Understanding GAPP: Making Pediatric Home Health Care Affordable for Georgia Families

When your child needs skilled nursing or therapy at home, the financial and administrative challenges can feel overwhelming. Parents are often left trying to navigate a maze of rules, denials, and unclear coverage. That’s where the Georgia Pediatric Program (GAPP) becomes life-changing.

GAPP is a Medicaid-funded program that helps eligible children under 21 receive skilled nursing services, personal care, and therapies at home—without placing the financial burden on families. By covering the full cost of medically necessary services, GAPP allows children to thrive safely in their own homes while giving families peace of mind.

This guide breaks down how GAPP works, who qualifies, and how families can secure approval for these vital services.

What Is GAPP?

The Georgia Pediatric Program (GAPP) is a Medicaid program designed to help children with complex medical needs receive pediatric home health care outside of hospitals and institutions. GAPP pays for skilled nursing or personal care in the home or in a medical daycare setting.

Unlike private insurance or traditional Medicaid, GAPP is built specifically for children who need ongoing, medically necessary care such as ventilator support, tracheostomy care, feeding tube management, or therapies that support daily life and prevent hospital readmissions.

Who Qualifies for GAPP Services?

A child may qualify for GAPP if they:

• Are under 21 years old

• Have a complex medical condition requiring skilled nursing or personal care

• Are Medicaid-eligible (income guidelines apply)

• Have a physician-certified medical necessity for in-home services

Even if a family’s income would normally make them ineligible for standard Medicaid, special waivers can sometimes help children qualify for GAPP based on medical need rather than financial status.

What Services Does GAPP Cover?

GAPP provides a broad range of pediatric home health care services that reduce costs for families while ensuring children receive the care they need. Covered services may include:

• Skilled Nursing Care – for tracheostomy, ventilator, and G-tube management

• Personal Care Support – assistance with bathing, feeding, and mobility

• Therapies – physical, occupational, or speech therapy when ordered by a physician

• Medical Daycare Services – structured care in a medical setting for children who qualify

These services are designed to keep children stable, safe, and able to remain at home with their families instead of in long-term facilities.

How Do Families Apply for GAPP?

Applying for GAPP requires documentation and persistence, but with the right support, families can secure approval. The steps typically include:

1. Assessment – A physician documents the child’s medical necessity.

2. Application – Families submit medical records and forms through Medicaid or a home health agency.

3. Clinical Review – Medicaid evaluates the case based on eligibility and necessity.

4. Approval/Denial – Families receive notice of approval or may need to file an appeal if initially denied.

Working with a knowledgeable home health agency, such as Custom Living Care, helps streamline the process and ensures that families provide complete and accurate documentation.

What If GAPP Services Are Denied?

Denials are not uncommon—but families have the right to appeal. By submitting additional physician notes, therapy reports, or letters of medical necessity, families can often overturn an initial denial. Persistence is key, and having a care team advocate on your behalf can make all the difference.

How Does GAPP Reduce Family Costs?

Unlike private insurance, which may limit service hours or require costly copays, GAPP fully covers the approved hours of care at no cost to families. This eliminates the financial strain of paying out-of-pocket for services that can otherwise cost:

• $50–$150 per hour for skilled nursing

• Hundreds per week for therapies

• Thousands per month for private-pay personal care

By covering these services, GAPP allows families to focus on their child’s well-being—not on mounting medical bills.

How Custom Living Care Supports Families with GAPP

At Custom Living Care, we specialize in helping families access the Georgia Pediatric Program. Our team:

• Reviews eligibility and guides families through the application process

• Works with physicians to compile strong clinical documentation

• Coordinates with Medicaid to ensure approvals go through smoothly

• Assists with appeals if services are denied

• Provides high-quality, compassionate in-home care once approved

We take the stress out of the process, so families can concentrate on what matters most—caring for their child.

Frequently Asked Questions About GAPP

Does my child need to be Medicaid-eligible to apply for GAPP?
Yes, GAPP is a Medicaid-funded program. However, some children may qualify through special medical waivers even if their family’s income is higher than standard Medicaid limits.

What if my child only needs part-time care?
GAPP customizes service hours based on each child’s medical needs, from part-time to round-the-clock care.

Can GAPP cover therapies in addition to nursing?
Yes, if deemed medically necessary and ordered by a physician, therapies can be included.

How long does the approval process take?
Timelines vary, but with complete documentation, families can often receive approval within several weeks.

Final Thoughts

For families of children with complex medical needs, the Georgia Pediatric Program (GAPP) is a lifeline. It ensures that medically necessary care is delivered in the comfort of the home—without overwhelming families with financial stress.

At Custom Living Care, we are dedicated to helping families understand GAPP, apply successfully, and access compassionate, skilled pediatric home health services.

Contact us today for a free consultation to learn how GAPP can help your child receive the care they deserve.