GAPP Knowledge Center
Who qualifies for GAPP?
Georgia's GAPP program (Georgia Pediatric Program) has three eligibility requirements. All three must be met. Families who are uncertain should contact us — we verify eligibility for free, and many families who assume they don't qualify actually do.
Eligibility Requirements
Three requirements — all three must be met.
GAPP is not income-based. Families across all income levels can qualify as long as these three criteria are satisfied.
Age Under 21
Under 20 years, 11 months at enrollment
GAPP serves children and young adults from birth through age 20 years, 11 months. Once enrolled, services continue as long as the child remains medically eligible and Medicaid-enrolled. The program is designed to keep medically fragile children in their homes rather than in long-term care facilities.
Georgia Medicaid
Active Georgia Medicaid (Title XIX) enrollment
The child must be actively enrolled in Georgia Medicaid. Families who do not currently have Medicaid may still qualify — Georgia's Katie Beckett / TEFRA program provides an income-disregard pathway that allows many higher-income families to enroll a medically complex child in Medicaid based on the child's needs alone, not household income.
Medical Necessity
Physician-documented need for skilled nursing or personal care
A licensed physician must document that the child requires skilled nursing or personal care services based on medical necessity. This determination is then reviewed and authorized by Alliant Health Solutions, Georgia's fee-for-service prior authorization contractor, which has 7 calendar days to review a complete authorization packet.
Medicaid Pathway
Don't have Medicaid? Katie Beckett / TEFRA may help.
Many families assume GAPP is out of reach because their household income is too high for regular Medicaid. Katie Beckett / TEFRA changes that.
Your income doesn't disqualify your child.
Katie Beckett / TEFRA is a federal provision that allows Georgia Medicaid to evaluate a medically complex child based on the child's own financial situation — not the household's. If your child would be eligible for Medicaid if they were living independently, they may qualify through this pathway even if your family income is well above standard Medicaid thresholds.
Learn how Katie Beckett / TEFRA worksCommon Diagnoses
Conditions that commonly meet GAPP criteria.
This list is not exhaustive. Any condition that creates a documented need for skilled nursing or personal care support based on medical necessity may qualify. When in doubt, contact us for a free screening.
Common Questions
Eligibility questions, answered.
Yes — this is exactly what the Katie Beckett / TEFRA program is for. It allows Georgia to evaluate a medically complex child for Medicaid eligibility based on the child's own situation, setting aside household income and assets. Many middle- and higher-income families access GAPP this way. Contact us and we can walk you through whether your child may qualify through this pathway.
Your child's physician completes a physician order and clinical documentation describing the child's diagnoses, functional limitations, and the nursing or personal care services required. This documentation is submitted to Alliant Health Solutions, which reviews the clinical record against Georgia Medicaid's medical necessity criteria. Alliant has 7 calendar days to approve or deny a complete packet. Core Health Group Corp. coordinates this process on your family's behalf.
You have the right to choose your provider. Transferring to Core Health Group Corp. does not require re-authorization — your existing authorization follows your child to the new agency. We coordinate the transition with your current provider, your child's physician, and the Medicaid case manager to ensure there is no gap in care.
The timeline varies by case. Once a complete packet is submitted to Alliant Health Solutions, they have 7 calendar days to respond. Gathering the required physician documentation and medical records typically takes 1–2 weeks, depending on your child's care team. Core Health Group Corp. manages this process and communicates status updates to your family throughout.
No. GAPP is available for children living at home or transitioning from a hospital or facility. In fact, one of GAPP's core purposes is to allow medically complex children to return home safely from the hospital or avoid hospitalization altogether. We frequently assist with hospital-to-home transitions.
Free Eligibility Screening
Not sure if your child qualifies?
Our intake team reviews your child's diagnosis and Medicaid status at no cost — and at no obligation. We respond within one business day.