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Oklahoma State Medicaid Waiver Program Application Guide

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  • Oklahoma State Medicaid Waiver Program Application Guide




    Waiver #1: TEFRA Children Waiver


    Who can apply?

    Circumstances/Diagnosis: Any child under 19 who is diagnosed with either an intellectual and/or developmental disability (this includes autism). The state requires that individuals need at least an intermediate care facility level of care to qualify. This has a technical definition but essentially just means that the individual is unable to get through their day without a lot of supervision.

    Income: Income eligibility is only based on the child’s income and not the parents income. This means that your child is financially eligible for the waiver if they don’t have an income.

    What do I get?

    The way TEFRA waivers work is that they allow families with higher incomes to receive medicaid benefits for their child because eligibility is based on the child income. This means that you will be able to receive dental care, emergency and non-emergency transportation, inpatient and outpatient treatment, medical equipment, occupational therapy, pharmacy, physical therapy, vision.\

    Waiver #2: In-Home Supports Waiver for Children and the Community Waiver

    Who can apply?

    Both these waivers have the same eligibility requirements apart from two criteria: you are only eligible for the Community Waiver if the In-Home Supports Waiver doesn’t provide enough support for the applicant. Additionally, the In-Home Supports Waiver doesn’t service individuals older than 17.

    Circumstances/Diagnosis: Any child older than 3 who is diagnosed with either an intellectual and/or developmental disability (this includes autism). The state requires that individuals need at least an intermediate care facility level of care to qualify. This has a technical definition but essentially just means that the individual is unable to get through their day without a lot of supervision.

    Income: Income eligibility is only based on the child’s income and not the parents income. This means that your child is financially eligible for the waiver if they don’t have an income.

    What do I get?

    In Home Supports benefits:
    Respite Family Training
    Habilitation Training Specialists Adaptive Equipment
    Architectural Modifications Specialized Medical Supplies
    Community Waiver benefits:
    Adult Day Services Intensive Personal Supports
    Agency Companion Nutrition
    Architectural Modification Occupational Therapy
    Assistive Technology Physical Therapy
    Audiology Physician Services (provided by a psychiatrist)
    Community Transition Services Prescribed Drugs
    Daily Living Supports Prevocational
    Dental Psychological
    Family Counseling Respite Care
    Family Training Specialized Foster Care
    Group Home Specialized Medical Supplies
    Habilitation Training Specialist Speech Therapy
    Home Health Care Supported Employment
    Homemaker Transportation
    How do I apply?


    Call your local Oklahoma Human Services Office and set up an appointment and apply for any of these three waivers.

    What does the Goally Team Think?

    You can get the TEFRA waiver immediately, but it takes about 8 years to get services from Oklahoma’s other waiver programs. This wait is totally unacceptable and needs to be shortened. While you wait to get all the services the waiver can provide, ask your Oklahoma Human Services Office about the Family Support Assistance Payment that can get you $250-$400 a month in cash if you have a child under 18 with a disability.

    Goally Waiver Scorecard

    Website clarity and ease of navigation: 1/5
    Access and requirements of qualification: 0/5
    Healthcare coverage: 3/5

    Other online resources for Oklahoma:

    Oklahoma Autism Network has great information on Oklahoma’s resources and programs that connect and train parents.
    This list of Oklahoma Disabilities Organizations and Agencies may just help you find the school, funding, or program your child needs.
    Charitable Grants for families living with autism.

    Telephone Resources

    Oklahoma Health Care Authority -- 405-522-7752
    Last edited by Nate; 07-13-2020, 08:48 AM.
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