Deeming Waiver

(Previously called Katie Beckett Waiver)

One of the most frustrating situations for parents of children with disabilities is the income limit imposed for qualification of Supplemental Security Income (SSI). The Deeming Waiver is a way for parents to get Medicaid for their child with a disability when their income is too high to qualify for SSI. This federal waiver takes the family income out of the picture and looks at the income/assets of the child.  Even if a child has private insurance coverage, parents can apply for this waiver.  Most private insurance policies have service limitations, out of pocket expenses, and lifetime caps.  In cases where private insurance exists, the Deeming Waiver will be beneficial as secondary insurance to cover out of pocket expenses and will be helpful to have before a lifetime cap is met. As secondary coverage, Medicaid will pay for 20% of covered expenses that primary insurance does not pay. 

Eligibility Criteria:

In order to apply for the Deeming Waiver the child must meet the following guidelines.

1. Child must be under 18 years old.

2. Child must meet Social Security disability criteria.

3. Caring for child at home must be cost effective (less than nursing home cost).

4. Child must be ineligible for Supplemental Security Income (SSI) due to income and/or assets of the parents.

5. Child must meet the criteria for nursing home placement as established by the Georgia Medical Care Foundation (GMCF) for Medicaid recipients. *NOTE: This does not mean the child should be placed in a nursing home, simply that he/she meets the nursing home criteria for care.

How To Apply:

I.   Contact your county Department of Family and Children Services (DFCS).  Ask to speak with the Adult Medicaid worker, even though you are getting the waiver for a child.  The Adult Medicaid worker is the one who handles the Deeming Waiver (General DFCS personnel are not usually familiar with the Deeming Waiver).  The Medicaid worker will schedule an appointment for you, which will be long and in-depth.  The Medicaid worker should tell you ahead of time what you will need to bring with you to the appointment. (If not, make sure to ask so you do not waste your valuable time). The first step in the process is to determine ineligibility for SSI.  Most of the time, the county DFCS office can make this determination, but occasionally this is not possible.  If they cannot, they will refer you to the Social Security office to apply for SSI for your child.

II.  You will need to gather information and fill out forms in order to document your childs disability.  The DFCS worker will tell you about this information, give you the appropriate forms, and tell you where you can get assistance in completing the documents. 

These documents include:

1. Social History: a detailed family history.

2. Psychological Evaluation: for children with a mental retardation or developmental delay diagnosis.  This must be completed by a Psychologist (PhD.)

3. Plan of Care: service plan that states the childs strengths, needs and recommendations.

4. DMA- 6 Form: physicians recommendation for nursing home placement. Although the form can be filled out by the parent it must be signed by the doctor. This form is very important. Be sure to ask the DFCS worker to mark the areas that require the signature of the doctor. Form should be taken to the doctor that knows your child best.  Do not have the Dr. date the form when it is signed because it is only good for 30 days from the time it is dated. It should be dated at the time all of the paperwork is completed and the application is ready to be submitted.

III. When all paperwork is complete, the DFCS worker will submit the completed packet to the Georgia Medical Care Foundation (GMCF) for approval.

* Once a child is approved for the Deeming Waiver, a review of the childs continued eligibility must be completed annually. 

For More Information:

If you would like to talk with another parent that has already gone through the Deeming Waiver process, contact Parent to Parent of Georgia by phone to request a parent match or fill out the Peer Support Request now (be sure and note on the form that you want a match on the deeming waiver process).

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