Have you heard the news? There have been some changes for MA-TEFRA that impact our community! The parental fee associated with MA-TEFRA was eliminated July 1, 2023. As information continues to roll out about this change, DSAMn’s Family Connectors are working hard to stay in the know. Here are the latest updates:
What is MA-TEFRA?
Medical Assistance (MA) is Minnesota’s Medicaid program for families with low income. TEFRA is the MA option for children with disabilities in families with incomes too high to qualify for MA. Under TEFRA, only the child’s income is counted for MA eligibility. MA-TEFRA provides the same benefits as MA. It helps pay for medical expenses for your child with Down syndrome and helps with accessing most county services. The PCA program, CSG grant and waivers require that your child is on MA.
In the past, families often paid a parental fee (like a monthly premium) to access MA-TEFRA for their child with a disability. Effective July 1, 2023 there are no more parental fees for Medical Assistance under TEFRA or for children receiving Home and Community Based Services and Waiver Services.
How do I apply for MA-TEFRA?
Apply using the application for healthcare “WITH financial help" in the MNsure system.
This can be done in two ways:
Apply online through MNsure OR
Fill out and return MNsure Application for Health Coverage and Help Paying Costs
The application includes disability-related questions about your child:
Has your child been determined disabled by the Social Security Administration (SSA) or State Medical Review Team (SMRT)?
Does your child have a disability determination or a condition you believe is disabling, and need additional services or supports?
Previously, the MA-TEFRA application process differed by county. New guidelines from Minnesota’s Department of Human Services state that the county will use information from the disability-related questions and request additional information needed to look at eligibility for MA-TEFRA. After submitting the MNsure application, it could be helpful to call your county with any questions about MA-TEFRA and learn next steps.
SMRT Process
To access MA-TEFRA, your child must be certified disabled. If your child has not been certified disabled through SSA or SMRT, the county will put in a referral to the State Medical Review Team (SMRT) for a disability review. This is often referred to as the SMRT process. You will receive, fill out and return paperwork to SMRT and they will review your child’s disability. After SMRT is completed and approved, you will receive a disability certificate for your child and approval for MA-TEFRA will follow.
Important things to know for families currently using MA-TEFRA for their child:
Parental fees related to your child’s disability services prior to July 1, 2023 will still need to be paid.
Final fees owed are being calculated in Fall 2023.
You may receive paperwork requesting tax information needed to determine your fee for services that occurred prior to July 1, 2023.
If you use a recurring payment option, you will need to go to DHS Web Payments Page and stop recurring payments. You can do this by selecting “click here to stop an existing recurring payment.”
If you set up a recurring payment through your bank, you need to contact your bank to end the recurring payment.
Questions? Contact the Parental Fee Unit at 651-431-3806 or 1-800-657-3751.
The elimination of the MA-TEFRA parental fee was a big win for our community. More families are now able to access MA and explore county services for their loved ones with Down syndrome. Here at DSAMn we know that the processes for all of this can be overwhelming. And with changes involved, there can be many questions. We get it! Reach out to the Family Connector team and we’ll guide you along the way.
Connect with a Family Connector:
Call: 651-603-0720 option 2
Email: connect@dsamn.org
Click here to complete Family Connector intake form
Reference:https://edocs.dhs.state.mn.us/lfserver/Public/DHS-7960-ENG
