Katie Beckett Medicaid: How to Apply
Katie Beckett Medicaid is a special eligibility pathway for children under 19 who have certain health care needs and live at home. Katie Beckett provides Medicaid health care coverage for children who qualify.
Steps to apply
- Call 888-786-3246 to apply. You will speak to an eligibility specialist who can:
- Explain more about Katie Beckett Medicaid.
- Send you an application packet.
- Set up a meeting with you and the child. (The meeting can be either virtual or in person.)
- Attend a meeting with an eligibility specialist. During the meeting, the eligibility specialist will:
- Answer questions.
- Go over the application materials.
- Verify certain documents.
- Complete the Children’s Programs Eligibility and Functional Screen, P-03061, a tool that gives the eligibility specialist a picture of the child’s daily life and determines functional eligibility.
A clinical team within the Wisconsin Department of Health Services (DHS) will review medical information to determine if the child meets the necessary eligibility criteria under the Social Security Act.
If all eligibility standards are met, the child is approved for Katie Beckett Medicaid.
Once you’re enrolled
If you enroll in Katie Beckett Medicaid, your eligibility will be reviewed each year. We’ll also review your child’s eligibility if there is a significant change to your child’s condition.
Call ForwardHealth Member Services at 800-362-3002 to report:
- Problems getting a ForwardHealth Medicaid card.
- Changes to your child’s insurance.
Call the Katie Beckett Central Office at 888-786-3246 to report:
- Changes to your child’s address.
- Changes to your child’s medical condition.
- If your child is no longer living at home.
If you don't agree with a decision
If you don't agree with a decision, you can request a fair hearing with the Wisconsin Division of Hearing and Appeals (DHA).
- A fair hearing is held in an informal setting (generally over the telephone) with a judge (called an administrative law judge). The judge listens to both sides, reviews all documents, and decides what to do about the decision being appealed.
- A fair hearing gives you a chance to say why you think a wrong decision was made about the child’s eligibility.
You must request a fair hearing within 45 days of:
- A decision (if this is your first application to Katie Beckett Medicaid).
- When your coverage ends (if you have had Katie Beckett Medicaid and you are now found not eligible).
- Yes, if you are already getting benefits and you ask for a hearing before your coverage ends. You can keep getting the same benefits until the hearing officer makes a decision.
- If the hearing officer decides that the agency was right, you may need to return the extra benefits you got after your benefits were supposed to change.
Your request for a fair hearing must be made in writing and must be signed and dated, using one of the following options:
- Submit a DHA Request for Fair Hearing form. This form is available in several languages. Be sure to sign and date the form and include a copy of the denial letter when you send the form.
- Write on a copy of the denial letter or on a separate piece of paper that you would like to request a fair hearing about the decision described in the letter. Be sure to sign your name and write the date. If you write on a separate piece of paper, include a copy of the letter when you send your request.
- Do you have new information we haven't seen? Send it to the Katie Beckett Central office at DHSKatieBeckett@dhs.wisconsin.gov before your hearing. This way we have all the information needed for the hearing. Having all the information ahead of time helps get the most accurate decision.
Once you have the materials ready to submit, mail, email, or fax your request to:
Wisconsin Division of Hearings and Appeals
4822 Madison Yards Way
Madison, WI 53707-7875
Email: DHAMail@wisconsin.gov
Phone: 608-266-7709
Fax: 608-264-9885