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Aged, Blind and Disabled Manual Policy Manual Number: 115.035 Section: Categories of Eligibility Chapter: Katie Beckett

January 5, 2026 Division of TennCare 6 number of household members covered under the insurance and multiplying by 2. Emily’s insurance is $125 per month ($375/6 = $62.50 x 2 = $125). Emily’s monthly premium for Katie Beckett Part A is reduced by her portion of her family’s insurance. Emily’s monthly Katie Beckett Part A premium is $0 per month ($125 -$125 = 0). Emily does not have a Katie Beckett Part A premium obligation.

b. Initial Premium Payment The first month’s Katie Beckett Part A premium, along with electronic automatic payment arrangements for subsequent premiums, must be received before children who have a premium obligation can be enrolled in Katie Beckett Part A. The first month’s premium is due 60 days from the date the notice is mailed informing the household of the Katie Beckett Part A premium obligation amount. If the first month’s premium is not received within 60 days of the notice, the child will be denied for Katie Beckett Part A. The Katie Beckett Part A program slot will not be held unless a timely appeal is filed. If a timely appeal is filed, the Katie Beckett Part A program slot will be held until the conclusion of the appeal process.

c. Non-Payment of Premiums After the initial Katie Beckett Part A premium payment is made, ongoing premium payments must be made via automatic bank draft on the first of each month. If all or part of a premium is more than 30 days in arrears, an advance notice of suspension will be sent and program benefits for Katie Beckett Part A will be suspended if the premium is not paid. If all or part of premium payments are more than 60 days in arrears, an advance notice of program termination for non- payment of premiums will be sent. If the premium payments in arrears are paid in full before the effective date of termination, program benefits will return to active status back to the date they were suspended. If the premium payments in arrears are not paid in full before the effective date of termination, the child will be disenrolled from Katie Beckett Part A.

An appeal may be filed regarding the premium amount calculated or premium payments made. If an appeal is filed after the date of suspension, benefits will remain in suspended status pending the appeal but will be retroactively reinstated if resolved in the enrollee’s favor. A child who no longer qualifies for Katie Beckett Part A due to non-payment of premiums will be disenrolled from TennCare only after also being determined ineligible for all open TennCare categories. If the child later reapplies for Katie Beckett Part A, all arrearages and the first month’s premium must be paid in advance for the child to be re-enrolled in Katie Beckett Part A.

8. Premium Assistance If a family meets the requirements of a hardship exception, the family may receive premium assistance to help with the cost of the child’s private or employer-sponsored insurance, including the cost of coverage for the child’s parent when the parent must purchase health coverage in order to obtain coverage for the child. See Hardship Exception for Premium Assistance in section 4.a. Premium assistance will begin from the date the premium assistance is authorized or the date the