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La Medicaid to launch program allowing coverage to certain children with disabilities

1 month 2 days 18 hours ago Thursday, December 16 2021 Dec 16, 2021 December 16, 2021 5:34 AM December 16, 2021 in News
Source: Louisiana Department of Health

BATON ROUGE - The Louisiana Department of Health (LDH) announced Wednesday that the Centers for Medicaid and Medicaid Services (CMS) has granted approval for Louisiana Medicaid to launch Act 421 Children’s Medicaid Option, or TEFRA, effective January 1, 2022. 

This program allows certain children under 19 years of age with disabilities to receive Medicaid coverage, regardless of parental income. 

The TEFRA option disregards family income for children with disabilities who meet specific criteria, so they may qualify for Medicaid to cover the services they need to grow and thrive while living at home.

To qualify, children must have a disability that is recognized under the definition utilized in the Supplemental Security Income program of the Social Security Administration and must meet basic Medicaid and institutional level-of-care requirements. Additionally, their care must cost less at home than in an institution.

Applications for the TEFRA program can be submitted beginning January 1, 2022. 

Applicants must complete four steps which include:

1) Medicaid Application

2) Level of Care Assessment at your Local Governing Entity 

3) Disability Determination

4) Enrollment/Service Coverage through a Healthy Louisiana plan.

Consideration for Act 421 coverage will not occur before January 1, 2022. Anyone applying before that date will only be considered for existing Medicaid programs. 

Visit http://www.ldh.la.gov/act421 for additional information and answers to frequently asked questions.

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