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Aged, Blind and Disabled Manual Policy Manual Number: 115.005 Section: Categories of Eligibility Chapter: Breast or Cervical Cancer

July 1, 2021 Division of TennCare 2 3. Presumptive Eligibility Presumptive eligibility for the BCC COE is determined by the DOH. a. Primary Screening Providers and Locations All DOH offices are expected to provide assistance to qualified individuals who are diagnosed with breast or cervical cancer, or who have suspicious symptoms related to these two forms of cancer. Participating statewide providers, including local DOH offices and certain primary care clinics provide screening services. A list of participating Community Health Centers is available on the Department of Health Local and Regional Health Department website. b. Presumptive Eligibility Requirements To be eligible for presumptive eligibility, an individual must: i. Have a verified diagnosis of breast or cervical cancer, including precancerous conditions; ii. Be under age 65; iii. Be uninsured or lack creditable health insurance coverage; iv. Participate in the TBCCSP program; and v. Have income at or below 250% of the Federal Poverty Level (FPL), based on family size.

Note: Self-attestation of income is accepted by TBCCSP when determining presumptive eligibility. c. Presumptive Eligibility Benefits Presumptive eligibility benefits include TennCare Medicaid coverage not limited to the treatment of breast and/or cervical cancer but does not include experimental treatments. Presumptive eligibility extends through the end of the month following the month in which presumptive eligibility is established. If an individual files a Valid Application during that period, the individual’s presumptive eligibility will remain open until final disposition of the Valid Application.