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"Katie Beckett" TEFRA Children

Under Section 134 of the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA), (P.L.97-248), states were allowed to make Medicaid benefits available to certain disabled children who would not ordinarily be eligible for Supplemental Security Income (SSI) benefits because of their parent's income or resources. South Carolina began covering these children effective January 1, 1995.


To be eligible, a child must meet the following requirements:

  • Be age 18 or under;

  • live at home;

  • meet the SSI definition of disability;

  • have gross monthly income below $2,094 and countable resources at or below $2,000 (only the child's income and resources are counted);

  • meet an institutional level of care. The three levels of care are intermediate care for the mentally retarded (ICF-MR), nursing facility (skilled or intermediate care) or hospital care. Meeting a level of care does not mean a child must be institutionalized (see above);

  • it must be appropriate to provide care to the child at home; and

  • The estimated cost of caring for the child outside the institution does not exceed the estimated cost of treating the child in the institution.


A child who meets these requirements is eligible for the full range of Medicaid covered services. If the child needs special services, which are available only under the home and community based waiver, they must apply for and be accepted into one of the waiver programs to receive these special services.

Get an Application     Get Yearly Review Form

Applications may be obtained from the county Department of Social Services office in the child's county of residence or by contacting the TEFRA Coordinator in Columbia at (803) 898-2997 or statewide at the toll-free number: 1-888-549-0820. The completed application should be mailed to:
    Department of Health and Human Services Attention: TEFRA Coordinator Post Office Box 100101 Columbia, South Carolina 29202-3101