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Aged, Blind and Disabled Manual Section: Financial Eligibility Requirements Policy Manual Number: 110.055 Chapter: ABD Trusts

May 1, 2026 Division of TennCare 8 iv. Criteria for a Valid Trust The Trust must be irrevocable and cannot be modified or amended in whole or in part by the grantor at any time. However, the trustee or a court of competent jurisdiction shall have the right and jurisdiction to modify any provision of the Trust to the extent necessary to maintain the eligibility of the grantor for medical assistance. Each month the trustee shall distribute the entire amount of income transferred into the Trust except for an amount not to exceed $20, or another verified amount, for the expenses of the Trust. The sole beneficiaries of the Trust are the individual for whose benefit the Trust is established and the State of Tennessee. The Trust terminates upon the death of the individual, or when the Trust is no longer required to establish TennCare Medicaid eligibility in the State of Tennessee, or if nursing facility care or HCBS is no longer medically necessary for the individual, or if the individual is no longer receiving such services. The Trust must provide that upon the death of the individual or termination of the Trust, whichever occurs sooner, the State of Tennessee shall receive all amounts remaining in the Trust up to the total amount of medical assistance paid by the State on behalf of the individual along with an accounting of the payments from the Trust. v. Allowable Monthly Payments for Long-Term Care Facilities Allowable payments from the Trust include: 1. Personal Needs Allowance (PNA) the amount the individual is allowed to retain for his or her personal needs under Tennessee’s TennCare Medicaid policies. As of January 1, 2025, this amount is $70 for confinement in a nursing facility or ICF/MR and 300% of the SSI-FBR for HCBS enrollees and Self-Determination Waiver; and 300% for the Comprehensive Aggregate Cap (CAC) and Statewide Waivers; 2. A deduction not to exceed $20, or another verified amount, for expenses necessary for managing the trust (i.e. bank charges); 3. Community Spouse Income Maintenance Allowance/Dependent Income Maintenance Allowance (CSIMA/DIMA), if applicable; 4. Health Insurance Premiums – allowed when the individual has health insurance other than TennCare Medicaid (for example, Medicare premium or a Medicare supplement policy); and 5. Item D deductions - payment for types of medical or remedial care recognized under state law, but not covered as medical assistance under TennCare Medicaid.