TEFRA provides financial resources through Medicaid to pay for medical and therapeutic interventions and prescriptions for qualified children. This is secondary insurance, and, in some cases, will cover portions that the employer insurance will not. Eligibility is based on your child’s income—not yours. However, your child cannot have funds in a savings account; otherwise, based on the amount in the saving account, your child will not be eligible. If your child does have funds in an account in his name, it can take a few years before your child becomes eligible.
To find resources in your state go to: www.hdwg.org/catalyst/resources#general
One Family’s TEFRA Experience: An adoptive mother from South Carolina obtained TEFRA but it took her from January to July 2010; fortunately, the benefits were retroactive to November 2009. This mother also added that after you are approved, you must select an insurance plan through TEFRA. What the family was not told is that they could ask for the original Medicaid plan. The original Medicaid plan was the only one that was accepted by the service and health care providers from whom the child was already receiving services.
This mother noted that when signing up for insurance through TEFRA, those affiliated with the other insurance programs through the TEFRA program tried to discourage this family from sticking with the original Medicaid plan by offering them gift cards and personal care items. Of course there is no value in selecting a plan that will not cover your child’s treatment. Furthermore, do not automatically accept one of the plans listed through the TEFRA call-in number that reportedly indicates that your child’s physician or other health care providers will accept this plan. Check with your child’s health care providers directly to see which plans they accept. This family found that there was a huge discrepancy in what plan the child’s physician and other service providers would accept and what the TEFRA list indicated.
A good contact resource for SC residents to learn about these benefits is Family Connections. The website states that if you would like to talk to another parent whose child has TEFRA contact Family Connection at 1-800-578-875. You can visit the website at www.familyconnectionsc.org/
EARLY INTERVENTION PROGRAMS
These programs are provided at minimum to no cost to families regardless of income. Your insurance may first be used to cover expenses.
CO Early Intervention Programs
The Early Intervention Services booklet is an easy-to-read guide on the services your child who is under 36 months old can receive. If your child is more than 36 months old, there are other services also available. www.eicolorado.org
KY Special Parent Involvement Network (KY SPIN)
10301-B Deering Road
Louisville, KY 40272
This program is for children birth through 36 months of age who may have developmental delays or other issues such as sensory integration problems Children can receive in-home ser ices including occupational, physical and speech therapy. If you believe that your child may need early you can have your child evaluated at no cost to you. http://www.scfirststeps.org/BabyNet.html
SC First Steps to School Readiness
This program is coordinated with BabyNet but is for children 36 months old and older who need extra services due to developmental delays and other issues. To contact your regional office, go to http://scfirststeps.com/ to find the location and number.
State BabyNet Program
1300 Sumter St, Suite 100
Columbia, SC 29201
803-734-0479 803-734-1431 (fax)
Greenville and Pickens Counties
Center for Developmental Services
29 N. Academy Street
Greenville, SC 29601