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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 4 b. Citizenship Eligible individuals must be U.S. citizens, U.S. nationals or eligible non-citizens. c. Residency Eligible individuals must be residents of Tennessee. d. Enumeration Eligible individuals must possess and provide a valid Social Security Number (SSN) or proof of application for an SSN.

e. TBCCSP Participant Eligible individuals must be participants of the TBCCSP program. They must have received a cancer diagnosis from the TBCCSP and be approved for presumptive eligibility. f. Cancer Diagnosis and Ongoing Treatment Eligible individuals must have a diagnosis of breast or cervical cancer, including cancerous or precancerous conditions, and require on-going treatment. In order to be continuously eligible in the BCC COE after presumptive eligibility is established, individuals must submit a treatment plan to TennCare. The treatment plan is also submitted at each redetermination. Once a treatment plan is received by TennCare, it is reviewed by TennCare Member Services. Coverage in the BCC COE provides full TennCare Medicaid benefits; however, TennCare Medicaid does not cover experimental treatments. g. Lacks Creditable Coverage Eligible individuals must be uninsured. An individual who lacks “creditable coverage” is considered to be uninsured. “Creditable coverage” includes: i. Other health insurance, including individual plans; ii. Group health insurance plans; iii. Medicare; iv. Medicaid (Individuals applying for coverage will be screened for all open TennCare Medicaid COEs prior to being determined eligible in the BCC COE); v. Military health plans; vi. Medical care programs of the Indian Health Services or tribal organizations; vii. State risk pools; viii. Public health plans; and