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Administrative Manual Policy Manual Number: 200.045 Section: General Administrative Procedures and Compliance Chapter: Redetermination

August 1, 2024 Division of TennCare 3 2. CoverKids Women who are eligible for and enrolled in the CoverKids Pregnant Woman COE will remain eligible for benefits through the last day of the month of a 60-day postpartum period. The postpartum period begins on the day pregnancy ends, regardless of changes in circumstance and regardless of how pregnancy ends. ii. Children under the age of 19 Enrolled in Medicaid Children under the age of 19 who are determined eligible for and enrolled in certain TennCare Medicaid categories will remain eligible for that respective benefit through a 12-month continuous eligibility period, regardless of most changes in circumstance. Continuous eligibility for children is not applicable to the following TennCare Medicaid categories IE Foster Care, Widow/Widower, Medically Needy Child, Medically Needy Pregnancy, Katie Beckett Part B, Transitional Medicaid, Extended Medicaid, or EMS. Children in a presumptive eligibility period are not eligible for continuous eligibility. At the end of the 12-month continuous eligibility period, eligibility will be redetermined. A child may transition to another TennCare Medicaid COE that provides continuous eligibility during the 12-month period. At that time, they will be granted a new 12-month continuous eligibility period. Exceptions to the 12-month continuous eligibility period are as follows: 1. The child turns 19; 2. Coverage is voluntarily terminated; 3. The child is no longer a resident of Tennessee; 4. The State determines that eligibility was erroneously granted at the most recent eligibility determination or renewal of eligibility because of state error, or fraud, abuse, or perjury attributed to the child or the child’s representative; or 5. Death. If a child enrolled in the Child MAGI COE and is confined in a hospital at the time they turn 19, coverage will remain open until they have been discharged. iii. CoverKids Children Children under the age of 19 determined eligible for CoverKids Child will remain eligible for a 12-month continuous eligibility period, regardless of most changes in circumstance. At the end of the 12-month continuous eligibility period, eligibility will be redetermined. At that time, they will be granted a new 12-month continuous eligibility period. Exceptions to the 12-month continuous eligibility period are as follows: 1. The child turns 19; 2. Coverage is voluntarily terminated; 3. The child is no longer a resident of Tennessee; 4. The State determines that eligibility was erroneously granted at the most recent eligibility determination or renewal of eligibility because of state error, or fraud, abuse, or perjury attributed to the child or the child’s representative; or 3. Death.