Using your Katie Beckett funds

The short version

The best use is not necessarily the biggest purchase. It is the support your child will actually use and your family can realistically maintain. That might be therapy copays, reliable respite, an AAC support, adapted seating, swim instruction tied to a medical need, incontinence supplies, or a home change that removes a daily barrier.

First: is your child in Part A or Part B?

This guide focuses on Tennessee Katie Beckett Part B, the part with a flexible annual service budget.

• Part B is not Medicaid. A child may receive up to $10,000 per calendar year across the program's service options.
• Part A includes full Medicaid benefits plus up to $15,000 per calendar year in home- and community-based services. Medical equipment, supplies, and therapy generally follow Medicaid and health-plan rules; the HCBS portion has its own approved-plan rules.

If you are unsure which part your child has, ask your Katie Beckett case manager before using this guide to plan purchases.

Before you buy

These are ideas to discuss, not a guarantee of payment. An item appearing on a retailer or state list does not mean it is automatically approved for your child. Confirm the correct benefit path, support-plan authorization, documentation, service date, and available balance before purchasing.

Ask these four questions:

1. Which benefit path should pay for this: HRA, individualized therapeutic support reimbursement, self-directed care, or an agency-based service?
2. Must it be added to my child’s approved support plan before the purchase or service date?
3. Do I need a Letter of Medical Necessity, cost comparison, evaluation, quote, or prior approval?
4. What receipt, invoice, insurance EOB, or proof of final out-of-pocket cost will I need?

For a costly item, home or vehicle change, or anything you are not certain about, ask for an answer in writing before purchasing.

The five Part B spending paths

Health insurance premium assistance

Helps reimburse the child’s portion of a private health-insurance premium. This can be a sensible first use when the premium is one of the family’s largest predictable disability-related costs.

Healthcare Reimbursement Account (HRA)

The TASC-administered HRA pays or reimburses IRS-qualified health expenses for the enrolled child. Examples include eligible copays and deductibles, prescriptions, therapy, medical equipment and supplies, orthotics, dental and vision costs, medical mileage, and some items supported by a Letter of Medical Necessity.

The HRA allocation is chosen once per calendar year and cannot be changed during that year. Expenses before the HRA authorization date are not eligible, and unused funds do not roll over.

Individualized therapeutic support reimbursement

This is the path to ask about for medically necessary nontraditional therapies or items that private insurance and the HRA do not cover. Approval and documentation are required; start with the case manager rather than assuming an activity qualifies.

Consumer-directed respite and supportive home care

Allows a family to hire an eligible worker to provide respite or help care for the child at home. This can protect caregiver health, make time for siblings possible, or create dependable support during demanding routines. Enrollment, worker setup, documentation, and program rules apply.

Agency-based services

DDA-contracted community providers may offer respite, supportive home care, transportation, home and vehicle modifications, assistive technology, and other approved services. Your case manager can explain local options and participating providers.

Where the money may make the biggest difference

Before looking at products, think about the problem you want to solve.

1. Cover unavoidable costs first

Consider insurance premiums, therapy or medical copays, deductibles, prescriptions, orthotics, dental or vision expenses, eligible medical mileage, formula or nutrition supports, and incontinence supplies. These may not feel exciting, but paying a recurring cost can free family money for groceries, utilities, and ordinary childhood experiences.

2. Buy access, communication, and independence

A useful device may let a child communicate, eat, bathe, dress, move, sit safely, participate in school, or join family outings with less assistance. Ask the relevant SLP, OT, PT, assistive-technology professional, or medical provider to help identify the feature that solves the actual problem.

3. Make support sustainable

Respite and supportive home care are not consolation prizes. A dependable break, help with a difficult routine, or another trained adult who knows your child can benefit the whole family.

4. Choose practice that transfers to real life

Therapy, tutoring, or an adapted activity may be more valuable when it is tied to a concrete goal: communicating with new people, water safety, tolerating grooming, navigating a store, riding in the car safely, playing with peers, or managing a community routine.

5. Remove one recurring barrier

Notice what causes difficulty every day. A better bath seat, visual support, adapted cup, safe stroller, noise protection, ramp, communication switch, or toileting support can sometimes improve hundreds of ordinary moments.

Equipment and supply ideas

Ask your case manager before purchasing. The links below are places to browse examples—not endorsements, prescriptions, or proof that an item will be reimbursed.

Safety note: Ask the appropriate licensed clinician to help select, size, and use safety-sensitive equipment. Follow manufacturer installation, age, weight, and supervision requirements. This is especially important for swings, climbing equipment, weighted products, positioning, feeding, mobility, car seats, and sleep equipment.

Cool things families can actually ask for

Here are concrete examples at different price points. The price symbols are only a rough shopping guide: $ under $50, $$ $50–$249, $$$ $250–$999, and $$$$ $1,000 or more. Prices, models, and availability change.

Small purchases that can make daily routines easier

• Time Timer Original 3-inch — $ A portable visual countdown for getting dressed, screen-time endings, homework, taking turns, or showing how long until a transition. Useful when spoken time reminders are hard to understand.

• ARK Krypto-Bite chewable necklace — $ A wearable, purpose-made chew for a child who otherwise chews sleeves, pencils, or unsafe objects. Choose the correct toughness and use it only as directed.

• ARK Z-Vibe oral-motor tool — $ A vibrating tool with interchangeable tips that a feeding or speech therapist may recommend for specific oral-sensory, feeding, or motor goals. It is not a toy and requires direct adult supervision.

• Harkla Sensory Body Sock — $ Stretchy full-body fabric for pushing, pulling, imaginative movement, and proprioceptive play. A nice option for a child who enjoys active resistance more than sitting under something weighted.

• Harkla Weighted Lap Pad — $ A smaller, portable alternative to a weighted blanket for seated routines. Ask an OT or medical provider whether weight is appropriate and how long it should be used; the child must always be able to remove it.

Build a calming or movement space

• Sensory Tent — $$ A pop-up darkened nook that can become a low-stimulation retreat with familiar pillows, books, or safe lighting. Best used as a voluntary space, never as isolation or punishment.

• Harkla Compression Sensory Swing — $$ A stretchy indoor swing for a child who enjoys enclosed movement and pressure. Before buying, confirm ceiling structure, hardware, clearance, supervision, and whether this type of movement is appropriate.

• Tumbl Trak Boundex Cuddle Box — $$$ A padded steel frame with three stretchy Lycra layers that children can climb through, bounce on, push against, or curl beneath. It can offer active resistance, whole-body movement, deep-pressure input, and a cozy retreat in one piece of equipment. It takes substantial floor space, has a 100-pound user limit, and requires adult supervision; measure the room and ask the child’s OT or PT whether it fits their needs. Because Tumbl Trak is not one of Tennessee’s seven designated sensory-item websites, ask the case manager whether the LOMN must name the Boundex Cuddle Box specifically before ordering.

• National Autism Resources 5-by-5 Crash Pad — $$–$$$ A large foam landing zone for supervised jumping, crashing, rolling, or cozy floor time. Measure the room first and plan a safe fall zone away from furniture and walls.

• Calming Sensory Tent Kit — $$$ A ready-made calming corner with a tent and several sensory tools. A bundle can be convenient, but it is still worth checking whether the child likes each component before spending more than a build-your-own setup.

Communication and participation

• AbleNet BIGmack Communicator — $$ A large single-message button that can let a child call “go,” greet someone, join a repeated line in a song or book, or activate a compatible toy. It is a simple communication opportunity—not a replacement for a full AAC evaluation when more language is needed.

• AbleNet QuickTalker FT 12 — $$$ A lightweight recorded-message communication device with multiple locations and low-force activation. Ask an SLP or AAC specialist whether the layout and access method fit the child before ordering.

Daily care, travel, and getting out into the community

• Circle Specialty Anchor Bath Chair — $$$ A foldable, adjustable pediatric bath chair that may improve positioning and make bathing safer and less physically demanding for the child and caregiver. Measure the child and tub with an OT or PT.

• Mobo Mobito Recumbent Adaptive Tricycle — $$$ A low, stable trike with back support for a child who cannot comfortably or safely use a standard bicycle. It could turn family walks and neighborhood play into something the child can actively join.

• Roosevelt Special Needs Car Seat — $$$ An adaptive restraint for some older or larger children who still need specialized positioning. This must be selected and installed with qualified medical and special-needs child-passenger-safety guidance; it is not simply a larger conventional car seat.

• Special Tomato EIO Adaptive Stroller — $$$ A folding stroller-style mobility option with positioning supports for outings, appointments, school, and family trips. Confirm seat depth, width, back height, weight, posture, transport needs, and return terms before ordering.

Big-ticket possibilities worth planning early

• Rifton Small Adaptive Tricycle — $$$$ A highly adjustable supported trike with footplates, straps, back support, and caregiver brake. Ask for a PT or adaptive-equipment trial and a complete quote; accessories and fit can substantially change the final configuration.

• SleepSafe Low Safety Bed — $$$$ A specialized bed system that may be considered when nighttime falls, unsafe exits, seizures, positioning, or other documented risks cannot be addressed by a standard bed. This is a capital purchase: obtain clinical documentation, required comparisons, written approval, measurements, and a funding plan before ordering.

These examples are meant to spark a better conversation: “Would something like this solve a documented problem for my child, and what is the safest, most appropriate version?” A different brand, a less expensive version, a trial, rental, or a completely different support may be the better answer.

Communication and computer access

Possible ideas include low-tech communication boards, recorded-message buttons, speech-generating devices, adaptive switches, switch interfaces, keyguards, mounting systems, tablet cases, and access peripherals. A tablet or laptop may be considered when medically necessary for the child’s disability; the current state LOMN form includes tablets and laptops.

• Browse AAC and communication supports at eSpecial Needs
• Browse switches and computer-access equipment at eSpecial Needs

For robust AAC, seek an individualized AAC evaluation and a plan for language support. The most useful system is one the child can access across home, school, therapy, and community—not simply the least expensive device.

Feeding and daily living

Possible ideas include adapted utensils, divided or nonslip dishes, cups and drinking aids, stable feeding seating, dressing aids, easy-grip tools, bath or shower seating, toilet supports, reachers, and visual supports for routines.

• Browse dining and feeding aids at eSpecial Needs
• Browse bathing and toileting supports at eSpecial Needs
• Browse oral-motor tools at ARK Therapeutic

If choking, swallowing, aspiration, positioning, or nutrition is part of the concern, get clinical guidance before choosing products.

Mobility, positioning, and transportation

Possible ideas include gait trainers, walkers, standers, transfer aids, adaptive strollers, wheelchairs, ramps, supportive seating, adaptive tricycles, orthotics, and special-needs car seats or harness systems. These products must fit the child and the intended environment.

• Browse gait trainers and walkers at eSpecial Needs
• Browse adaptive strollers and wheelchairs at eSpecial Needs
• Browse car seats and seatbelt supports at eSpecial Needs
• Browse seating and positioning at eSpecial Needs

Ask a PT, OT, seating clinic, certified child passenger safety technician with special-needs experience, or assistive-technology professional to help when appropriate. Do not use an improvised restraint or buckle guard without a safety assessment.

Sensory access and regulation

Possible ideas include hearing protection, chewable tools, tactile tools, visual timers, movement equipment, crash pads, body socks, fidgets, calming lighting, or weighted lap products. Start with the child’s preferences and a real setting or routine. No sensory product works for every person, and distress should not be treated as something to suppress for adult convenience.

Tennessee currently gives simplified LOMN instructions for sensory items found on seven designated websites:

• Autism Community Store
• Fun and Function
• Harkla
• National Autism Resources sensory tools
• Autism-Products.com
• eSpecial Needs
• ARK Therapeutic

The designated-site rule simplifies how the item can be described on a LOMN; it does not eliminate the need for a LOMN or guarantee claim approval. If you find the same item for less elsewhere, Tennessee says you may submit documentation showing the item on both the designated site and the alternate retailer.

Medical, continence, nutrition, and sleep supports

Possible HRA expenses include durable medical equipment, medical-monitoring devices, orthotics, incontinence products, medically necessary formula or nutrition supplements, and some adaptive sleep equipment. The current state LOMN form specifically lists formula/nutritional drinks and incontinence supplies.

Adaptive beds or bedding, specialty food, and specialty clothing or shoes can require a comparison with the cost of an ordinary version. Do not order a specialty bed or other capital item before the administrator confirms the required forms and comparison.

Home access and safety

Depending on the child’s needs and benefit path, ideas may include bathroom accessibility, ramps, environmental controls, medically necessary air-quality equipment, emergency alert systems, protective padding, or a home or vehicle modification. Large capital expenses require advance planning; Tennessee advises families to contact TASC before a large capital-improvement purchase.

• Browse home-accessibility equipment at eSpecial Needs
• Browse assistive technology and environmental controls at eSpecial Needs

Therapies and activities to ask about

Traditional health and developmental care

The HRA may help with the child’s final out-of-pocket responsibility for eligible care, including:

• Speech-language therapy and AAC support
• Occupational therapy
• Physical therapy
• Feeding or swallowing therapy within a qualified provider’s scope
• Counseling, psychotherapy, and behavioral-health treatment for a medical condition
• Eligible behavioral programs
• Dental, orthodontic, and vision care
• Medical, nursing, chiropractic, acupuncture, nutrition, or other eligible professional services when program and IRS requirements are met

Use insurance first when required. Submit the EOB showing the final patient responsibility, or the documentation required when no other reimbursement is available. Therapy sessions must have occurred; the HRA card cannot be used to prepay a future block of visits.

Nontraditional and participation-based supports

Tennessee’s April 2026 Letter of Medical Necessity specifically gives these examples of nontraditional therapy:

• Swimming
• Horseback riding
• Music
• Gymnastics

The same form also names therapeutic camp, and it allows school tuition, tutoring, and education materials when the documentation shows the program is designed to address the child’s specific disability.

The activity should be connected to an individualized need or outcome—not merely described as generally healthy or fun. Examples might include water safety, strength and coordination, communication, self-regulation, community participation, or practicing independence. A licensed provider must describe why the activity is medically necessary, and the case manager should confirm the reimbursement route before enrollment.

Ordinary recreation, general wellness programs, nonmedical lessons, vacations, or a standard camp are not automatically eligible just because a child has a disability.

Caregiver and community supports

Depending on the plan and provider path, the budget may also support:

• Respite
• Supportive home care
• Community transportation
• Family caregiver education and training
• Community integration supports
• Assistive technology assessment or setup
• Home or vehicle modifications

Ask the case manager which services require a contracted agency and which may be consumer-directed.

Three ways a family might build a budget

These are planning examples, not benefit decisions. Your child’s approved plan, needs, and available amount control.

The “reduce our monthly strain” plan

Use most of the budget for recurring premium assistance, copays, prescriptions, supplies, mileage, or respite. Reserve a smaller amount for one practical device that removes a daily barrier.

The “access and independence” plan

Prioritize an AAC or access evaluation, recommended communication or mobility equipment, fitting and training, and a smaller amount for therapy or community practice that helps the child use it in real life.

The “caregiver sustainability” plan

Build dependable respite or supportive home care into the year first. Use the remaining amount for a therapeutic activity, safety item, or daily-living support. Consistent help is often more useful than a closet full of equipment.

Keep a clean paper trail

Before submitting a claim, check for:

• The expense occurred on or after the service’s authorization date
• The child is the person receiving the item or service
• The item or service is included in the approved support plan when required
• An itemized receipt or invoice with merchant/provider and date
• A clear description of the item or completed service
• The insurance EOB, or the required statement that no other reimbursement is available
• The final amount owed after insurance or any other reimbursement
• A current Letter of Medical Necessity when required, attached to each applicable claim
• Any requested quote, screenshot, cost comparison, capital-expense form, or provider documentation
• Proof that a session or activity occurred rather than a prepaid package of future services

Keep your own copy of every approval, LOMN, receipt, EOB, claim submission, and response.

Ideas to approach carefully

• Do not spend just to empty the account. Unused funds do not roll over, but an unnecessary or poorly documented purchase can still be denied.
• Do not let a retailer define “medical necessity.” Connect the item to your child’s assessed need and obtain the required clinician documentation.
• Do not assume a diagnosis makes every sensory item eligible. The item still needs an individualized rationale and the correct paperwork.
• Avoid large equipment without a trial when possible. Fit, access, return policies, maintenance, and training matter.
• Do not duplicate payment. A cost already reimbursed—or eligible for reimbursement—from another plan cannot be paid again through the HRA.
• Be cautious with weakly supported or high-cost treatments. “Alternative,” “natural,” or “autism therapy” does not automatically mean effective, safe, or reimbursable.

Who to call before you spend

For support-plan questions and help choosing the correct service path, contact your Katie Beckett case manager.

For Part B HRA claim and card questions, contact TASC at 844-529-8137 or use the Tennessee Katie Beckett TASC portal.

For general Katie Beckett application help, Tennessee lists:

• West Tennessee DDA: 866-372-5709
• Middle Tennessee DDA: 800-654-4839
• East Tennessee DDA: 888-531-9876
• DDA Katie Beckett assistance: DDA_KBAssist@tn.gov

Program rules and vendor processes can change. This guide was researched for Tennessee on September 6, 2026; verify current requirements with your case manager and the program administrator.