Count the sequences of $8$ tosses whose running total reaches $4.$ With at most $2$ tails he certainly reaches $4,$ contributing $$\begin{gathered} \binom80+\binom81+\binom82\\ =1+8+28\\ =37 \end{gathered}$$ sequences.

With exactly $3$ tails, he can first reach $4$ on toss $4$ or toss $6.$ Reaching it on toss $4$ requires four initial heads, after which the remaining head has $4$ possible positions. Otherwise, tosses $5$ and $6$ are heads, one of the first four tosses is a tail, and the last two are tails, again giving $4$ possibilities. Thus this case contributes $8.$ With exactly $4$ tails, only HHHHTTTT works, giving $1.$ He cannot reach $4$ with fewer than $4$ heads.

So there are $37+8+1=46$ favorable sequences out of $2^8=256,$ a probability of $\dfrac{46}{256}=\dfrac{23}{128}.$ Then $a+b=23+128=151.$

Thus, the correct answer is B.