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Aged, Blind and Disabled Manual Policy Manual Number: 125.005 Section: Institutional Medicaid Chapter: Institutional Status
November 3, 2025 Division of TennCare 4
5. Inmate of a Public Institution
a. Inmate Status
Inmate means any person living in a public institution who was committed under the penal system with no exception. Inmate status suspends receipt of Medicaid benefits, but is no longer considered a factor when looking at non-financial eligibility criteria.
The following would not be considered inmates:
i. Individuals in public educational or vocational institutions designed for the primary purposes of educational or vocational training designed to prepare her for gainful employment; ii. Individuals temporarily confined pending other arrangements appropriate to his needs; or iii. Individuals receiving medical treatment in a ward approved by TennCare, such as patients in certified wards of State Developmental Centers for Intellectual and Developmental Disabilities, including certified ICF/IID wards and certified SNF, as well as patients in certified wards of State Mental Health Hospitals and Private Certified Mental Health Hospitals.
b. Termination of Inmate Status
Inmate status is interrupted or terminated when an individual is admitted as an inpatient to a medical institution for more than 24 hours, except for those committed under the penal system. Inmate status for those committed under the penal system terminates upon release from custody. Release means:
i. Parole; ii. Pardon; iii. Bail; or iv. Dismissal of charges.
6. Verification of Institutional Status
Establish the individual’s institutional status using any one of the following methods or evidence as appropriate.
a. Continuous Confinement to a Medical Institution for 30 Days (Hospital or Similar Institution)
Verify that the individual has been continuously confined in a medical institution for a period of at least 30 days. Check with the hospital admission office either by phone or written correspondence to verify admission and discharge dates. Review the individual’s bill for hospital charges as it may include an admission and a discharge date.