Georgia’s Katie Beckett program gives an approved child a standard Georgia Medicaid card, so coverage includes doctor visits, hospital care, prescription drugs, physical, occupational, and speech therapies, behavioral health services, dental and vision care, durable medical equipment and supplies, home health and private duty nursing, and non-emergency transportation to medical appointments.1Georgia Medicaid. TEFRA/Katie Beckett Georgia charges no monthly premium or patient liability for the coverage.2Georgia Department of Human Services. 2133 TEFRA/Katie Beckett
Because a Katie Beckett child is enrolled in Georgia Medicaid, the services available are the same ones any Medicaid-enrolled child can receive. Federal Early and Periodic Screening, Diagnostic, and Treatment rules shape that package for anyone under 21, which means Georgia must cover any service that is medically necessary to correct or improve the child’s condition, not just a minimum benefit set.3Medicaid.gov. Early and Periodic Screening, Diagnostic, and Treatment
Doctor, Hospital, and Preventive Care
The card covers primary care visits, wellness checks, immunizations, specialist consultations, and lab work at no cost to the family. Emergency room visits, inpatient hospital stays, and outpatient procedures are billed directly to Medicaid. For families coming off high-deductible private plans, the absence of copays and coinsurance on most services is one of the most immediate effects of enrollment.
Prescription Drugs
Prescription medications are covered under Georgia Medicaid for Katie Beckett enrollees. Georgia uses a Preferred Drug List that steers prescribers toward certain medications, but all medically necessary Medicaid-covered drugs are available. When a child needs something off the preferred list, the prescriber can request an exception, and the pharmacy team usually reviews those requests within 24 hours.
This matters most for children on specialty medications. Drugs for seizure disorders, metabolic conditions, or chronic respiratory illness can run into the thousands per month, and Medicaid covers them as long as the prescriber documents medical necessity.
Therapies and Behavioral Health
Therapy services are often the reason families pursue Katie Beckett in the first place. Physical therapy, occupational therapy, and speech-language pathology are all covered when a provider documents medical necessity. Physical therapy generally focuses on mobility, strength, and gross motor skills. Occupational therapy targets fine motor development and everyday tasks like dressing and eating. Speech-language pathology covers both communication disorders and the swallowing problems common in children with neurological conditions.
Behavioral health is a major component of the benefit, particularly for children with autism spectrum disorder. Georgia Medicaid covers adaptive behavior services, including applied behavior analysis, for members under 21 who have a qualifying diagnosis from a licensed physician or psychologist, and services must meet medical necessity standards.4Georgia Medicaid. Autism Spectrum Disorder Georgia enrolls board-certified behavior analysts to deliver the services. Psychological services and counseling are available for broader mental health needs. Providers must file regular progress reports documenting ongoing necessity, so keep close contact with the treatment team to avoid gaps in authorization.
Dental and Vision
Dental coverage includes routine exams, cleanings, X-rays, fillings, and extractions, with more complex procedures and surgeries covered when a provider documents medical necessity.1Georgia Medicaid. TEFRA/Katie Beckett
Vision benefits include annual eye exams and prescription eyeglasses, with Medicaid paying for both frames and lenses. Ophthalmic surgeries are covered when medically necessary.1Georgia Medicaid. TEFRA/Katie Beckett
Medical Equipment and Supplies
Georgia Medicaid covers durable medical equipment such as custom-fitted wheelchairs, walkers, orthotics, and hospital beds for home use. The program also pays for consumable supplies like enteral feeding tubes, bags, and formulas, and for respiratory equipment including nebulizers and oxygen concentrators for children with chronic breathing difficulties.
Incontinence supplies such as briefs are covered for children age two and older when the condition relates to an underlying medical disability, in quantities that meet daily needs. The program also covers repair and replacement as a child grows or as items wear out, which keeps families from absorbing the cost of a new wheelchair or hospital bed every few years.
Home Health and Private Duty Nursing
Children who depend on medical technology such as ventilators or tracheostomies may qualify for private duty nursing, which provides continuous skilled nursing care in the family home.5Georgia Department of Community Health. Private Home Care Program This is a separate benefit from standard home health visits, which are shorter and intermittent and cover tasks like wound care or medication management.
To start private duty nursing, a physician develops a detailed plan of care that justifies the number of hours based on the child’s clinical needs. The Georgia Department of Community Health reviews the plan to confirm the level of care matches the child’s condition and meets state regulatory standards. The review is thorough, and approval takes time, but the practical effect of the benefit is significant: it lets medically fragile children stay with their families rather than live in an institution, and it reduces hospital readmissions by putting trained professionals with the life-sustaining equipment around the clock. Families coordinate nursing schedules through home health agencies.
Rides to Medical Appointments
Georgia Medicaid covers non-emergency medical transportation at no cost for members who have no other way to reach covered services.6Georgia Medicaid. Non-Emergency Medical Transportation That includes rides to doctor visits, therapy sessions, pharmacy pickups, and medical equipment fittings.
As of April 2026, Verida coordinates transportation across all five Georgia regions. Rides generally need to be scheduled at least three business days in advance, not counting the appointment day. You can book online at member.verida.com or by phone during weekday business hours. Have the child’s Medicaid ID, appointment details, and any special accommodation needs ready when you call.6Georgia Medicaid. Non-Emergency Medical Transportation
How Katie Beckett Works With Private Insurance
Many Katie Beckett families also carry private health insurance through an employer. Federal law requires Medicaid to be the payor of last resort, so private insurance pays first and Medicaid picks up remaining covered costs, including the copays and deductibles the private plan leaves behind. That is where Katie Beckett adds the most value for insured families: it fills the gaps the commercial plan does not.
Georgia requires families to report their private coverage to the Third-Party Liability unit. If your coverage changes, complete a DMA-285 form and submit it to the TPL/COB Unit at Gainwell Technologies or through your local DFCS office.7Georgia Medicaid. Third-Party Liability Failing to report insurance creates billing confusion and delays claims. Providers cannot bill you for any balance remaining after Medicaid pays its share.
What Families Pay
Nothing, in most cases. Georgia does not charge a monthly premium or patient liability for Katie Beckett coverage, and most covered services carry no copay.2Georgia Department of Human Services. 2133 TEFRA/Katie Beckett For families who have been paying privately for therapies, equipment, or specialty medications, the shift in household budget can be substantial.
When Coverage Ends
Katie Beckett coverage ends in the month the child turns 18.2Georgia Department of Human Services. 2133 TEFRA/Katie Beckett Before that birthday, work with a Medicaid eligibility specialist to look at adult disability Medicaid categories or home and community-based waiver programs that may continue some level of support for your child as an adult.