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Aged, Blind and Disabled Manual Section: Financial Eligibility Requirements Policy Manual Number: 110.040 Chapter: ABD Deeming of Income and Resources

August 1, 2025 Division of TennCare 6

4. Ineligible Spouse to Eligible Spouse Deeming a. Overview The countable income of an applicant/enrollee’s ineligible spouse living in the home may be deemed available to the applicant/enrollee. Income belonging to an ineligible spouse receiving public income-maintenance payments is not deemed to the applicant/enrollee. Spousal deeming applies to the Medicare Savings Program (QMB, SLMB, QI-1, AND QDWI) and Pickle Passalong. Note: Spousal responsibility for Institutional Medicaid COEs is based on spousal impoverishment rules. See the Post Eligibility Treatment of Income and Resource Assessment policy. Spousal responsibility for the Medicare Savings Programs is based on the financially responsible relatives principle. See the ABD Eligibility Determination Group and ABD Financially Responsible Relatives policy. b. When Spousal Deeming Applies Spousal deeming only applies when the spouses share a living arrangement; i.e. live in the community or home together. An FRR’s responsibility ends the month that the individual and spouse are separated for any reason such as one spouse moving to another home. If an ineligible spouse incurs mandatory child support expenses paid to support an individual outside of the household, then the income used to pay those expenses is not considered deemed. For treatment of Institutional Medicaid, see the Post Eligibility Treatment of Income policy. Spouse to spouse deeming only occurs when the deemed amount available to the eligible spouse is greater than the difference between the FBR for a couple and the FBR for an individual. When spousal deeming does occur, the Eligibility Determination Group (EDG) size increases by 1, so an EDG of 1 would become 2. c. Ineligible Spouse Income Deeming The ineligible spouse of an ABD TennCare Medicaid applicant/enrollee will receive all applicable ABD disregards prior to determining the deemed income amount. See the ABD Income Disregards and Expenses policy for specific deduction/expenses descriptions. If an ineligible spouse is required to pay mandatory child support to an individual outside of the household, then the income used to pay the mandatory child support is not deemed. d. Ineligible Spouse Income Deeming Budget The example below is for Pickle Passalong, which considers living arrangements when determining whether deeming applies. See the Pickle Passalong and ABD Eligibility Determination Group policies.