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  • Fm 3290 Me Tefra Application 4-07doc

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South Carolina Department of Health and Human Services APPLICATION FOR TEFRA MEDICAID COVERAGE Date Received by DHHS: 1. Name of Child (the Applicant) applying for Medicaid: Last Name: First Name:.

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Expansion Adults (effective: 4/1/2023) Size of HouseholdMonthly IncomeAnnual Income1$1,677$20,1242$2,269$27,2283$2,860$34,3204$3,450$41,4004 more rows • 15-May-2023

TEFRA/Katie Beckett is a category of eligibility for Medicaid coverage for children under age 19 who meet the Supplemental Security Income (SSI) childhood disability definition and level of care and can be provided care at home more economically than in a hospital or community home.

Medicaid is a Federal and state entitlement program that provides medical benefits to low-income individuals who have no or inadequate health insurance coverage. Oklahoma Medicaid guarantees coverage for basic health and long-term care services based upon income and/or resources for eligible Oklahoma residents.

If you are not sure what to send, call our toll-free line at 1-888-549-0820 TTY 1-888-842-3620 for help. DHHS Form 3291ME, TEFRA In-Home Care Certification. Your child's physician must complete this form.

SoonerCare, Oklahoma's Medicaid program, provides health care to children under the age of 19, adults with children under the age of 18, pregnant women and people who are older than 65 or have blindness or another disability.

Apply for Medicaid in Oklahoma Eligibility: The aged, blind, and disabled. Also, parents with income up to 42% of poverty, pregnant women with income up to 138% of poverty level, and children under age 19 with income up to 205% of poverty.

How to apply. Call 405-522-7752 or email TEFRAFax@okhca.org. A packet of forms and information will be emailed to you. Click here for tips on completing the TEFRA application.

Eligibility 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.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232