Under current federal law, states may expand coverage to certain groups of people based on certain criteria it deems appropriate. In some states this expanded coverage is provided to families of children with exceptional health care needs who would not otherwise meet eligibility exceeding income and asset requirements. The concept of providing Medicaid as a secondary or primary insurance option to assist families is an effort to help children remain in the community and from being placed in a nursing care facility provided the cost of coverage does not exceed the cost of placement in a facility. Often referred to as a “Katie Beckett” or home and community based waivers, these programs provide additional coverage for many. These waivers vary considerably by state in the numbers covered, services provided and whether there is a waiting period for application and coverage.
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