GAPP Medicaid Requirements

GAPP requires active Georgia Medicaid. Here's exactly what that means and how to qualify if your family income seems too high.

Pending Medicaid Does Not Count

GAPP agencies cannot submit prior authorization until Medicaid is active with an ID number. A submitted application, approval letter, or "pending" status is not sufficient.

What "Active Medicaid" Means

Counts as Active

  • • Medicaid card with ID number
  • • Verified active status in Georgia Gateway
  • • Confirmation from 1-866-211-0950
  • • Coverage showing in provider verification

Does NOT Count

  • • Application submitted (pending)
  • • Approval letter without ID number
  • • "Processing" status
  • • PeachCare (separate program)

How to Check Your Medicaid Status

  1. 1

    Call Georgia Medicaid

    1-866-211-0950 (Mon-Fri 7am-7pm)

  2. 2

    Check Georgia Gateway

    Log in at gateway.ga.gov to view your benefits status

  3. 3

    Confirm you have an ID number

    The Medicaid ID is required for GAPP prior authorization

Types of Medicaid That Work for GAPP

✓

Regular Georgia Medicaid

Standard Medicaid based on family income. If you qualify, this works for GAPP.

★

Katie Beckett / TEFRA

For children who need institutional-level care, regardless of family income. This is the pathway for families with higher incomes.

✓

SSI-Linked Medicaid

Children receiving SSI (Supplemental Security Income) automatically qualify for Medicaid in Georgia.

✓

Foster Care Medicaid

Children in foster care have Medicaid coverage that works for GAPP.

✓

Medically Needy

A spend-down program for families with higher incomes but significant medical expenses.

The Katie Beckett Pathway

If your family income is too high for regular Medicaid, your child may still qualify through the Katie Beckett waiver (also called TEFRA).

Katie Beckett Eligibility

  • Child is under 18 years old
  • Has a disability or chronic medical condition
  • Requires care typically provided in a hospital or nursing facility
  • Can be appropriately cared for at home
  • Home care costs less than institutional care

Family income is NOT considered for Katie Beckett eligibility.

Learn more about Katie Beckett vs GAPP →

PeachCare vs Medicaid

PeachCare is Georgia's CHIP (Children's Health Insurance Program). It's separate from Medicaid and does not qualify for GAPP.

If your child has PeachCare and needs GAPP services, you may need to:

  • Apply for Medicaid through the Katie Beckett waiver (if your child qualifies based on medical need)
  • Check if your child qualifies for regular Medicaid (different income limits than PeachCare)
  • Contact Georgia DFCS to discuss your options

Medicaid Requirement FAQs

What does "active Medicaid" mean for GAPP?
Active Medicaid means your child has been approved and has a Medicaid ID number. Pending applications, submitted applications, or approval letters without an ID number do not count as active Medicaid.
Can my child get GAPP with PeachCare instead of Medicaid?
PeachCare is Georgia's CHIP program and is separate from Medicaid. GAPP requires Medicaid specifically. However, some children may qualify for Medicaid through the Katie Beckett waiver even if their family income is too high for regular Medicaid.
What if my family income is too high for Medicaid?
The Katie Beckett waiver (also called TEFRA) allows children with disabilities to qualify for Medicaid based on their medical condition, not family income. If your child needs an institutional level of care, they may qualify regardless of your income.
How do I check if my child's Medicaid is active?
Call Georgia Medicaid at 1-866-211-0950 or check your Georgia Gateway account online. You need to confirm you have a Medicaid ID number, not just that an application is in process.
What type of Medicaid does my child need for GAPP?
Any Georgia Medicaid coverage that includes home health benefits works for GAPP. This includes regular Medicaid, Katie Beckett/TEFRA, foster care Medicaid, and SSI-linked Medicaid.
Can I apply for GAPP while waiting for Medicaid approval?
No. You cannot start the GAPP approval process until Medicaid is active. GAPP agencies cannot submit prior authorization without an active Medicaid ID. Use the waiting time to research agencies and gather medical documentation.

Related Resources

Complete GAPP Approval Guide

Step-by-step approval process.

Katie Beckett & TEFRA Guide

Compare Medicaid waiver programs.

Have Active Medicaid?

Find GAPP providers accepting new patients in your county.

Find a ProviderCheck Eligibility

This directory is not affiliated with the State of Georgia or the official GAPP program. We help families find providers but are not a state agency.