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obtained from licensed or certified ophthalmologists, optometrists, or optical dispensing laboratories participating with CoverKids. Prior approval is required for any other services or visual aids deemed to be necessary by recommendation of the provider.

6.2.25 Premiums for private health care insurance coverage (Section 2110(a)(25)) 6.2.26 Medical transportation (Section 2110(a)(26))

Ambulance Service – Air and Ground: When medically necessary.

6.2.27 Enabling services (such as transportation, translation, and outreach services (See instructions) (Section 2110(a)(27)) 6.2.28 Any other health care services or items specified by the Secretary and not included under this section (Section 2110(a)(28))

In addition to the services indicated above, the CoverKids benefit package will also include:

• Emergency Care • Chiropractic Care: Maintenance visits not covered when no additional progress is apparent or expected to occur. • Routine Health Assessments and Immunizations in accordance with AAP and ACIP recommendations. • Mothers of unborn children eligible under the CoverKids Healthy Babies program will receive maternity services consistent with those available under the CoverKids program. • Mothers of unborn children eligible under the CoverKids HealthyTNBabies program will receive dental benefits consistent with those available under the CoverKids program for the duration of their maternity coverage.

6.3 The state assures that, with respect to pre-existing medical conditions, one of the following two statements applies to its plan: (42CFR 457.480)

6.3.1 The state shall not permit the imposition of any pre-existing medical condition exclusion for covered services (Section 2102(b)(1)(B)(ii)); OR 6.3.2 The state contracts with a group health plan or group health insurance coverage, or contracts with a group health plan to provide family coverage under a waiver (see Section 6.4.2. of

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