GAPP vs. ICWP vs. NOW Waiver: Which Georgia Medicaid Program Fits Your Patient?

GAPP vs. ICWP vs. NOW Waiver: Which Program Is Right for Your Patient?

Georgia offers several Medicaid waiver programs that fund home and community-based services, and for case managers, knowing which program applies to which patient is essential to making the right referral. GAPP, ICWP, and NOW are three of the most common waivers case managers encounter — but each serves a distinct population with different eligibility rules and covered services.

Here’s a strategic breakdown to help you match your patient to the right program and the right provider.

 

GAPP: Georgia Pediatric Program

GAPP is designed for children under age 21 who are medically fragile or technology-dependent and require a level of nursing care that would otherwise be provided in a hospital or skilled nursing facility. This includes children who rely on ventilators, tracheostomies, feeding tubes, or require ongoing clinical skilled nursing monitoring. GAPP funds private duty nursing in the home, allowing children to receive hospital-level care while living safely with their families. Referrals often come from NICUs, pediatric hospitals, and pediatricians managing complex chronic cases.

 

ICWP: Independent Care Waiver Program

ICWP serves adults ages 21 to 64 with physical disabilities, including traumatic brain injuries and spinal cord injuries, who would otherwise require nursing facility care. ICWP participants are assigned a case manager who develops an individualized service plan, which may include personal support services, skilled nursing, and other supports that allow the individual to live independently in the community rather than in an institutional setting.

 

NOW: New Options Waiver

The New Options Waiver (NOW) serves individuals with intellectual and developmental disabilities who need community-based supports but do not require the more intensive level of service covered under the COMP waiver. NOW typically covers personal support, community access, and — when medically necessary — skilled nursing services, all aimed at helping participants live as independently as possible in a home environment.

 

Quick Comparison Table

Program Population Age Range Primary Focus
GAPP Medically fragile / technology-dependent children Under 21 Pediatric skilled nursing
ICWP Adults with physical disabilities / brain or spinal injuries 21–64 Skilled nursing + personal support
NOW Adults with intellectual/developmental disabilities All ages Personal support + community access

 

Choosing a Provider That Covers Multiple Waivers

Because patients and their circumstances can change — a child aging out of GAPP, or an adult moving between NOW and COMP — it’s highly valuable to work with a home care agency approved across multiple waiver programs. This completely reduces the need to find a new provider every time a patient’s coverage shifts, allowing for perfect continuity of care over time.

 

First Choice Home Care Agency: Approved Across All Three

First Choice Home Care Agency is an approved provider for GAPP, ICWP, NOW, COMP, CCSP, SOURCE, and VA benefits, serving Metro Atlanta and surrounding counties. Whether you’re referring a medically fragile child, an adult with a physical disability, or a NOW waiver participant, our team can build an immediate care plan around the specific waiver and services required.