QUICK ANSWER: Aging out of GAPP happens when your child turns 21, because GAPP serves Georgia children under age 21. Georgia does not automatically move your child into an adult program. You must apply for options such as the ICWP waiver or NOW and COMP waivers. Some have waitlists.
Aging out of GAPP is one of the biggest changes a Georgia family with a medically fragile child will face. When your child turns 21, the Georgia Pediatric Program ends. This guide explains what happens next and how to plan early.
GAPP is a Georgia Medicaid program for medically fragile children under 21. It pays for in-home skilled nursing, personal care support, and respite care.
Eligibility depends on age, so your child stops qualifying at 21. Review GAPP eligibility rules and our complete guide to GAPP for the basics.
Families aging out of GAPP should plan for services to stop around the 21st birthday. Ask your agency and the Georgia Department of Community Health (DCH) for the exact end date on your child’s authorization.
Georgia does not transfer your child to an adult program for you. The same nurses and hours do not carry over on their own. You must find, apply for, and qualify for each adult service.
Your child’s Medicaid coverage is a separate question from GAPP. Ask DCH how coverage works at 18 and at 21. This matters most if your child has Katie Beckett Medicaid, which serves children and has an age limit of 18.
Three things change at once.
Three things change at once when you are aging out of GAPP. The numbers show the pressure on families aging out of GAPP. The Georgia Council on Developmental Disabilities (GCDD) reports more than 7,800 Georgians are waiting for a NOW or COMP waiver.
State data shared in January 2026 showed 1,217 people urgently needed one. The final state budget funded only 100 new waivers.
There is no single adult version of GAPP. Georgia uses several programs, run by different agencies. Here are the main ones.
Program | Run By | Who It Serves | How to Start |
ICWP | DCH | Adults ages 21 to 64 with severe physical disabilities or traumatic brain injury | Call Alliant GMCF at 800-982-0411 |
NOW | DBHDD | People with intellectual or developmental disabilities, with a lower funding cap | Ask DBHDD about the planning list |
COMP | DBHDD | Same group, with a higher funding cap and residential support options | Ask DBHDD about the planning list |
CCSP and SOURCE | DCH | Older adults and adults with disabilities at risk of nursing home placement | Contact the Georgia ADRC |
The Independent Care Waiver Program (ICWP) is a Medicaid waiver run by DCH. Georgia describes it as serving a limited number of adults ages 21 to 64. It is one program to check when aging out of GAPP with a physical disability or traumatic brain injury.
ICWP waiver Georgia eligibility generally includes these points:
Funding limits approvals. The state also weighs time on the waiting list, ability to live independently, and estimated cost of care.
ICWP services can include:
To apply, call Alliant Georgia Medical Care Foundation (GMCF) at 800-982-0411. Ask when your young adult can start the application. Time on the waiting list counts, so early action helps.
The Department of Behavioral Health and Developmental Disabilities (DBHDD) runs the NOW and COMP waivers. They serve people with intellectual or developmental disabilities. Both offer similar services, but NOW has a lower funding cap.
Families aging out of GAPP with a developmental disability should ask DBHDD about the planning list. This is Georgia’s term for a waitlist. DBHDD sets priority using health and safety needs, plus the strength of the caregiver and support system.
Services include respite, therapies, behavioral supports, and community living help. These waivers focus on daily-life and community support, as our GAPP and NOW/COMP comparison guide explains. They are built differently from GAPP nursing, so ask what health supports your child’s approved plan covers.
The Community Care Services Program (CCSP) and SOURCE help older adults and adults with disabilities who are at risk of nursing home placement. Families aging out of GAPP can contact the Georgia Aging and Disability Resource Connection (ADRC) to ask if their young adult fits.
Some young adults fit more than one program, especially with both medical and developmental needs. Each program decides eligibility on its own, so never assume approval. Ask each office whether you can join more than one list.
Use this timeline as a starting point. Confirm each step with your care team and the state agency.
Under GAPP, eligible families pay $0 out of pocket for approved services. After 21, your cost depends on the path your young adult takes.
Medicaid pays for authorized waiver services. Each program sets its own rules for hours, dollars, and covered services. The hours may not match what GAPP gave your child.
CareScout’s 2025 Cost of Care Survey lists Georgia’s median for in-home non-medical care at $73,216 a year. That is about $6,101 a month, or roughly $32 an hour. Skilled nursing usually costs more.
Example: 40 hours a week at $32 an hour is $1,280 a week. That is about $5,500 a month.
Parent caregiver pay that comes through GAPP ends when GAPP ends. Learn how parents get paid to care for their child under GAPP now. Some NOW and COMP participants direct their own services, so ask DBHDD if that option allows paid family caregivers.
Care Within Reach supports children and families across Georgia with home-based skilled nursing and personal care services. Our team helps families understand the care process, prepare the necessary information, and receive support that meets the child’s daily medical needs.
Families choose Care Within Reach because of our:
Our goal is to help children with medical needs receive safe, consistent care at home while guiding families throughout the process.
You do not need every answer today. Start with one step, and write down your child’s 21st birthday. Count back 24 months and put your first task on the calendar.
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GAPP services end when your child turns 21, and Georgia does not automatically move your child into an adult program. You must apply for options such as the ICWP waiver or NOW and COMP waivers. Start early, because some have waitlists.
The Independent Care Waiver Program (ICWP) is a Georgia Medicaid waiver for adults with severe physical disabilities or traumatic brain injury. DCH runs it. It serves a limited number of adults ages 21 to 64 who apply.
ICWP waiver Georgia eligibility generally requires Georgia Medicaid and a nursing facility or hospital level of care. You must be medically stable but at risk of placement without support. You must also be able to manage your own services.
Call Alliant Georgia Medical Care Foundation (GMCF) at 800-982-0411. Have medical records, Medicaid verification, and functional assessments ready, because the state will ask for them. Approval depends on eligibility and funding.
Both waivers serve people with intellectual or developmental disabilities and offer similar services. NOW has a lower funding cap and suits people living at home. COMP has a higher cap and can include residential support.
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