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Families and Children Manual Section: Non-Financial Eligibility Requirements Policy Manual Number: 005.015 Chapter: Qualified Non-Citizens

August 1, 2024

Division of TennCare 4 5. Five-Year Period of Ineligibility

The PRWORA established a five-year period of ineligibility for all federally funded benefits, including Medicaid and CoverKids, for certain qualified non-citizens entering the U.S. on or after August 22, 1996. The five-year period of ineligibility is not applied to qualified non-citizens admitted to the U.S. prior to August 22, 1996 who have been continuously present in the U.S. from the date of entry through the date the individual became a qualified non-citizen. An individual has been continuously present in the U.S. if the individual can demonstrate there has not been a single absence greater than 30 days or multiple absences totaling more than 90 days. Once the individual becomes a qualified non-citizen, absences from the U.S. do not impact the five-year period of ineligibility.

a. Non-Citizens Subject to the Five-Year Period of Ineligibility

The following qualified non-citizens are ineligible for TennCare Medicaid or CoverKids for a period of five years from the date they are granted qualified non-citizen status unless they meet an exception as described in 5.b.:

i. LPRs admitted under the INA, 8 USC 1101, et seq., after August 22, 1996; ii. Non-citizens granted parole for at least one year under the INA (8 USC 1182(d)(5)); and iii. Battered immigrants and children who meet the conditions set forth in Section 431(c) of the PRWORA.

A qualified non-citizen may apply for coverage once the five-year period of ineligibility expires. The five-year period of ineligibility expires on the five-year anniversary of the date the individual was granted a qualified status. Once the five-year bar expires, a qualified non-citizen may apply for benefits as if he was a U.S. citizen. No previous application is required. If the qualified non- citizen meets the technical and financial eligibility criteria for a TennCare Medicaid or CoverKids category and the five-year period of ineligibility has expired, he is eligible to receive coverage in the appropriate category as of the date of application.

A non-citizen granted parole for at least one year is considered a qualified non-citizen from the date he is granted parole. For non-citizens paroled in the U.S. for at least one year, the five-year period of ineligibility begins on the first day of the parole period.

Qualified non-citizens who are subject to the five-year bar are eligible to receive EMS and CoverKids Pregnant Woman during their period of ineligibility, if otherwise eligible.

b. Non-Citizens Exempt from the Five-Year Period of Ineligibility

The five-year period of ineligibility does not apply to the following qualified non-citizens:

i. Non-citizens who are victims of a severe form of trafficking or who have been granted nonimmigrant status under Section 101(a)(15)(T) of the INA or who have a pending application that sets forth a prima facie case for such nonimmigrant status;