TEFRA Medicaid Coverage...

A parent called me a couple days ago & asked about the TEFRA Medicaid program & how does someone become eligible for this particular program. So after telling her about how my son, Brandon, qualified & how he became eligible, I thought it would be best for posting this information on our POPS blog..

My son, Brandon, has been on the TEFRA program for about 7 years now. I was working at the DMV-Department of Motor Vehicles at the time. I was discussing Brandon's medical & school issues with a co-worker, when a parent came in to renew her license. This parent told me about this particular program & all I could think was, "I will never qualify, I make too much money". What I didn't realize was, qualifying didn't go by how much money I or my husband made, it went by how much Brandon made.

As I was talking to her, she gave me a phone number to receive a TEFRA application. Well, after filling out the application, adding in all the necessary paperwork, a nurse visiting our home, me calling just about everyday to ask,"When are we getting qualified." & 7 months later, Brandon finally qualified.

All I can say is, Please be the squeaky wheel that gets the oil kind of person or they will certainly deny you from qualifying. I made a point to call them everyday or at least every other day to ask about Brandon's eligibility status.. It might have took 7 months to qualify, but he didn't get denied..

Here is information about the TEFRA Medicaid program:

"Katie Beckett" TEFRA Children
Under Section 134 of the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA), (P.L.97-248), states were allowed to make Medicaid benefits available to certain disabled children who would not ordinarily be eligible for Supplemental Security Income (SSI) benefits because of their parent's income or resources. South Carolina began covering these children effective January 1, 1995.

Eligibility:

To be eligible, a child must meet the following requirements:

* Be age 18 or under;
* live at home;
* meet the SSI definition of disability;
* have gross monthly income below $2,022 and countable resources at or below $2,000 (only the child's income and resources are counted);
* meet an institutional level of care. The three levels of care are intermediate care for the mentally retarded (ICF-MR), nursing facility (skilled or intermediate care) or hospital care. Meeting a level of care does not mean a child must be institutionalized (see above);
* it must be appropriate to provide care to the child at home; and
* The estimated cost of caring for the child outside the institution does not exceed the estimated cost of treating the child in the institution.

Benefits:

A child who meets these requirements is eligible for the full range of Medicaid covered services. If the child needs special services, which are available only under the home and community based waiver, they must apply for and be accepted into one of the waiver programs to receive these special services.

Applications may be obtained from the county Department of Social Services office in the child's county of residence or by contacting the TEFRA Coordinator in Columbia at (803) 898-2997 or statewide at the toll-free number: 1-888-549-0820. The completed application should be mailed to:
Department of Health and Human Services Attention: TEFRA Coordinator Post Office Box 100101 Columbia, South Carolina 29202-3101

The online TEFRA Application:
Please click here for the online TEFRA application