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Aged, Blind and Disabled Manual Policy Manual Number: 120.020 Section: Medicare Savings Programs Chapter: Qualifying Individuals 1

January 5, 2026 Division of TennCare 3 January. This can cause individuals who were previously QI1 eligible to become income- ineligible due to their increased Social Security income in the period between the COLA adjustment and the FPL increase. To address the discrepancy caused by the timing of the COLA and FPL adjustments, QI1 enrollees who become income-ineligible in January are provided with a COLA deduction for the months of January through the month following when the FPLs are released. The COLA deduction is equal to the amount of the monthly COLA increase.

e. Budget Mrs. Harrison is applying for medical assistance. She is entitled to and enrolled in Medicare Parts A and B and meets all non-financial eligibility requirements. Mrs. Harrison receives $1200 in OASDI payments per month, $430 in additional unearned income per month, and $0 in earned income. Mrs. Harrison is not married.

Mrs. Harrison’s total countable income, $1,260, is greater than 120% FPL but less than 135%, so she is eligible for the QI1 category.

Income Budget Calculation

Unearned Income $1,63 0.00 Irregular Unearned Income Disregard $ 0.00 In-Kind Support and Maintenance + $ 0.00 Ineligible Spouse’s Deemed Unearned Income + $ 0.00 Ineligible Parent’s Deemed Income + $ 0.00 General Deduction ($20) - $ 20.00 Child Support Disregard - $ 0.00 Widow/Widower Entitlement Disregard - N/A DAC Entitlement Disregard - N/A COLA Deduction - N/A Total Net Unearned Income = $1,260.00 Self-Employment Income

$ 0.00 Earned Income + $ 0.00 Irregular Earned Income Disregard - $ 0.00 Student Earned Income Exclusion - $ 0.00 Ineligible Spouse’s Deemed Earned Income + $ 0.00 Remaining General Deduction - $ 0.00 Earned Income Deduction - $ 0.00 Impairment Related Work Expense - $ 0.00 ½ Deduction - $ 0.00 Blind Work Expense - $ 0.00 Total Net Earned Income = $ 0.00 Total Countable Income (Total Net Unearned Income + Total Net Earned Income) = $1,260.00