TEFRA Children Overview
Care for children with disabilities
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.
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
- physical therapy
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.
How to apply
Or you can mail in your information to OHCA, Attention TEFRA unit, 4345 N. Lincoln Blvd., Oklahoma City, OK 73105.
Visit our TEFRA Frequently Asked Questions web page for application tips.
For more information, visit the DHS TEFRA Parent Guide web page.
Call 405-522-7752 (OHCA)
What to bring with you or mail in:
- Income Verification: DHS forms 08MP001E, 08MP002E, 08MP003E (completed)
- Assessment form (TEFRA-1 for families)
- Letter of denial from Social Security Administration
- Current medical documentation from an MD or DO the child sees
- Current IEP (if applicable)
- SoonerStart Batelle (if applicable)
- Out-of-pocket expenses
- Tips for completing application