Understanding Your Medicaid Rights

TEFRA (also known as Katie Beckett) is a Medicaid eligibility option for children under age 19 with significant disabilities or medical complexity.

It allows a child to receive Medicaid based on their medical needs alone, even if their parents’ income would normally be too high to qualify.

No.

TEFRA establishes Medicaid eligibility, but it does not automatically authorize services.

Families must still request and receive approval for services such as:

• Home health nursing

• Private duty nursing

• Other Long-Term Services and Supports (LTSS)

Families may find it helpful to say:

 

“Our child qualifies under TEFRA and requires medically necessary in-home services. We would like to discuss all available options, including agency-provided nursing and other authorized LTSS supports.”

No.
TEFRA is specifically designed for minors under age 19.

Once approved:

• the child is considered a Medicaid recipient in their own right, and

parental income is not counted for eligibility.

Nevada provides in-home supports through:

• Long-Term Services and Supports (LTSS)

• Home and Community-Based Services (HCBS) frameworks

These programs exist to support care in the home instead of institutional settings, when safe and appropriate.

Key takeaways:

✔ Being a minor does not disqualify a child
✔ TEFRA confirms that a child has significant medical or functional care needs beyond routine parenting
✔ Some restrictions apply only to specific programs (like PCS)
✔ Licensed parent nurses may be paid through an agency, if hired
✔ Unlicensed LRIs cannot be paid under self-directed skilled care
✔ Clear, accurate wording matters

Medicaid distinguishes between typical parenting tasks and medically necessary care.

Examples of needs that may qualify as medical or functional care include:

• Inability to walk or transfer independently

• Lack of head or trunk control

• Seizure monitoring

• G-tube or medically assisted feeding

• Continuous positioning or safety monitoring

When these needs are present, continuity of care becomes a medical safety issue, not a preference.

In limited and specific circumstances, Nevada Medicaid may allow family caregivers to be reimbursed when care is medically necessary and authorized.

This may include:

• Licensed family members (nurses) hired by a Medicaid-enrolled agency, and

• Certain self-directed service models, when permitted and authorized under Medicaid rules.

Eligibility, payment method, and caregiver qualifications depend on the type of service authorized, the child’s medical needs, and current Nevada Medicaid policy.

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➡️ Families should ask their case manager to review all authorized options based on their child’s situation.