TEFRA 134(a), a provision of the Tax Equity and Fiscal Responsibility Act of 1982, allows states to extend Medicaid coverage to certain disabled children. Also known as the Katie Beckett option, TEFRA is a category of Medicaid that provides care to disabled children in their homes rather than in institutions. To qualify for TEFRA benefits, the child must be disabled according to the Supplemental Security Income (SSI) definition of disability and must meet the medical-necessity requirement for institutional care. Children who live in institutions or who receive extended care in institutions are not eligible in the TEFRA category.
To qualify for TEFRA benefits, the child
- must be younger than 19
- cannot have income that exceeds the Long Term Care Medicaid limit
- cannot have countable resources that exceed $2,000
Parental income and resources are not considered. Only the income and resources of the child are counted. Appropriate medical services must be available to provide care for the child in the home. The estimated cost of care in the home cannot exceed the estimated cost of care for the child in an institution.
Children who receive SSI but lose coverage intermittently due to fluctuating parental income may be eligible for TEFRA benefits in the months they do not receive SSI. The child's parent or guardian can apply for TEFRA at the DHS office in the child's county of residence. Applications also are accepted at Arkansas Children's Hospital and by Children's Medical Services service team workers.
The TEFRA program is coordinated by the Office of Long Term Care. For more information about the program, contact the Office of Long Term Care at (501) 320-6239 or (501) 320-6266.