Katie Beckett Waiver in Georgia

The Katie Beckett waiver helps children with disabilities qualify for Medicaid regardless of family income. Learn if your child qualifies and how to apply.

No Income Limits

Unlike regular Medicaid, Katie Beckett eligibility is based only on your child's medical needs — not your family's income.

Eligibility RequirementsHow to ApplyWhat It CoversKatie Beckett vs GAPPFAQs

What is the Katie Beckett Waiver?

The Katie Beckett waiver (officially known as TEFRA — Tax Equity and Fiscal Responsibility Act) is a Medicaid eligibility option that allows children with significant disabilities to qualify for Medicaid based on their own medical condition, regardless of their parents' income.

Named after Katie Beckett, a child who was ventilator-dependent and could only receive Medicaid coverage while in the hospital, this program was created to allow medically fragile children to receive care at home while still qualifying for Medicaid benefits.

In Georgia, the Katie Beckett program is administered by the Department of Community Health and provides a pathway for families who might not otherwise qualify for Medicaid due to income to get coverage for their child with disabilities.

Key Point

Katie Beckett is an eligibility pathway to Medicaid — it's how your child qualifies. Once on Medicaid, you can access services like GAPP nursing care.

Katie Beckett Eligibility Requirements in Georgia

To qualify for the Katie Beckett waiver in Georgia, your child must meet all of the following criteria:

1

Age Requirement

Child must be under 18 years old

2

Disability Requirement

Child must have a disability as defined by Section 1614 of the Social Security Act

3

Level of Care

Child must require care at an institutional level (hospital, nursing facility, or ICF)

4

Home Care Appropriate

Child must be able to be safely and appropriately cared for at home

5

Cost Effective

Home care must cost less than institutional care (this is almost always the case)

6

Georgia Resident

Child must be a resident of Georgia

Important Note

Family income and assets are NOT considered for Katie Beckett eligibility. Your income does not disqualify your child if they meet the medical criteria.

Conditions That May Qualify for Katie Beckett

The following conditions commonly qualify for Katie Beckett in Georgia. Eligibility is based on level of care needed, not specific diagnoses:

Cerebral palsy
Muscular dystrophy
Spina bifida
Severe autism spectrum disorder
Traumatic brain injury
Ventilator dependence
Tracheostomy care needs
G-tube/feeding tube requirements
Seizure disorders requiring monitoring
Genetic syndromes
Congenital heart defects
Chronic respiratory conditions
Spinal cord injuries
Cancer requiring ongoing treatment
Organ transplant recipients

This is not an exhaustive list. Any condition requiring institutional-level care may qualify. Contact the Katie Beckett team if you're unsure about your child's eligibility.

How to Apply for Katie Beckett in Georgia

1

Apply for SSI First (Required)

You must apply for Supplemental Security Income (SSI) and receive a denial before applying for Katie Beckett. This establishes that your child doesn't qualify for Medicaid through SSI.

Call Social Security at 1-800-772-1213 to apply for SSI. If approved for SSI, you don't need Katie Beckett — you'll automatically get Medicaid.

2

Gather Medical Documentation

Collect comprehensive medical records including:

  • Diagnosis documentation from physicians
  • Hospital discharge summaries
  • Current treatment plans
  • Therapy evaluations (PT, OT, speech)
  • Documentation of daily care needs
  • Any nursing or personal care requirements
3

Contact the Katie Beckett Team

Reach out to Georgia's Centralized Katie Beckett Medicaid Team:

Centralized Katie Beckett Medicaid Team

5815 Live Oak Parkway, Suite D-2

Norcross, GA 30093

Phone: 678-248-7449
Fax: 678-248-7459

4

Complete the Application

Submit the Katie Beckett application along with your SSI denial letter and all medical documentation. The team will review your application and may request additional information.

5

Medical Level of Care Evaluation

Your child will be evaluated to confirm they require care at an institutional level. This evaluation determines if home care is appropriate and cost-effective compared to facility care.

6

Approval & Next Steps

Once approved, your child will have Medicaid coverage. Approvals are now authorized for a minimum of two years. You can then access services including:

Timeline

The Katie Beckett application process typically takes 45-90 days in Georgia. Having complete documentation ready can help speed up approval.

What does Katie Beckett cover in Georgia?

Once your child is approved for Medicaid through Katie Beckett, they get the full range of Georgia Medicaid benefits. For families with medically fragile kids, this changes everything.

Here's what Katie Beckett Medicaid covers:

Doctor visits and specialists

Pediatricians, neurologists, pulmonologists, and any specialist your child needs. No referral hoops for Medicaid-enrolled providers.

Hospital stays

Inpatient and outpatient hospital care, emergency room visits, and surgeries.

Prescription medications

Covered prescriptions including specialty medications that private insurance often limits or denies.

Durable medical equipment

Wheelchairs, feeding pumps, oxygen equipment, suction machines, hospital beds, and other equipment your child uses daily.

Therapy services

Physical therapy, occupational therapy, and speech therapy. These are often capped by private insurance but covered more fully through Medicaid.

Home nursing through GAPP

RN, LPN, and personal care services in your home. This is the big one for most families — private insurance rarely covers the hours medically fragile children actually need.

Mental health services

Behavioral health support, counseling, and psychiatric care for children who need it.

Dental care

Pediatric dental services including sedation dentistry when needed for children who can't tolerate regular dental visits.

Medical transportation

Non-emergency medical transportation to and from appointments. One less thing to figure out on appointment days.

Katie Beckett + private insurance

Your child can have both Katie Beckett Medicaid and private insurance at the same time. Medicaid acts as secondary coverage and picks up what your private plan doesn't cover. Start by finding a GAPP provider to get in-home nursing set up.

Katie Beckett vs GAPP: What's the Difference?

Many families confuse Katie Beckett and GAPP, but they serve different purposes and often work together:

Katie BeckettGAPP
What it isMedicaid eligibility pathwayService delivery program
PurposeGets your child ON MedicaidProvides in-home nursing care
Income limitsNo family income limitMust have Medicaid first
Age limitUnder 18Under 21
ServicesAccess to all Medicaid servicesRN, LPN, and PCS in-home care
Choose provider?N/AYes - you choose your provider

How They Work Together

Katie BeckettMedicaidGAPP Services

Many Georgia families use Katie Beckett to qualify for Medicaid, then enroll in GAPP to receive in-home nursing care for their medically fragile child.

Approved for Katie Beckett? Find a GAPP Provider

Once your child has Medicaid through Katie Beckett, you can access GAPP nursing services. Search our directory of verified GAPP providers in Georgia.

Find GAPP ProvidersGAPP Approval Guide

Katie Beckett Waiver Georgia: FAQs

What is the Katie Beckett waiver in Georgia?
The Katie Beckett waiver (also called TEFRA) is a Medicaid eligibility pathway in Georgia that allows children with disabilities to qualify for Medicaid based on their medical condition alone, regardless of family income. This means even families with higher incomes can get Medicaid coverage for their medically fragile child.
What are the Katie Beckett eligibility requirements in Georgia?
To qualify for Katie Beckett in Georgia, your child must be under 18 years old, have a disability or chronic medical condition, require care at an institutional level (hospital or nursing facility), be able to be safely cared for at home, and home care must cost less than institutional care.
Does family income affect Katie Beckett eligibility?
No. Unlike regular Medicaid, Katie Beckett determines eligibility based solely on the child's disability and care needs, not on family income or assets. This is one of the main benefits of the program.
How long does Katie Beckett approval take in Georgia?
The Katie Beckett application process in Georgia typically takes 45-90 days. Having complete medical documentation ready can speed up the process. Recent policy changes now authorize approvals for a minimum of two years.
What is the difference between Katie Beckett and GAPP?
Katie Beckett is a Medicaid eligibility pathway - it gets your child ON Medicaid. GAPP (Georgia Pediatric Program) is a service program that provides in-home nursing care. Many families use Katie Beckett to qualify for Medicaid, then use GAPP for nursing services.
Can my child have both Katie Beckett and GAPP?
Yes! They work together. Katie Beckett gets your child Medicaid coverage, and once on Medicaid, your child can receive GAPP services (in-home nursing and personal care) if medically necessary.
What conditions qualify for Katie Beckett in Georgia?
Qualifying conditions include cerebral palsy, muscular dystrophy, spina bifida, severe autism, traumatic brain injury, ventilator dependence, tracheostomy needs, feeding tube requirements, seizure disorders, genetic conditions, and other conditions requiring institutional-level care.
How do I apply for Katie Beckett in Georgia?
Contact the Centralized Katie Beckett Medicaid Team at 678-248-7449. You'll need to gather medical documentation, complete the application, and your child will undergo a medical evaluation to confirm they need institutional-level care.
What if my Katie Beckett application is denied?
You have the right to appeal any denial. Common denial reasons include incomplete documentation or not meeting the institutional level of care requirement. You can request a fair hearing to appeal the decision.
What services does my child get with Katie Beckett Medicaid?
Once approved for Medicaid through Katie Beckett, your child has access to all Medicaid services including doctor visits, hospital care, medications, therapy services, medical equipment, and specialized programs like GAPP for in-home nursing.
What does Katie Beckett Medicaid cover that regular insurance might not?
Katie Beckett Medicaid covers the full range of Medicaid services: doctor visits, hospital stays, prescriptions, durable medical equipment like wheelchairs and feeding pumps, therapy services (PT, OT, speech), home nursing through programs like GAPP, mental health services, dental care, and medical transportation. For many families, the biggest benefit is access to GAPP in-home nursing — something private insurance rarely covers at the hours medically fragile children need.

Related Resources

GAPP Providers

Find verified providers in Georgia

GAPP Approval Guide

Step-by-step approval process

All Georgia Waivers

Compare GAPP, Katie Beckett & more

GAPP services explained

What RN, LPN, and PCS nurses do

How to apply for GAPP

Steps after Katie Beckett approval

What does GAPP stand for?

Plain-English program guide

Medically fragile children care

Care options for your child

Pediatric home nursing

In-home nursing in Georgia

Get paid as a caregiver

Family members as paid caregivers

This information is provided for educational purposes only and is not legal or medical advice. For official Katie Beckett eligibility information, contact Georgia's Centralized Katie Beckett Medicaid Team at 678-248-7449.