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Aged, Blind and Disabled Manual Policy Manual Number: 130.005 Section: CHOICES Chapter: TennCare CHOICES in Long-Term Services and Supports August 01, 2024 Division of TennCare 6 5. Institutional Medicaid Eligibility and CHOICES Enrollment Dates a. Institutional Medicaid i. If approved for Institutional Medicaid and CHOICES Group 1 (NF), the Medicaid approval date is the latter of the date of application or the date of NF admission. ii. If approved for Institutional Medicaid and CHOICES Group 2 (HCBS), the Medicaid approval date is the date the case is approved/authorized in the eligibility determination system. iii. If approved for Institutional Medicaid and CHOICES Group 3 (At Risk HCBS), the Medicaid approval date is the date the case is approved/authorized in the eligibility determination system. Note: If an applicant requires a QIT or is required to spend down resources to establish eligibility for Institutional Medicaid, then the approval date is the first day of the month in which the QIT is established or resources are at or below the resource limit, but not before the application date or date of NF admission. b. CHOICES Enrollment CHOICES enrollment cannot begin until both financial eligibility and medical eligibility have been determined. 6. Institutional Medicaid Approval based on 30 Days Continuous Confinement An applicant in a medical institution who has met 30 days continuous confinement may be determined eligible for Institutional Medicaid. Categorically eligible individuals approved for Institutional Medicaid based on 30 days continuous confinement are not eligible for payment of NF services but are eligible for TennCare Medicaid benefits. Eligibility will be established in an Institutional Medicaid category based on the special income standard (300% of the SSI-FBR) if: a. The applicant is categorically eligible (i.e., aged, blind, disabled, a child under age 21, or pregnant); b. The applicant has been admitted to a medical institution and has been continuously in a medical institution (i.e., hospital, NF, ICF, SNF or ICF/IID) for at least 30 days; and c. Has met all financial and non-financial eligibility criteria for Institutional Medicaid. Individuals approved for Institutional Medicaid who have met 30 days continuous confinement may not have an approved, unexpired PAE. Categorically eligible individuals approved for Institutional Medicaid based on 30 days continuous confinement in a medical institution, who then later have an approved, unexpired PAE for CHOICES Group 1, will be eligible and enrolled in CHOICES.