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Families and Children Manual Policy Manual Number: 010.050 Section: Financial Eligibility Chapter: Medically Needy Spenddown

February 2, 2026 Division of TennCare 2 c. Expenses incurred during the 3 calendar months prior to the date of application, whether paid or unpaid; and d. Expenses incurred before the 3 calendar months prior to the month of application, only if:

i. Payment is made on those expenses during the month of application, and only the amount paid during the month of application is counted; or ii. All of the following carry forward conditions are met:

1. The expenses were previously verified in order to meet spenddown criteria; 2. The individual has remained continuously eligible in a medically needy category since that time; 3. The individual has met a spenddown during each period of eligibility in order to qualify; and 4. The expenses remain unpaid and have not been written off by a provider. Expenses paid during the 3 calendar months prior to the month of application will not be counted unless bills were also incurred during those calendar months. 5. Whose Expenses May be Counted Medical expenses that are incurred or paid within the spenddown period for the following individuals may be used to meet the spenddown requirement: a. The applicant; b. Members of the applicant’s EDG; c. The applicant’s FRRs or anyone for whom the applicant is financially responsible; and d. Individuals not living in the home or eligible for inclusion if an EDG member or their FRR is legally obligated to pay their medical expenses. This could include old bills of a child now over the age of 21 or bills a parent is obligated to pay due to a child support order. This may also include medical bills of an individual who is now deceased.

6. Allowable Expenses a. General Rule Allowable medical and remedial expenses include verified expenses that are incurred within the spenddown period or payments made on medical bills during the application month regardless of when the bill was incurred. Allowable expenses are those for which the individual is still liable and that are:

i. For medical or remedial care, including over the counter; ii. Verifiable and for which the individual provides substantiation;