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Aged, Blind and Disabled Manual Policy Manual Number: 120.015 Section: Medicare Savings Programs Chapter: Specified Low Income Medicare Beneficiary

January 5, 2026 Division of TennCare 5 Version History Version Date Section Section Title Page Number(s) Reason for Revision Reviser 03.10.2015

Publication

06.02.2017 2.; 6.c. Policy Statement; Resource Limit 1-2 Policy Clarification RH 01.03.2018 2.; 5.a.; 6.c. Policy Statement; Medicare Part A (Hospital Insurance); Resource Limit 1-2 Policy Clarification AJ 03.18.2019 2.; 6.a.; 6.c.; 6.e. Legal Authority; Policy Statement; Eligibility Determination Group; Resource Limit; Budget 1-4 Policy Clarification RZ 07.01.2019 2.; 5.a. Policy Statement; Medicare Part A (Hospital Insurance) 1 Policy Clarification AJ 01.02.2020 2.; 6.c. Policy Statement; Resource Limit 1-2 Non-Substantive Change TN 01.04.2021 2.; 6.c. Policy Statement; Resource Limit 1; 2 Non-Substantive Change TN 01.04.2022 2.; 6.c. Policy Statement; Resource Limit 1; 2 Non-Substantive Change TN 01.03.2023 2.; 6.c. Policy Statement; Resource Limit 1; 2 Non-Substantive Change KF 01.02.2024 2.; 6.c. Policy Statement; Resource Limit 1; 2 Non-Substantive Change CE 01.02.2025 6.d. Legal Authority; Cost-of- Living Adjustment (COLA) Disregard 1; 3 Policy Change CE 05.01.2025 2.; 6.c.; 6.d.; 6.e. Policy Statement; Resource Limit; Cost-of-Living Adjustment (COLA) Deduction; Budget 1; 3; 4 Non-Substantive Change KJ 08.01.2025 2; 5.a. Policy Statement; Medicare Part A (Hospital Insurance) 1;2 Policy Change LW 08.01.2025 6.e Budget 3-4 Non-Substantive Change LW 01.05.2026 2.; 6.c. Policy Statement; Resource Limit 1; 3 Non-Substantive Change KJ