Few things have a steeper learning curve than the alphabet soup of insurance for a medically
fragile child. Let me untangle the most important pieces for Metro Atlanta families.
TRADITIONAL GEORGIA MEDICAID is income-based. If your family meets income limits and
your child has a qualifying medical condition, your child is enrolled, and Medicaid functions as
primary or secondary coverage.
PEACHCARE FOR KIDS is Georgia’s CHIP program — for families whose income exceeds
Medicaid limits but who still need affordable children’s coverage.
KATIE BECKETT DEEMING WAIVER (TEFRA) is the pathway most middle-income Georgia
families don’t know about. It allows states to ignore parent income and consider only the child’s
income/resources, provided the child requires an institutional level of care that can be safely
delivered at home. Apply through the Centralized Katie Beckett Medicaid Team at 678-248-
7449 or visit AxessHS.Com to learn about consultants on our Resources page.
PRIVATE COMMERCIAL INSURANCE (your employer’s plan) usually remains primary.
Medicaid becomes secondary, picking up what commercial insurance doesn’t.
GAPP is not insurance or waiver program — it’s a service program funded by Medicaid that
delivers in-home skilled nursing and personal care.
The Medicaid Care Management Organizations (CMOs) in Georgia — Amerigroup,
CareSource, Peach State, and Wellcare — handle Medicaid for most enrollees. If your child is in
a CMO, GAPP prior authorization goes through that CMO.
The single most useful free resource I can point Georgia families to is Parent to Parent of
Georgia (770-451-5484, p2pga.org). They will sit with you on the phone and walk through your
specific situation.
We also help families navigate this at Axess Health Solutions. If you’re trying to figure
out which door to walk through first, give us a call. AxessHS.com.
Works Cited
Georgia Department of Community Health. “TEFRA/Katie Beckett.” Georgia Medicaid,
medicaid.georgia.gov/programs/all-programs/tefrakatie-beckett. Accessed 2026.
Georgia Department of Community Health. “Georgia Pediatric Program (GAPP).” Georgia Medicaid,
medicaid.georgia.gov/programs/all-programs/georgia-pediatric-program-gapp. Accessed 2026.
Parent to Parent of Georgia. “Frequently Asked Questions.” P2PGA, www.p2pga.org/about-us/faqs/. Accessed 2026.
Disclaimer: This post is for general educational purposes and is not legal, financial, or medical advice. Program rules and figures
may change — please verify current details with Georgia DCH, the VA, Medicare.gov, or a licensed attorney before making care decisions.