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Aged, Blind and Disabled Manual Policy Manual Number: 115.035 Section: Categories of Eligibility Chapter: Katie Beckett

January 5, 2026 Division of TennCare 5 7. Katie Beckett Part A Premium Payment Requirement a. General Rule As a condition of enrollment and continued eligibility for Katie Beckett Part A, children whose families have income of more than 150% of the FPL may be required to pay a monthly premium. The child’s premium is determined based on the family’s income and household size, using the MAGI methodology. The premium is calculated on a sliding scale using the table below:

The Katie Beckett Part A premium is reduced by the cost of the child’s portion of employer- sponsored or private insurance. If the child’s portion of employer-sponsored or private insurance (including the cost of coverage for the parent when the parent is required to purchase health coverage in order to obtain coverage for the child) equals or exceeds the child’s monthly premium for Katie Beckett Part A, the child will not have a premium obligation for Katie Beckett Part A.

Example 1: Jacob Zimmerman lives in the home with his mother, father, and sister. The family’s MAGI is $10,000 a month. The FPL for a household of 4 for 2020 is $2,184 a month. The family’s household income is more than 400% of the FPL. Since the household income is between 400% and 500% of the FPL, the Katie Beckett Part A premium would be $225 per month. However, Jacob has private insurance. The total cost of the family’s private insurance is $400 per month. Jacob’s father is not required to obtain coverage for himself in order to obtain coverage for Jacob. Jacob’s portion of insurance is calculated by dividing the total cost of the insurance by the number of household members covered under the insurance. Jacob’s insurance is $100 per month ($400/4 = $100). Jacob’s monthly premium for Katie Beckett Part A is reduced by his portion of his family’s private insurance. Jacob’s monthly Katie Beckett Part A premium is $125 per month ($225 - $100 = $125).

Example 2: Emily Cruz lives in the home with her mother, father, and 3 siblings. The family’s MAGI is $8,800 a month. The FPL for a household of 6 for 2020 is $2,930 a month. The family’s household income is more than 300% of the FPL. Since the household income is between 300% and 400% of the FPL, the Katie Beckett Part A premium would be $125 per month. However, Emily has insurance through her mother’s employer. The total cost of the family’s insurance is $375 per month. Emily’s mother is required to purchase insurance for herself in order to obtain coverage for Emily. Emily’s portion of insurance, including the cost of coverage for her mother, is calculated by dividing the total cost of the insurance by the Household Income (MAGI) Premium % of income for a household of two Monthly premium >150% - 250% FPL 1.5% $25 >250% - 300% FPL 2.5% $75 >300% - 400% FPL 3% $125 >400% - 500% FPL 4% $225 >500% FPL - No limit 5% $350 + $70 for every 100% above 500%