January 23, 2010

What is the Deeming Waiver?

I had a couple people ask me more about the Katie Becket / Deeming Waiver which I had mentioned in my last post, so I thought I'd explain a bit more about it. The manual, with full instructions can be found by clicking here. This is a Georgia specific program, but all states have been given the right (by the federal govt) to implement plans like this. 

The Katie Beckett Waiver allows states to make Medicaid services available to certain disabled children who would not ordinarily be eligible for Social Security Income (SSI) benefits because of their parents’ income. Income qualifications for Katie Beckett are based solely on the child’s income, but a number of different factors are considered for approval. If approved, the same eligibility for health coverage will be available to the child as other Medicaid members.           

Even if a child has private insurance coverage, parents can apply for this waiver.  Most private insurance policies have service limitations, out of pocket expenses, and lifetime caps.  In cases where private insurance exists, the Deeming Waiver will be beneficial as secondary insurance to cover out of pocket expenses and will be helpful to have before a lifetime cap is met. As secondary coverage, Medicaid will pay for 20% of covered expenses that primary insurance does not pay. 

Once a child is approved for the Deeming Waiver, a review of the child's continued eligibility takes place annually - so you have to fill out the paperwork again each year. (though it's much easier after the first time you apply and are accepted)

Your county Department of Family and Children Services (DFCS) can let you know if your state has such a waiver - it's worth the trouble of making the calls and filling all the paperwork to get the benefits in the end!

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