The federal government has given approval for Tennessee to provide Medicaid coverage to some children of middle-class families. To qualify, the children have to have disabilities or other complex medical needs.

The program is called a “Katie Beckett waiver,” named for a young girl with special needs who inspired the Reagan administration to expand Medicaid for families who wouldn’t typically qualify for the government insurance program because they’re not considered low-income.

Tennessee was one of the few states that had not yet opted in, mostly because of the considerable expense: Roughly 300 children with the most severe needs would cost the state about $50,000 a year, on average.

The state will begin taking referral forms online Nov. 23. There are two tiers: The first provides full Medicaid services to children with the most significant needs; the second tier provides $10,000 toward medical needs but does not grant them insurance coverage.

Roughly 700 families have indicated they intend to apply, but TennCare estimates suggest as many as 3,000 could qualify, mostly for the second tier of the program.