TEFRA Children Overview

TEFRA (Tax Equity and Fiscal Responsibility Act of 1982) gives states the option to make Medicaid (SoonerCare in Oklahoma) benefits available to children with physical or mental disabilities who would not ordinarily be eligible for Supplemental Security Income (SSI) benefits because of their parent's income or resources. This option allows children who are eligible for institutional services to be cared for in their homes.

Call 405-522-7752 or email TEFRAFax@okhca.org. A packet of forms and information will be emailed to you.

You can email your completed forms and documents to TEFRAFax@okhca.org, fax the information to 405-530-3312 or you can mail your information to:

Oklahoma Healthcare Authority
Attention: TEFRA unit
4345 N. Lincoln Blvd
Oklahoma City, OK 73105

Click here for tips on completing the TEFRA application.

Fax: 405-530-3312
Email: tefrafax@okhca.org
Call: 405-522-7752

Depending upon the person's needs, services may include:

• child health/EPSDT
• dental care
• emergency and non-emergency transportation
• inpatient and outpatient treatment
• medical equipment
• occupational therapy
• pharmacy
• physical therapy
• vision

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

• Be under age 19;
• Meet the Social Security definition of disability;
• Have qualifying income and resources;
• Meet an institutional level of care. The three levels are: intermediate care for individuals with intellectual disabilities, nursing facility, or hospital;
• It must be appropriate to care for the child at home;
• The estimated cost of caring for the child at home cannot exceed the estimated cost of caring for the child in the institution.

• TEFRA Financial Application Form 08OA002E-002 (completed).
• Assessment form (TEFRA-1 for families): English | Spanish
  
• TEFRA child letter of denial from Social Security Administration due to excess income and/or resources
• Current (within last 90 days) medical documentation from an MD or DO (specialist or PCP) the child sees
• Current IEP or educational plan (if applicable) 
• Developmental tool (such as SoonerStart Batelle or DP-3) (if under age 3) 
• Psychological evaluation with full-scale IQ and age equivalency (if age 3 and over)
• Out-of-pocket expenses statement
• TEFRA Parent Guide