1. (1) The following dual eligibles are eligible for TennCare to make Medicare crossover payments on all Medicare covered services, regardless of whether or not these services are also covered by TennCare:

   1. (a) QMBs;
   2. (b) Non-QMB FBDEs who are under age 21; and
   3. (c) Non-QMB FBDEs who are active SSI beneficiaries.
2. (2) Non-QMB FBDEs who are age 21 and older and who are not active SSI beneficiaries are eligible for TennCare to make Medicare crossover payments on all Medicare covered services that are also TennCare covered services. They are not eligible for TennCare to make Medicare crossover payments when the service on which the payment is requested is not a TennCare covered service.

Authority: T.C.A. §§ 4-5-202, 71-5-105, and 71-5-109. Administrative History: Public necessity rule filed July 1, 2008; effective through December 13, 2008. New rule filed September 24, 2008; effective December 8, 2008.