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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 5 ix. Health plans under Section 5(e) of the Peace Corps Act.

Note: Once third party coverage of cancer has been exhausted, the applicant will be considered to no longer have health insurance. Insurance through the Exchange does not prevent eligibility for the BCC COE. h. TennCare Medicaid Eligibility An eligible individual cannot be eligible for any other open TennCare Medicaid COE. 6. Financial Eligibility Requirements Income and resources are not taken into account by TennCare when providing continuing eligibility in the BCC COE after presumptive eligibility is approved. However, this information is required for processing the eligibility determination of other open TennCare Medicaid COEs. 7. Coverage in another TennCare Medicaid COE If an individual receiving coverage in the BCC COE gains eligibility in another TennCare Medicaid COE, BCC coverage will close. This policy applies to all COEs, except Emergency Medical Services (EMS) and both Presumptive Pregnancy and BCC. 8. Case Closure a. Presumptive Eligibility If an individual is diagnosed with breast or cervical cancer and is approved for presumptive eligibility, and the diagnosis is determined to be benign or the individual fails to provide necessary information for ongoing coverage in the BCC COE (or other TennCare Medicaid COE), the presumptive eligibility coverage will end the last day of the month following the month in which presumptive eligibility was established. b. BCC Eligibility Once an oncologist determines that the enrollee is cancer-free or in remission, the BCC coverage will be terminated. Individuals losing eligibility in the BCC COE will be reviewed for coverage in an open TennCare Medicaid COE prior to termination.