GAPP Knowledge Center
Katie Beckett / TEFRA: Medicaid for children regardless of family income
Many families assume they earn too much for their child to qualify for Medicaid — and therefore GAPP. Katie Beckett / TEFRA changes that equation: Georgia Medicaid evaluates your child based on your child's own situation, setting household income aside entirely.
Background
What is Katie Beckett / TEFRA?
Understanding the provision that opened Medicaid to higher-income families with medically complex children.
Katie Beckett / TEFRA is a federal Medicaid provision that allows states to evaluate a medically complex child for Medicaid eligibility based solely on the child's own situation — independent of the household's income and assets. The provision is named after Katie Beckett, a child who was kept hospitalized in the 1980s because her family's income disqualified her from Medicaid-funded home care, despite home care being far less expensive. President Reagan signed legislation to allow states to waive the deeming of parental income for medically complex children.
Georgia administers this program and uses it to allow families who would otherwise be above Medicaid income limits to enroll their medically fragile child.
The provision allows Georgia to waive “deeming” — the process of attributing parental income to the child. Without deeming, the child is evaluated as an individual. Most children have near-zero income and near-zero assets, so they qualify financially regardless of what their parents earn.
How It Works
Three key points about the Katie Beckett pathway.
The pathway removes the income barrier — but medical necessity requirements still apply. Here is what families need to understand.
Income Disregard
Georgia Medicaid evaluates the child as if they were living independently. If the child would qualify for Medicaid based on their own situation (minimal income, significant medical expenses), they are enrolled regardless of household income.
Medical Necessity Required
The child must still meet medical necessity criteria — meaning a physician must document that the child requires skilled nursing or personal care. Not every child with a disability qualifies; the need must be for ongoing skilled services.
Same GAPP Benefits
Once enrolled through the Katie Beckett / TEFRA pathway, the child receives the same GAPP services as any other Medicaid-enrolled child: skilled nursing, personal care, and related supports at home.
Common Qualifying Diagnoses
Children who may qualify through this pathway.
This list is not exhaustive. Any condition creating a documented need for ongoing skilled nursing or personal care may qualify. When in doubt, contact us for a free screening.
Common Questions
Katie Beckett / TEFRA questions, answered.
The standard Medicaid income limit does not apply. Instead, the child's own financial situation is evaluated — which for most children means near-zero income. However, the child's medical needs must still meet the program's clinical criteria. Income of the parents is set aside.
Contact Core Health Group Corp. We will verify whether your child may qualify through this pathway, explain the documentation required, and assist with the application process. The application is submitted through Georgia Medicaid / the Georgia Department of Community Health.
No — Katie Beckett / TEFRA is a Medicaid enrollment pathway. Once your child is enrolled in Georgia Medicaid through this pathway, they are eligible to receive GAPP services just like any other Medicaid-enrolled child. Think of it as the door to Medicaid, and GAPP as the services available once inside.
Any cost-sharing is determined by the Katie Beckett Medicaid team. For specific cost-sharing questions, contact the team directly at 678-248-7449.
The timeline depends on how quickly documentation can be gathered and reviewed. Core Health Group Corp. coordinates the process and works to minimize delays.
Free Eligibility Screening
Not sure if your child qualifies?
We review your child's diagnosis, age, and Medicaid status at no cost. Many families who assume they don't qualify are surprised. Let us check.