Special Health Issues: TEFRA/Katie Beckett

D.C. Medicaid and Application Process

Step 1: Complete the Initial Medicaid Application

• The first step is to log in to dchealthlink.com to complete an application for financial assistance for Medicaid. You can also apply by phone, mail, or in person.
• The applicant will be screened for MAGI Medicaid coverage and receive a decision within forty-five (45) calendar days.
• If the applicant meets all non-financial and financial requirements, the applicant will be determined eligible for MAGI Medicaid and will receive an approval notice.
• If applicant does not meet all non-financial and financial requirements, the Department will issue a notice to the applicant of their ineligibility for MAGI Medicaid and their opportunity to be evaluated for Medicaid through the TEFRA/Katie Beckett eligibility group.
• In cases where an applicant is denied for over income and there is a child with a disability in the household, a TEFRA/ Katie Beckett Application Packet will be mailed to the applicant.

Step 2: Submit the TEFRA/Katie Beckett Application

• You must submit the Katie Beckett application packet (including clinical documents) to the Division of Children’s Health Services at the Department of Health Care Finance:
• Email: HealthCheck@dc.gov
• Mail: Send your completed application to:
  • Department of Health Care Finance Division of Children’s Health Services
  • Attn: TEFRA/Katie Beckett
  • 441 4th Street NW, Suite 900S, Washington, DC 20001
• Required Katie Beckett documents include:
  • TEFRA/Katie Beckett application
  • Pediatric Level of Care Determination Form
  • TEFRA/Katie Beckett Care Plan Form
  • Supporting documents, such as Letter of Medical Necessity, Individualized Education Program/Individualized Family Service Plan, and therapy assessments such as diagnostic reports

Step 3: Submit Level of Care (LOC) Documents

• An applicant must submit the following completed Level of Care (LOC) Determination documents to the Division of Children’s Health Services (DCHS) at the Department of Health Care Finance (DHCF) via email at HealthCheck@dc.gov:
• Pediatric Level of Care Determination Form;
• TEFRA/Katie Beckett Care Plan Form; and
• Supporting documents, such as the Letter of Medical Necessity, the Individualized Education Program / Individualized Family Service Plan, therapy assessments, including diagnostic reports.

Step 4: Eligibility Determination

• The District will make an eligibility determination within sixty (60) calendar days of receipt of the completed TEFRA/Katie Beckett Application Packet.

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