Arc Guide to Medical Assistance - TEFRA

The TEFRA (Tax Equity Fairness and Responsibility Act) provides Medical Assistance benefits for children with disabilities who would not qualify due to parents’ income being above program limits. The child’s eligibility is based on a certifiable disability and additional requirements listed below. Parents pay a monthly fee based on their Adjusted Gross Income (AGI) in order for their children to access services and support. Navigators are available at The Arc Greater Twin Cities to explain various Insurance Affordability Programs (Medical Assistance, MinnesotaCare) and can answer your questions about benefits and services.

MA-TEFRA is different from regular MA (Medical Assistance) because only the child’s income is counted. With regular MA, the parent’s income is counted. After your child is approved, coverage may:

Go back to the date your application was received, or go back three months from the date your application was received.

MA-TEFRA Eligibility requirements:

-Live with at least one parent

-Under age 19

-Determined as disabled by the State Medical Review Team (SMRT) or by the Social Security Administration (i.e. receiving a Social Security benefit based off a disability.)

-Require a level of care to remain living at home that is comparable to that provided in a hospital, nursing home or group home for individuals with a developmental disability

-The costs for the child to remain at home are less than those at a hospital, nursing home or group home

Determination of disability by SMRT: A county financial worker makes the referral to the State Medical Review Team once they have determined the applicant's eligibility ofor the program. Parents will receive a SMRT welcome letter and the name of a caseworker in the mail. parents can send documents directly to the worker at the state. 

Please click here for further information or call The Arc Greater Twin Cities at 952-920-0855.

Portico Healthnet
Portico Healthnet helps low-income populations access health care coverage (public programs and safety-net programs) through a toll-free phone service that also provides referrals to primary and preventive health care clinics. 651-489-CARE (2273) or 1-866-489-4899 (toll free) offers application assistance and referrals to nearby community clinics seeing uninsured patients on a sliding-fee scale. Operators can also assist non-English speaking callers.

Prescription Drug Resources
Many prescription drug manufacturers offer help to people who cannot pay for their medications. Some programs are only for people with low income; in which case, prescriptions may be provided at no cost. Other programs offer discounts on prescriptions for qualified individuals.

Child and Teen Checkups
651-201-3760
Child and Teen Checkups (CTC) is Minnesota's Early Periodic Screening, Diagnosis and Treatment (EPSDT) program. It is designed to provide comprehensive prevention and early intervention for children and youth at risk, from birth until age 21. CTC helps families on Medical Assistance or MinnesotaCare obtain preventive health care and follow-up. CTC also helps make appointments, arranges for rides, finds a clinic that will best serve the client, and helps connect the family with other services.

Quit smoking resources

QUITPLAN® Services is a free, professional support program available for any Minnesotan looking for help to quit tobacco. Since 2001, QUITPLAN Services has helped more than 20,000 Minnesotans successfully quit tobacco and provides free help regardless of insurance coverage. QUITPLAN Services is available over the phone through the QUITPLAN Helpline at 1-888-354-PLAN (7526) or online. The QUITPLAN Helpline offers free phone coaching with a trained cessation expert and access to free nicotine patches, gum or lozenges to eligible callers. The online program offers helpful quitting tools, an online community of support and access to live chat with quitting coaches. For more information, call 1-888-354-PLAN or visit www.quitplan.com