Medicaid for Children with Special Needs
Aged, Blind, Disabled Medicaid for Special Needs Children
ABD Medicaid is no cost health insurance, offering medical, dental and vision services that meet the needs of disabled and medically-fragile children.
ABD Medicaid with Supplemental Security Income (SSI)
SSI Medicaid is designed to provide cash assistance for families of disabled children to help meet basic needs for food, clothing, and shelter.
Eligibility for ABD Medicaid with Supplemental Security Income (SSI)
Social Security has a strict definition of disability for children.
- The child must have a physical or mental condition(s) that very seriously limits his or her activities; and
- The condition(s) must have lasted, or be expected to last, at least 1 year or result in death
Household income and family resources are considered in determining eligibility for SSI. Determinations can take from 3-5 months.
Families with disabled children who qualify for SSI automatically qualify and are enrolled into Medicaid by the Social Security Administration. Please click here for more information.
Katie Beckett Deeming Waiver Medicaid
Katie Beckett Deeming Waiver is Medicaid health insurance for special needs children where income limits are not considered in determining eligibility or are “waived”.
Eligibility for Katie Beckett Deeming Waiver Medicaid
Families with disabled children who do not qualify for SSI because of income and meet the level of care requirements for disability or chronic illness qualify for Medicaid under the Katie Beckett Deeming Waiver.
Families with disabled children must be screened for SSI Medicaid first and if denied based on income and family resources then they are able to apply for the Katie Beckett Deeming Waiver. For more information and application, click here.
New Options Waiver (NOW) and Comprehensive Waiver (COMP)
A Medicaid Waiver is money that can pay for services for people with developmental disabilities. These services can take place in the person’s home or in the community. Both children and adults can be supported by Medicaid Waiver services.
Medicaid usually pays for doctor appointments, hospital expenses, medicine, therapy and some adaptive equipment. The Medicaid Waiver allows for Medicaid to be used to pay for additional services:
- Behavioral Support Consultation
- Community Access
- Community Guide
- Community Living Support
- Community Residential Alternative
- Environmental Accessibility Adaptation
- Supported Employment
- Financial Support Services
- Specialized Medical Equipment/Supplies
Eligibility for New Options Waiver (NOW) and Comprehensive Waiver (COMP)
The NOW/COMP Waivers is available to individuals of all ages with developmental disabilities. The NOW waiver provides support to people who do not need 24 hour care. The COMP waiver provides support to people who need 24 hour care.
It is the largest waiver program in Georgia. Parents are strongly encouraged to apply for the NOW/COMP Waiver as early as possible in a child’s life starting at age 4 because of the very long waiting period. Applicants will be put on a long-term or short-term waiting list based on individual needs. Long-term applicants may receive family support services while waiting for a waiver.
What is needed to apply
- Birth certificate
- Form of Government-issued Photo ID: e.g. Driver’s License, Passport (US or foreign) State issued identification card.
- Social Security number.
- Documentation supporting the child’s diagnosis and level of disability will include but is not limited to medical providers, therapists, school staff and psychologists.
There are no out of pocket costs for covered benefits. .
Non-US Citizens Parents/Legal Guardians
Some non-citizens do qualify for SSI Medicaid. Non-U.S. citizens who apply for Medicaid for their U.S.-born children do not have to prove citizenship, legal residency status or present a social security number. Applying for services does not trigger any action with USCIS Immigration Service.
Choosing a Health Plan
ABD Medicaid through SSI & Katie Beckett Deeming Waiver programs are not assigned to a specific health plan and determinations for care are made through the Department of Community Health.