Author: medicaidsaveslives

TEFRA is a resource that is available to certain families/people in Arkansas. “Also known as the Katie Beckett option, TEFRA is a category of Medicaid that provides care to disabled children in their homes rather than in institutions. To qualify for TEFRA benefits, the child must be disabled according to the Supplemental Security Income (SSI) definition of disability and must meet the medical-necessity requirement for institutional care.”

More information on whether a child is eligible

FACT SHEET – page 2 includes how your premium cost is determined.

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Here’s how you can apply:

Step 1: Have your PCP fill out the Physician Assessment Form.

Step 2: Get a copy of all of your child’s evaluations (OT, PT, SLT) or any other medical documentation that proves your child needs this assistance.

Step 3: Complete the Application Form.

Step 4: Take the completed forms to the Arkansas Children’s Hospital admissions desk, and ask to meet with a financial counselor. Expect to be there at least an hour because you will have additional forms to fill out. (Hours: M-F 7:30am – 6:00pm; Sat & Sun 9:00am – 6:00pm)

You may also take these forms to your local county DHS office. Find it!

You must take the following items with you:
– Child’s Birth Certificate
– Copy of Child’s current evaluations
– Any asset in the child’s name (savings account, CDs, etc.)
– Last year’s taxes for parent/guardian
– Copy of insurance cards

Ask them to make a copy of the completed application. Make sure they sign their name, date of receipt, and add their phone number. This will help you check the status later.

The Arkansas Health Insurance Premium Payment Program (ARHIPP) is “sponsored by Arkansas Department of Human Services, Division of Medical Services. HIPP is designed to save money for Medicaid clients with high healthcare costs by reimbursing all or a portion of the cost of their health insurance provided by an employer or COBRA and by eliminating some of their out-of-pocket medical expenses. In some cases, clients may qualify to receive reimbursement for the premium cost of a family health insurance policy. Membership is completely free for those who qualify and does not affect eligibility for Medicaid.”

The ARHIPP Website

Common Questions

How to Qualify

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How to Apply

Some parents have found that it is easiest to apply online, but you can apply through mail or fax. It has also been discovered that it is easier to email your documents instead of fax.

You must be able to provide the following Information:

• Policyholder’s Social Security number
• Policy number & group number of the group insurance
• Employer & employee share of premium cost
• Case identification number(s)

Along with your application, you must provide a copy of:

• Insurance card (front and back)
• Summary of benefits for your plan or desired plan
• Employer health insurance rate sheet
• Paystub if it shows premium deduction

Tips:

• Do not ever mail your original documents.
• Keep all conformation numbers.
• Keep a record of the dates you have called and representatives you have spoken to.