How to Apply for Katie Beckett Medicaid Deeming Waiver in Georgia

Georgia's Katie Beckett Deeming Waiver

The Katie Beckett Deeming Waiver in Georgia permits the state to ignore the family’s income for certain children, who are considered disabled. It provides benefits to children, 18 years of age and younger, qualify as disabled individuals under the Social Security Act (§1614), and live at home rather than an institution. These children must meet specific criteria to be covered.

Qualification is not based on medical diagnosis, instead, it is based on the institutional level of care the child requires. Title 42 Code of Federal Regulations outlines the criteria used to determine eligibility.

Below you will find a step-by-step guide explaining how to apply for Katie Beckett Deeming Waiver in Georgia. If you qualify for Katie Beckett, you may also qualify for a program which pays your family’s entire health insurance premium. Contact us for additional information.

Benefits of the Katie Beckett Deeming Waiver

  • Provides medical insurance, which helps to cover the costs of doctor visits and therapeutic services for children with physical or developmental disabilities.
  • Eliminates all co-payments and deductibles obligated by your private/commercial insurance.
  • Provides assistance with monthly insurance premiums of the family’s current private insurance (this means the state may pay for your family’s entire insurance premium each month).

Steps to Katie Beckett

Step 1: SSI Determination

To receive assistance via the Katie Beckett Deeming Waiver in Georgia, it must be established that you do not qualify for Social Security disability benefits (SSI). Call (800) 772-1213 to apply for SSI via phone. If you are approved for SSI, you can bypass the Katie Beckett process and enter the state’s Medicaid system. If you are not approved for SSI, the denial letter from the IRS will become apart of your application for Katie Beckett.

Step 2: Contact the Centralized Office

Call and request an application packet (or download instantly — see below). This may be a first timer or renewal.
Centralized Katie Beckett Deeming Waiver Medicaid Team
5815 Live Oak Parkway
Suite D-2
Norcross, GA 30093
678-248-7449 (phone)
678-248-7459 (fax)

Use this contact information for any specific questions you may have about the Katie Beckett process.

Step 3: Gather Your Child’s Medical Records

Make a list of all doctors and providers your child has seen. Contact each professional and request a copy of the medical records. For your child’s therapists, this includes daily notes. A fee may be associated with this request.

Step 4: Begin Completing Forms

(DO NOT DATE ANYTHING)
While you wait for the SSI denial letter to be received via mail, begin completing the forms. This will take approximately 4-8 hours for your initial application and approximately 2 hours for renewal applications.

Start with the Financial, Citizenship, TANF, HIPPA, and Insurance form. These forms are similar to those used when applying for a credit card. All forms are paired with instructions to complete as directed.

Complete the Medical forms with enough information that your primary care physician only has to sign. The information to complete the forms will come from the documents you requested in step 3.

Physician’s Recommendation for Pediatric Care: (Box #13) The medical records will contain all ICD (diagnoses) identified for your child. (Box #18) Select ICF-MR

Level of Care Statement is one of the key review points of an application that will determine if you qualify for KB. Children must participate in FIVE THERAPIES per week. If your child does not currently participate in 5 therapies, ask your pediatrician to write a prescription recommending five therapies a week (PT, OT, and/or SLP twice a week). This prescription will become a part of your application. On this form select ICF-MR. Include the current therapies your child receives and attach all therapy evaluations, daily notes, IEPs/IFSPs.

When completing the Medicaid application, do so as if you are the child. Each question corresponds directly to the child and household members’ (income, wages, employment, etc.).

The Cost-Effectiveness form must state a good prognosis. Total monthly costs must be less than $2400 a month. Use the Medicaid rates for therapy. These amounts can be determined by calling your provider(s) and asking directly. Examples of amounts are PT $84.12/hr, OT $79.04/hr, and SLP $62.50/30 mins.

You must complete the Voter Registration Declaration Statement.

Step 5: Attach/Complete Developmental Evaluation

An evaluation of five domains needs to be completed by a licensed professional (psychologist, early interventionist with BCW, etc.). This evaluation must have been completed and dated within the last 3 years. A psychological evaluation should contain an IQ score and needs to be signed by the licensed professional.

Final Notes

Remember to ask the physician not to date the documents in step 4. The date on the document determines when the next application is due and you want this date to be as late as possible (i.e. the day you actually mail all documents to the centralized office)

DO NOT LEAVE ANY QUESTION OR PAGES BLANK. Your application will be returned due to a technical denial, if so.

Submit your e-mail and instantly receive the current Katie Beckett Deeming Waiver Application!


 

ADDITIONAL RESOURCES

Additional assistance completing the Katie Beckett Deeming Waiver forms is available via a FREE 2-hour seminar on Parent to Parent of Georgia’s website; review Deeming Waiver Basics and A Guide to the Deeming Waiver Application Process. Details of past application instructions can also be found here.

Or if you prefer to pass the task of completing this process (for a fee) to a healthcare advocate, contact us and we can e-mail the contact information of two local consultants who will complete the process for you or review your documentation and walk you through the application. **We are not affiliated with any healthcare advocate. We are only sharing information.** Additionally, questions about Katie Beckett can also be answered by the Katie Beckett Team (see step 2 for the Centralized Office contact info).

Did your pediatrician inform you the about Katie Beckett Deeming Waiver in Georgia? If not, chances are he or she may not be aware of the resources available to families like yours. We’ve created a packet which you and your pediatrician will find helpful.  Step-by-step instructions of the Katie Beckett application process is also included.