GAPP vs. Katie Beckett vs. TEFRA: Which Georgia Program Is Right for Your Child?
If you've been researching in-home care in Georgia, you've probably seen 'GAPP,' 'Katie Beckett,' and 'TEFRA' used almost interchangeably — and it's genuinely confusing. Here's the reassuring truth: they aren't three competing programs you have to choose between. They're pieces of one system that often work together.
This guide untangles the three terms so you can see exactly where your child fits, without the jargon.
The one-sentence version
Katie Beckett (authorized by TEFRA) is a way to get your child onto Medicaid; GAPP is the Medicaid benefit that pays for in-home skilled nursing. One is the door, the other is the care behind it.
TEFRA and Katie Beckett: the eligibility pathway
TEFRA is a federal law; Katie Beckett is the common name for the option it created. Together, they let certain children with significant disabilities qualify for Medicaid based on the child's own income rather than the family's. In Georgia this is the Katie Beckett Deeming Waiver. If your family was denied Medicaid because you earn too much, this is the pathway to ask about.
GAPP: the in-home nursing benefit
The Georgia Pediatric Program (GAPP) is a Medicaid benefit that covers in-home skilled nursing and personal care for medically fragile children under 21. GAPP is what actually brings a nurse into your home. But to use GAPP, your child needs Medicaid first — which is where Katie Beckett may come in for higher-income families.
- Katie Beckett / TEFRA → qualifies your child for Medicaid
- GAPP → provides the in-home nursing once your child has Medicaid
- Many families use both: the pathway to get covered, then the benefit to get care
So which one do you need?
If your child already has Medicaid, you may be able to go straight to GAPP for nursing. If your child doesn't have Medicaid because of your income, ask about Katie Beckett/TEFRA first, then GAPP. If you're not sure where your child stands, that's normal — a care coordinator can help you map it out in a single conversation.
Because eligibility for each piece depends on your child's specific situation and a state review, use this as a framework and confirm the details with the Georgia Department of Community Health or your case manager.
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Helpful resources
BrightStars Care Team
Pediatric Home Care Specialists · RN-supervised
The BrightStars Care Team is made up of licensed registered nurses, care coordinators, and pediatric caregivers serving medically fragile children across Metro Atlanta. Every article is written from real family-support experience and reviewed for clinical accuracy by our nursing staff before publishing.
Medically reviewed by the BrightStars registered nursing team.