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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 7 individual enrolls in and pays their initial private or employer-sponsored insurance premium, whichever is later.

Assistance with premium payments is limited to the lesser of:

a. The amount by which the child’s portion of the family’s monthly private or employer-sponsored insurance premium exceeds the child’s Katie Beckett Group Part A premium; or b. The amount by which the lowest cost silver-level child-only plan in the highest rating region in Tennessee offered through the Federally Facilitated Marketplace (FFM).

Effective 01/01/2026, the lowest cost silver-level child-only plan in the highest rating region in Tennessee offered through the FFM is $466 per month.

If the child’s monthly Katie Beckett Part A premium equals or exceeds the child’s portion of private or employer-sponsored insurance or the lowest cost silver-level child-only plan in the highest rating region in Tennessee offered through the FFM, whichever amount is less, the premium assistance amount is $0.

Example: Ryan White lives with his parents and 2 siblings. The family’s MAGI is $7,500 a month. The FPL for a household of 5 for 2020 is $2,557. Since the family’s MAGI is less than 400% of the FPL, and Ryan does not have access to insurance through either of his parent’s employer and was not enrolled in private insurance when he was enrolled in Katie Beckett Part A, Ryan meets the conditions for hardship and may receive premium assistance to help cover the cost of insurance. The cost of private insurance for the family is $600 a month. Ryan’s portion of the insurance is $120 ($600/5 = $120). Since the household income is between 250% and 300% of the FPL, his Katie Beckett Part A Premium is $75 per month. Ryan is eligible for $45 per month in premium assistance ($120 - $75 = $45).

9. Katie Beckett Effective Date a. Katie Beckett Part A i. For children who do not have a Katie Beckett Part A premium obligation, Katie Beckett Part A begins on the date the case is approved in the eligibility determination system.

ii. For children who have a Katie Beckett Part A premium obligation, Katie Beckett Part A begins on the date the initial premium payment is received in full, along with automatic electronic payment arrangements for ongoing premiums.

b. Katie Beckett Part B Katie Beckett Part B begins on the date of application or the date all eligibility requirements are met, whichever is later.