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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 9 TennCare Appeals Officer will determine whether the additional resource allocation is needed. See the Resource Assessment policy. e. DIMA When determining patient liability, an allowance is deducted from the individual’s income for the needs of her dependents. i. General Rules 1. Dependent relatives include the individual’s or spouse’s adult dependent children, parents, siblings, and minor children who are residing with the community spouse. 2. A DIMA is not allowed for any dependent receiving HCBS or who is institutionalized. 3. A dependent does not have the option of declining all or a portion of the income allocation for any reason according to the TennCare interpretation of the Medicare Catastrophic Coverage Act (MCCA), even if needs-based benefits may be decreased or lost because of the allocation. 4. The DIMA for each additional dependent family member is equal to one-third of the difference between the SMA and the dependent’s gross income. ii. Calculate DIMA The dependent allocation(s) equals the SMA for the community spouse minus the dependent's own gross countable income divided by 3 (SMA – gross countable income = deficit/3 = dependent allocation). a. Determine Dependent’s Gross Income Earned Income + Self-Employment Income + Unearned Income (other than Child Support) + Gross Child Support = Dependent Gross Income b. Calculate DIMA SMA $2,705.00 – Dependent Gross Income Determined in Step 1 ÷ 3 1/3 of the difference of the subtotal = DIMA iii. Dependent Relatives Living in the Home Without a Community Spouse When determining patient liability, an allowance is deducted from the individual’s income for the needs of dependent relatives living in the home without a community spouse.