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Aged, Blind and Disabled Manual Section: Institutional Medicaid Policy Manual Number: 125.020 Chapter: Post-Eligibility Treatment of Income

July 1, 2026 Division of TennCare 12 4. The expense must be outstanding and considered collectible by the party who provided the medical service and one for which the client is legally liable. Debt sent to a collection agency is still considered collectible by the original party for purposes of this IME policy. 5. Medical expenses incurred up to three months prior to the month of application during TennCare Medicaid ineligibility do not impact whether the bill is an allowable medical expense, e.g. while an applicant is spending down resources to become eligible. Example: Mrs. Carter applied for TennCare Medicaid for the month of January. She did not meet TennCare Medicaid eligibility for that month due to exceeding the resource limit. She reapplied on April 1, 2016. She incurred charges for the facility stay from January, February, and March. The facility charges may be used as an allowable expense as they occurred during the three months prior to eligibility. ii. Incurred Medical Expenses in the Budget Verified IME deductions are allowed from patient liability for qualifying paid medical expenses. IMEs are allowed until the full unpaid balance has been deducted, or until the expenses are paid in full, whichever comes first. iii. Qualifying Expenses Payments for the following types of medical or remedial care recognized under state law, but not encompassed within the State Plan, are subject to the following criteria: 1. Eyeglasses and necessary related services Deductions can only be made for the following services and must be the least of the provider's usual and customary charges, billed charges or the Medicaid fee schedule: a. Examination and refraction; b. Frame; c. Lenses (bifocal); and d. Lenses (single). No deductions should be made for the first pair of eyeglass or contact lenses after cataract surgery, since those are allowed by TennCare. 2. Hearing aids and necessary related services Deductions can only be made for the following services and must be the least of the provider's usual and customary charges, billed charges or the Medicaid fee schedule: a. Audiogram;