An Introduction to the Katie Beckett Waiver in Tennessee
*Last updated 6/19/25
This article provides an overview of the KB waiver in TN. For updates to the program, see Key 2025 Changes.
The first Katie Beckett waiver was implemented in 1981 after President Ronald Reagan was inspired by the story of Katie Beckett. She was a young girl in Iowa who developed a brain infection when she was 5 months old which led to her being paralyzed and spending three years in the hospital. After the hard work of many advocates, the Katie Beckett program launched in Tennessee in November 2020 and is available for ages 1-18.
To apply for Katie Beckett, families must first go through a financial review and a medical review. The financial review will determine whether the child qualifies for Medicaid or the Katie Beckett waiver. The medical review helps determine what level of care the child needs.
When applying families need to create a profile with self-referral at TennCare Connect. Creating this online is the fastest and easiest method, however, a DIDD case manager can help you complete the self-referral. To get help, call the DIDD office in your region:
West Tennessee Regional Office: (866) 372-5709
Middle Tennessee Regional Office: (800) 654-4839
East Tennessee Regional Office: (888) 531-9876
A DIDD case manager will be in contact to set up an assessment where medical documentation will be required regarding an individual's condition or disability. Proof will be required through these documents at the time of assessment or applications can be denied or delayed.
This visual helps walk through the application process:
Children are grouped into 3 tiers. Tier 1 is for children with complex medical and behavioral needs. Tier 2 is for children who have complex needs, but their needs aren’t as high as Tier 1. These children can have medical, behavioral, or functional needs. Tier 1 will enroll in Part A. Other children can enroll for Part B while waiting. Part A receives $15,000/year and is enrolled in Medicaid. Part B receives $10,000/year.
There are a limited number of slots available in both Part A and Part B. Part A is based on the level of need, while Part B is on a first come first first-served basis. An individual can remain in the program until 18 if they continue to meet all qualifications.
There is a third tier, Part C, which is for children who currently have Medicaid, but their coverage is ending due to an increase in income or resources. If a child would qualify for Part A, but there is no available slot, this tier would allow them to keep their Medicaid coverage until a Part A slot opens. Individuals in Part C will NOT receive Home and Community-Based Services (HCBS).
What About Income Limits?
A common question families have is whether there are income limits for the Katie Beckett program. The important thing to know is that there is no income ceiling based on the parents’ income. Instead, eligibility is determined based on the child’s assets.
The program uses an asset ceiling that applies only to the child, not the parents. Unless the child has a significant amount of assets (such as a large savings account or an estate in their name), income and financial resources do not impact eligibility. This structure allows many families who might not qualify for other programs due to income to still receive support through Katie Beckett.
Billing Provider Changes for the Katie Beckett Program
The Katie Beckett program has undergone several changes in billing service providers over the last two years. In 2024, the program transitioned from PayFlex to Inspira, following PayFlex’s rebranding. Now, in 2025, the program is making another transition — this time from Inspira to TASC, as a result of the State of Tennessee’s competitive bidding process.
Families have continued to use Inspira's debit card, online portal, and mobile app to manage their reimbursement accounts. With Inspira, families have had the flexibility to purchase a variety of eligible physical items and services to support their child’s needs, including music therapy. Some purchases require a LOMN (letter of medical necessity) from a healthcare provider, while others do not. The Inspira debit card can only be used at point-of-sale (POS) machines coded for medical, dental, or vision expenses, and pharmacy use may be restricted to the pharmacy register. As a result, most families have used Inspira primarily as a reimbursement service.
Reimbursements typically take about two weeks to process. Payments are usually issued on a Friday and deposited by the following Monday. Families may also opt to receive reimbursement via check and must provide proof of receipt for all submitted charges.
Upcoming Transition to TASC – July 2025
Inspira’s contract with the state officially ended on June 1, 2025, and TASC will begin processing reimbursement requests starting July 11, 2025. This change means families will once again transition to a new billing service provider within a short time frame.
During this shift, there will be a temporary blackout period when families cannot access funds or submit reimbursement requests. Despite this short-term disruption, all existing HRA balances will be fully transferred, and families will receive new TASC HRA cards in time for the July go-live date.
There will be no changes to case managers or funding amounts, and TASC is expected to offer improved functionality and long-term system enhancements. TASC is also offering dedicated support resources to help families navigate the transition.
View more in-depth information regarding this change here.
There are a limited number of slots available in both Part A and Part B of the Katie Beckett program. Part A is based on level of need, while Part B is first-come, first-served. The current estimated waitlist time is 2–6 months.
Example Items/Services not covered
Property Taxes
Washing machine
Care.com monthly membership fees
Monthly reoccurring Medical Fees
Disney tickets/Out of state amusement parks, museums, etc.
Printer
Example Items/Services that are potentially covered (most require a LOMN)
Wheelchair ramp
Specialized locks for doors/windows
Respite Care
Service animal
Testing and evaluations
Speech Devices
ASL courses
Homeschooling curriculum and supplies
Non-traditional therapies are covered under the Katie Beckett waiver. Supporting developmental challenges can often be effectively supported through services like our specialized pediatric music therapy programs! A LOMN is needed for Music Therapy to be covered for reimbursement. The paperwork can be challenging to navigate but we’re here to support you along the way. Music Therapy is not covered by insurance in the state of Tennessee which makes the Katie Beckett waiver a phenomenal assistance in getting Music Therapy services.
Explore inspiring success stories from Tennessee families who have benefited from using their Katie Beckett funds for music therapy.
Helpful Links:
DIDD Katie Beckett Page:
TennCare Katie Beckett Page:
Part A - https://youtu.be/0AJFjwHC-Fg
Part B - https://youtu.be/HbQ7lM8gr0U
While this is just a very brief overview, you can find more information about the Katie Beckett Program on both the DIDD and TennCare websites. Musical Bridges has many clients successfully enrolled in the program who are thriving in Music Therapy. If you have any questions about how your child can benefit from Music Therapy, please contact us to explore the benefits of our music therapy services for children with complex needs!
