Federal, exists in every state
Medicaid without using parents’ income (TEFRA background)
Arkansas offers TEFRA, a Medicaid route for children with disabilities that leaves parents’ income out of eligibility.
What it is
Arkansas offers TEFRA, a Medicaid route for children with disabilities that leaves parents’ income out of eligibility.
The name Katie Beckett describes a type of Medicaid route. In Arkansas the route is TEFRA, run as a federal demonstration. It can cover a child at home without counting parents’ income for eligibility, but the state still reviews care needs and the child’s finances.
Other details
- Your child must be 18 or younger and meet Social Security’s disability standard.
- The state also reviews hospital or nursing-home care needs, including risk of that level of care. Home care must be available, appropriate and cost no more.
- Your child’s own countable savings cannot exceed $2,000.
- TEFRA also checks your child’s own income. The cited policy uses three times the federal SSI amount: a $2,982 monthly benchmark in 2026 before the applicable child-income rules. DHS must confirm which income and exclusions apply.
What you get
- Medicaid for a qualifying child, including behind a work plan.
- Parents’ income and savings left out of eligibility.
Other details
- The TEFRA premium schedule begins above 150% of poverty and has a 5% family-income cap. DHS must calculate the applicable premium from its current schedule and income rules; the cap alone is not a premium estimate.
If you decide to apply
- Ask the hospital social worker or county office for the TEFRA packet.
- Have the oncology team describe daily care needs and bring records of your child’s finances.
County Department of Human Services office, 1-855-372-1084 · Official page ↗
Other details
- The demonstration approval runs January 1, 2026 through December 31, 2030.
Good to know
Parents’ income still sets the monthly premium. The state TEFRA card explains that cost.
Other details
- A disability finding does not replace the separate care-level decision.
- An inpatient stay can be a time to plan and obtain an assessment. The counselor must check inpatient coverage and earlier eligible at-home months separately; TEFRA does not promise coverage of every pre-discharge month.
Related Arkansas card: Medicaid that leaves out parents’ income (TEFRA).
Official sources
“We have heard the name Katie Beckett. Would Arkansas TEFRA help us, what would the premium and drawbacks be, and could you help with the packet if it fits?”
Why I’m asking: I want to understand the Arkansas route and the care review it needs.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Ask for the application paperwork this week, gather the child's own account balances, and get it filed within two weeks with fresh signatures.
Your social worker
Gets the application paperwork, sends the level-of-care form to the right clinician, and checks the signatures are current when it goes in.
The care team
Writes the level-of-care description: every daily task, how often, and what happens without it.
- Who decides
- The state Medicaid agency's disability review
- Ask your social worker
- “Can you help me apply for Katie Beckett (TEFRA)? Who on the team writes the level-of-care application paperwork, and how soon can it go in?”
How to apply
First step: Ask the social worker for the state's Katie Beckett application paperwork this week and who on the team writes the level-of-care section.
- Get the state packet this week.
- Have the clinician describe every daily task and what happens without it.
- File in the first two weeks. Coverage reaches back to the application month.
Where it starts: State TEFRA/Katie Beckett application
What to gather
- Pathology report and oncologist's letter with diagnosis and relapse dates
- The doctor's and nurse's description of daily skilled care (line care, medicines, monitoring)
- The child's own accounts (the child's money is tested, usually at $2,000)
How long: Up to 90 days by federal rule for a disability application. File in the first two weeks so coverage reaches back to the application month.
What a yes looks like
Medicaid on the child's own record, no premium in most states, with a level-of-care end date on the letter.
What a no looks like, and the next move
“Level of care not met”: the doctor's description of daily care decides it. Ask what was missing, add the log, and appeal within the notice's period.
Watch out
- Not every state has it. TEFRA states: AK, DC, DE, GA, ID, LA, ME, MA, MI, MN, MS, NE, NV, NH, OK, RI, SC, SD, WV, WI. Texas and California use other options. The state item explains.
- The application paperwork expires: signatures usually have to be recent when it reaches the reviewer. Do not let it sit at the clinic.
- A child on maintenance can be re-reviewed at the next level-of-care date. Ask when that date is.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 7, 2026.
What it is worth
Full Medicaid on the child's own record, usually with no premium, regardless of parents' income.
Covers: Full state Medicaid benefits · EPSDT home nursing and equipment once enrolled
Legal protection: The test is disjunctive: hospital, nursing facility or ICF level of care. Any one suffices
What it costs the family: No premium in most states. Nevada charges by income.
The eligibility facts, as published
- State option required
- yes
- Child at home
- yes
- Parental income
- not counted
- Child resource limit
- usually $2,000
- Level of care
- hospital, nursing facility or ICF/IID; any one
- Disability
- SSI medical standard where applicable: documented acute leukemia meets listing 113.06A for at least 24 months from diagnosis or relapse, or at least 12 months after transplant, whichever is later; the agency still verifies evidence
Decisions this site cannot make: Disability · Institutional level of care · Cost-effectiveness (some states)
Expect friction on: Detailed medical packet with recent signatures · Re-review at the level-of-care date
The trap: The level-of-care test is separate from the disability test: the child must need the care of a hospital, a nursing facility, or an intermediate-care facility, any one of them. The doctor's description of daily care decides it, not the diagnosis.
What changes by state: Whether it exists, the name (Georgia calls it the Deeming Waiver), the premium (none in most. Nevada charges), the level-of-care form and how long a letter is valid.
Where I read this
- Medicaid Program — Centers for Medicare & Medicaid Services, read August 27, 2026
- Full List of Medicaid Waivers and Programs — Kids’ Waivers, read August 27, 2026
- 42 CFR 435.912: Timely determination of eligibility — Cornell LII (eCFR mirror), read September 7, 2026