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Aged, Blind and Disabled Manual Policy Manual Number: 115.020 Section: Categories of Eligibility Chapter: Pickle Passalong

January 05, 2026 Division of TennCare 7 Version History Revision Date Section Section Title Page Number(s) Reason for Revision Reviser 3.15.2015

Publication

03.16.2016 4.c.iii. Determining the Amount of the COLA Disregard 3 Policy Clarification LW 03.16.2016 5.b.vi. COLA Disregard and Eligibility Determination 6 Policy Clarification; Non- Substantive Change LW 05.02.2016 2. Policy Statement 1 Policy Clarification LW 01.05.2017 4.c.iii,

Determining the Amount of the COLA Disregard 3 Policy Clarification RH 01.05.2017 5.b.vi. COLA Disregard and Eligibility Determination 6 Policy Clarification RH 03.09.2018 1. Overview 1 Policy Change TN 03.09.2018 2. Policy Statement 1 Policy Clarification TN 03.09.2018 4.b. Couples 2 Policy Clarification TN 03.09.2018 4.c.iii. Determining the Amount of the COLA Disregard 3 Policy Clarification TN 03.09.2018

5.a.6. Countable Income Computation 5

TN 03.09.2018 5.b. Example Budget 5 - 6 Non-Substantive Change TN 03.18.2019 4.a.; 4.c.iii. Eligibility Determination Group; Determining the Amount of the COLA Disregard 2-3 Policy Clarification TB 03.18.2019 5. Budget 3 - 4 Non-Substantive Change SN 01.02.2020 4.b.iv.; 5. Legal Authority; Pickle Conversion Factor Table; Budget 1; 3-5 Non-Substantive Change TN 01.04.2021 4.b.iv. Pickle Conversion Factor Table 3 Non-Substantive Change TN 01.04.2022 4.b.iv. Pickle Conversion Factor Table 3 Non-Substantive Change SA 01.03.2023 4.b.iv. Pickle Conversion Factor Table 3 Non-Substantive Change KF 01.02.2024 4.b.iv. Pickle Conversion Factor Table 3 Non-Substantive Change CE 01.02.2025 4.b.iv. Pickle Conversion Factor Table 3 Non-Substantive Change CE 08.01.2025 1.; 4.c.ii- iii; 5 Legal Authority; Overview; COLA Disregard; Determining the Amount of the COLA Disregard; Budget 1-6 Policy Clarification TC 09.25.25 4.c.iii; 5 Determining the Amount of the COLA Disregard; Budget 3; 5-6 Policy Clarification KJ