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Aged, Blind and Disabled Manual Policy Manual Number: 115.025 Section: Categories of Eligibility Chapter: SSI Cash Recipient

January 5, 2026 Division of TennCare 2

Note: SSI payments may be suspended for an Achieving a Better Life Experience (ABLE) account owner if his ABLE account balance exceeds $100,000 or distributions from his ABLE account for housing-related qualified disability expenses (QDEs) are retained past the month of receipt and exceed the SSI resource limit. If the individual’s SSI was suspended for no other reason, the ABLE account owner remains eligible for SSI Medicaid. 5. Financial Eligibility Requirements a. Income Standard The SSA uses the Federal Benefit Rate. For 2026 the income standard is:

i. $994 for an individual; or ii. $1,491 for a couple. b. Resource Test Resource limits used by the SSA are:

i. $2,000 for an individual; or ii. $3,000 for a couple. 6. Additional Criteria for TennCare Medicaid Coverage As a condition of receiving TennCare Medicaid coverage, SSI cash recipients are subject to the following additional requirements: c. Cooperation with Third Party Liability SSI cash recipients must provide TennCare with any and all information necessary to obtain medical support or payment including, but not limited to, names of parties responsible for payment, address, and policy, account or claim numbers. See Assignment of Third Party Medical Support policy. d. Long Term Services and Supports (LTSS) Requirements SSI recipients who are requesting LTSS, either in a nursing facility or through Home and Community Based Services (HCBS), must have an approved Preadmission Evaluation (PAE). In addition, SSI recipients requesting LTSS who have a community spouse must complete a resource assessment and have asset transfers made within the look back period evaluated. In order to comply with the resource assessment requirements, SSI cash recipients seeking LTSS may be required to submit additional information to TennCare.