option or comparable waiver) | MO HealthNet for Kids (CHIP) |
| Montana | Healthy Montana Kids Plus (Medicaid) | no (KFF 2026) | Healthy Montana Kids |
| Nebraska | Nebraska Medicaid (Heritage Health) | yes: Katie Beckett Program (TEFRA) and Medicaid HCBS waivers | Nebraska CHIP (Kids Connection) |
| Nevada | Nevada Medicaid | yes: Katie Beckett Program (TEFRA) | Nevada Check Up |
| New Hampshire | New Hampshire Medicaid | yes: Home Care for Children with Severe Disabilities (Katie Beckett option, TEFRA) | New Hampshire Medicaid (CHIP is part of Medicaid) |
| New Jersey | NJ FamilyCare | yes (KFF 2026: state plan option or comparable waiver) | NJ FamilyCare |
| New Mexico | Turquoise Care (New Mexico Medicaid; formerly Centennial Care) | no (KFF 2026) | New Mexico Medicaid (CHIP is part of Medicaid) |
| New York | New York Medicaid | yes (KFF 2026: state plan option or comparable waiver) | Child Health Plus |
| North Carolina | NC Medicaid | yes (KFF 2026: state plan option or comparable waiver) | NC Medicaid (NC Health Choice merged into Medicaid in 2023) |
| North Dakota | North Dakota Medicaid | yes (KFF 2026: state plan option or comparable waiver) | North Dakota CHIP |
| Ohio | Ohio Medicaid (Healthy Start) | no (KFF 2026) | Healthy Start (CHIP) |
| Oklahoma | SoonerCare | yes: TEFRA Children | SoonerCare (CHIP is part of SoonerCare) |
| Oregon | Oregon Health Plan (OHP) | yes (KFF 2026: state plan option or comparable waiver) | Oregon Health Plan (CHIP is part of OHP) |
| Pennsylvania | Medical Assistance (Pennsylvania Medicaid) | no (KFF 2026). KFF lists No. Pennsylvania's PH-95 Medical Assistance category for children | Pennsylvania CHIP |
| Rhode Island | RIte Care | yes: Katie Beckett Program (TEFRA) | RIte Care |
| South Carolina | Healthy Connections Medicaid | yes: Katie Beckett TEFRA Children | Healthy Connections (CHIP is part of Medicaid) |
| South Dakota | South Dakota Medicaid | yes: Disabled Children's Program (TEFRA) | South Dakota CHIP |
| Tennessee | TennCare | yes: Katie Beckett Program (1115 demonstration, Parts A and B) | CoverKids |
| Texas | Texas Medicaid | no (KFF 2026). KFF lists No. Texas Medically Dependent Children Program (MDCP) waiver is c | Texas CHIP |
| Utah | Utah Medicaid | yes (KFF 2026: state plan option or comparable waiver) | Utah CHIP |
| Vermont | Dr. Dynasaur (Green Mountain Care) | yes: Disabled Children's Home Care, Katie Beckett Program (TEFRA) | Dr. Dynasaur |
| Virginia | FAMIS Plus (Virginia Medicaid for children), Cover Virginia | no (KFF 2026) | FAMIS |
| Washington | Apple Health for Kids | no (KFF 2026) | Apple Health for Kids |
| West Virginia | West Virginia Medicaid | yes: Children with Disabilities Community Service Program (TEFRA) and Medicaid waivers | WVCHIP |
| Wisconsin | BadgerCare Plus | yes: Katie Beckett Program (TEFRA) | BadgerCare Plus |
| Wyoming | Wyoming Medicaid | no (KFF 2026) | Kid Care CHIP |
Medicaid waivers
Waivers pay for care at home instead of in a hospital or institution: nursing, respite, home changes and more. Each state names and runs its own. Many have wait lists that take years, so apply as soon as your child may qualify. Waivers and wait lists, explained on IDD Atlas.
Your state's Title V program
Every state has a program for children and youth with special health care needs, funded through the federal Title V block grant. What it does varies: many help coordinate care, some pay for care or supplies that insurance does not. Your state guide has its phone number.
Some state Medicaid programs also offer health homes for children with medical complexity, a care coordination option a 2019 federal law (the ACE Kids Act) made possible. Ask your state Medicaid agency or Title V program whether yours does.
Private insurance
- Many services need prior authorization. Ask your doctor's office to send it early.
- If a claim or service is denied, ask for the reason in writing. You can appeal inside the plan, and then ask for an independent outside review.
- Children can have private insurance and Medicaid at the same time. Medicaid then pays after the private plan.
Appeals
- Read the notice. It says what was decided, why, and the deadline to appeal.
- Appeal before the deadline. For Medicaid, if you appeal quickly (the notice says how soon), services can usually continue while you wait.
- Ask your doctor for a letter of medical necessity.
- Ask your Family-to-Family Health Information Center or your state's disability rights agency for free help.
SSI and ABLE accounts
- SSI for children: Social Security counts part of the parents' income until 18. At 18, parent income stops counting and Social Security reviews the young adult under adult rules.
- ABLE accounts: tax-advantaged savings for a person whose disability began before age 46 (since 1 January 2026). Up to $100,000 does not count against SSI.
- More on work and benefits at Employment Atlas.
This is general information, not financial, legal or medical advice. Programs and rules change. Check with the program named before you decide.
Last reviewed: November 2026. Programs, rules and phone numbers change. Check with the program named on this page. Report outdated or wrong information.