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Aged, Blind, and Disabled Manual Policy Manual Number: 115.015 Section: Categories of Eligibility Chapter: Institutional Medicaid

January 5, 2026 Division of TennCare 4 ii. MIC The MIC is $2,982 effective 01/01/2026.

iii. Budgeting Process, Based on Eligibility Determination Group 1. Adult Individual with No Spouse or Spouse is Institutionalized Income eligibility for an adult individual with no spouse, or who has a spouse who is already institutionalized, is determined based on the individual’s income only.

2. Adult Individual with a Community Spouse Income eligibility for an adult individual with a community spouse is determined based on the applying individual’s income only. The community spouse’s income is considered post-eligibility when determining the appropriate Community Spouse Income Maintenance Allowance (CSIMA). This may include individuals where the community spouse is eligible for and receiving HCBS.

3. Individual is a Dependent Child and Lives with Parents (Prior to Institutionalization or Application for HCBS) If the individual is a dependent child (under age 18), income from the individual’s FRRs is deemed available to him when determining income eligibility until the child applies for LTSS. No income is deemed available to him when determining income eligibility after application for LTSS has been made, unless a child under 18 is requesting HCBS services in the ECF CHOICES program, and an exception does not apply. For Institutional Medicaid Hospital, Parent to Child income deeming does not apply. See the Parent-to-Child Deeming section in the Employment and Community First CHOICES policy for more information.

i. 250% Federal Poverty Level (FPL) Disregard Earned income up to 250% of the FPL is disregarded for the Comprehensive Aggregate Cap (CAC), Self-Determination, and Statewide Waivers. For more information on the Department of Disability and Aging (DDA) waivers, see the Institutional Status policy and the TennCare CHOICES in Long-Term Services and Supports policy.

b. Income Budget Income eligibility is first determined for the individual without consideration of a QIT. This is necessary in order to determine if the individual needs to establish a QIT to become income eligible. If the individual passes the initial budget, it is not necessary for her to establish a QIT.