Page 5

Administrative Manual Section: General Administrative Procedures and Compliance Policy Manual Number: 200.030 Chapter: The Application Process

May 1, 2024

Division of TennCare 5

c. Applicant’s or responsible party’s signature.

NOTE: To approve benefits, a Complete Application must be filed as described below.

12. Signatures Required

Individuals must sign initial applications and renewal forms under penalty of perjury. Individuals may submit paper signatures, electronic signatures such as telephonically recorded signatures, and signatures transmitted by any other electronic transmission.

13. Complete Application

While the receipt of an application according to the policy stated above determines the application date, coverage cannot be approved or authorized until:

a. All required questions on the application are answered; b. All necessary verifications are received, unless otherwise excepted by policy (i.e., reasonable opportunity to verify citizenship).

14. Application Processing Time Limits

Federal regulations require that TennCare process an application and notify the applicant of the eligibility determination within 45 days, or 90 days for individuals who apply for Medicaid on the basis of disability.

15. Reinstatement of Withdrawn FFM Applications

If an individual is assessed and found ineligible for TennCare Medicaid or CoverKids by the FFM, the FFM reviews the individual for Advanced Premium Tax Credits (APTCs) and cost sharing reductions. The FFM gives these individuals the option of withdrawing the TennCare Medicaid or CoverKids application. If the individual elects to withdraw the TennCare Medicaid or CoverKids application and appeals an APTC or cost sharing reduction determination by the FFM, the original FFM application date is reinstated on appeal when the Office of Marketplace Eligibility and Appeals (OMEA) finds the individual potentially eligible for TennCare Medicaid or CoverKids.

16. Assistance with Application and Renewal

a. Accessibility

The TennCare application is accessible to individuals with Limited English Proficiency (LEP) and individuals that have disabilities. Language services and auxiliary aids and services are provided at no cost to LEP individuals and individuals with disabilities.