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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 2 b. VA Pensions Limited to $90 Per Month VA pension payments are limited to $90 per month for the following individuals who receive Medicaid-covered nursing home care in a Medicaid-approved nursing facility: i. Veterans who do not have a spouse or a dependent child; ii. Surviving spouses of veterans who do not have a dependent child; and iii. Surviving children of veterans. When the VA pension payment is limited to $90 per month, the payment is aid and attendance and is not included in total income. The VA pension is not limited to $90 per month when the individual receives Home and Community-Based Services (HCBS) or is in a state veterans home. If a veteran or the surviving spouse of a veteran is in a state veterans home and receives more than $90 per month in VA pension, the VA pension, including any payment made for aid and attendance or for unreimbursed medical expenses, is counted in total income and applied to the state veterans home’s cost of providing nursing home care to the veteran or surviving spouse. 3. PETI Deductions from Total Income a. Allowable Deductions The following are deducted from total income to determine patient liability: i. A Personal Needs Allowance (PNA) for clothing and other personal needs while residing in the institution; ii. Mandatory expenses, such as garnishments, conservatorship or guardianship fees, court- ordered bankruptcy, court-ordered child support, court-ordered alimony, and Qualified Income Trust (QIT) fees; iii. A Community Spouse Income Maintenance Allowance (CSIMA), for institutionalized individuals with a spouse residing in the community; iv. A Dependent Income Maintenance Allowance (DIMA), for institutionalized individuals with a dependent residing in the community; v. Health insurance premiums, coinsurance and deductibles; vi. Incurred medical expenses not covered by TennCare Medicaid and allowed under the State Plan; and vii. An Incurred Medical Expenses Carry Forward Amount, for allowable medical expenses not previously deducted. b. PNA The PNA is provided to cover the institutionalized individual’s personal needs and incidentals while residing in the nursing facility or receiving HCBS waiver services. Apply the appropriate PNA based on the type of LTSS the individual receives.