Special needs navigator
Katie Beckett Medicaid in Georgia
The Katie Beckett (TEFRA) pathway gives Georgia children with significant disabilities Medicaid coverage based on the child’s needs, not the parents’ income. Consultants write the application; Dare2Care supplies the detailed medical documentation it depends on.
NCQAPatient-Centered Medical HomeWhat it is
Medicaid for a child with a disability, regardless of family income
Katie Beckett, formally the TEFRA option in Georgia Medicaid, covers children under 18 who have a serious disability or medical condition and who would qualify for care in a hospital or nursing facility but are cared for at home. The child’s own income and resources are counted; the parents’ are not. That is why families who earn too much for regular Medicaid can still qualify.
Coverage is full Georgia Medicaid. For many families it becomes secondary insurance behind a commercial plan and pays for what the primary plan does not: therapies, equipment, supplies, nursing hours, medicines and copayments. The financial part is reviewed every year; the level-of-care approval now lasts at least two years.
Approval turns on how thoroughly the application shows the child’s medical needs and level of care. That documentation is the part Dare2Care Pediatrics owns.
Who qualifies
What the state looks at
| Requirement | What it means | How we help |
|---|---|---|
| Age | Under 18 (children turning 18 move to adult Medicaid pathways) | We start transition planning early so coverage does not lapse |
| Disability | A physical, developmental or mental condition expected to last at least 12 months, meeting Social Security’s definition of disability for children | Diagnosis history, testing and specialist reports, summarized clearly |
| Level of care | The child needs the level of care given in a hospital, nursing facility or intermediate care facility, but can safely receive it at home | The physician level-of-care form and a functional description in the areas the reviewers score |
| Cost of home care | Care at home costs Medicaid no more than care in a facility | Documentation of therapies, equipment, nursing and supplies actually used |
| Child’s own income and assets | Counted; the parents’ are not | Not a medical question; the consultant or Georgia Gateway handles it |
The process
How an application usually runs
Step 1: Talk to us first
Tell us you are considering Katie Beckett. We review your child’s chart, make sure the diagnoses, evaluations and therapy reports are current, and order anything that is missing.
Step 2: We prepare the documentation
The physician forms, a detailed medical and functional summary, letters of medical necessity and copies of records, written for the reviewers who score the application. Allow about two weeks.
Step 3: A consultant or you assemble the application
Many of our families hire an independent Katie Beckett consultant to write and file the application; others file it themselves through the state. We are glad to share names of consultants families have used.
Step 4: Decision, then a yearly review
The Centralized Katie Beckett Medicaid Team at the Department of Community Health reviews the medical and financial parts and sends a decision. Eligibility is reviewed every year, and we provide updated documentation each time so coverage does not lapse.
What we provide
The documentation package
- Physician level-of-care and medical forms the application requires, completed and signed
- A diagnosis and history summary: onset, testing, hospitalizations, specialists involved
- Current level of function in daily living, communication, mobility, learning and behavior
- Medications, equipment, supplies and therapies, with frequency and who provides them
- Letters of medical necessity for therapies, equipment and nursing hours
- Copies of relevant records, evaluations and specialist notes, released with your signed authorization
- Updated documentation at each annual renewal
- A point of contact at the office for the consultant’s questions
Consultants
Working with a Katie Beckett consultant
The application is long and the wording matters. Independent consultants who specialize in Katie Beckett know what the reviewers look for and write the family’s sections accordingly. Most of our families use one, and we work with the consultant directly so the medical documentation matches what the application needs.
Our role is the medicine: complete, specific and on time. The consultant’s role is the application itself. Ask the front desk and we will share names of consultants our families have used; we do not receive anything from them.
Questions
Katie Beckett questions families ask
Does my income matter?
No. Katie Beckett counts only the child’s own income and assets. That is the whole point of the pathway: children with significant needs get Medicaid even when the family earns too much for regular Medicaid or PeachCare for Kids.
My child has autism. Does that qualify?
Autism can qualify when the child’s needs meet the level-of-care standard; the diagnosis alone does not decide it. What the reviewers weigh is how much support the child needs in daily living, communication and behavior, which is exactly what our documentation describes.
We have good commercial insurance. Is Katie Beckett still worth it?
Often, yes. As secondary coverage it can pay therapy copayments, equipment, supplies and services the primary plan limits or excludes. Families with complex needs commonly save thousands a year.
How long does it take?
Our documentation takes about two weeks once the records are current. The state does not publish a processing time; families commonly wait one to three months after filing, and it varies. We cannot speed the state up, but complete documentation avoids the requests for more information that add months.
What if the application is denied?
Denials can be appealed, and many are overturned when the medical picture is documented more fully. Tell us right away; we review what the state relied on and strengthen the documentation for the appeal.
Do you fill in the application?
No. We complete the physician forms and provide the medical documentation. The family, or the consultant the family hires, completes and files the application.
Resources
Katie Beckett resources in Georgia
Every link below was checked on September 18, 2026. The state pages are where the rules and forms live; the nonprofits help families for free; the legal-aid groups take on denials and appeals.
Official program pages
- Georgia Medicaid: TEFRA/Katie Beckett program: eligibility rules, the forms in English and Spanish, and the Centralized Katie Beckett Medicaid Team (678-248-7449) that receives every application.
- Katie Beckett application forms: the Medicaid application (Form 94) and instructions.
- Katie Beckett portal: after the first application, families upload documents and check the status of their case here (new in 2026).
- Georgia Gateway: the state benefits site where the application can be started online, and where yearly reviews are completed.
- Eligibility manual, section 2133: the full rules the reviewers apply, for families who want the detail.
- Children’s Medical Services, Babies Can’t Wait, NOW and COMP waivers and Family Support Services: the programs that often sit alongside Katie Beckett. Compared on our waivers and programs page.
Free help with the application
- Parent to Parent of Georgia (800-229-2038): statewide family navigators, a parent-to-parent match, and a recorded step-by-step Katie Beckett application walkthrough with the current blank packet.
- Cam and Madi’s Promise (770-239-1522): a Georgia nonprofit that helps families complete Katie Beckett and NOW/COMP applications and appeals at no charge.
- Together We Care (678-270-2462): a Georgia nonprofit that completes Katie Beckett applications with families.
- FOCUS + Fragile Kids (770-234-9111): metro Atlanta family support with a current guide to Georgia programs.
- Georgia Council on Developmental Disabilities: waiver waiting-list advocacy and policy updates.
Denials, appeals and rights
- Georgia Advocacy Office (800-537-2329): Georgia’s protection and advocacy organization for people with disabilities.
- Atlanta Legal Aid (404-524-5811) for Fulton, DeKalb, Gwinnett, Cobb and Clayton, and Georgia Legal Services (833-457-7529) for the rest of the state: free legal help with Medicaid denials for families who qualify.
- The Health Law Partnership at Children’s Healthcare of Atlanta (404-785-2005): a medical-legal partnership for Children’s patients that has handled Katie Beckett appeals.
Paid consultants also prepare applications; ask the front desk and we will share names of consultants our families have used.
Sources
Where this comes from
Sources: Georgia Medicaid, TEFRA/Katie Beckett program page (medicaid.georgia.gov); Georgia Department of Behavioral Health and Developmental Disabilities (dbhdd.georgia.gov); Georgia Department of Public Health, Babies Can’t Wait and Children’s Medical Services (dph.georgia.gov); Social Security Administration, SSI for children (ssa.gov). Program rules change; the state’s own pages are the final word. Content checked September 18, 2026.
Official program page: Georgia Medicaid, TEFRA/Katie Beckett and the DFCS eligibility manual, section 2133. Parent support and navigation: Parent to Parent of Georgia.
Thinking about Katie Beckett?
Call or text (770) 615-7000 and ask for a Katie Beckett documentation visit. Established patients can also message us in the portal.