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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 3 iii. Incurred by the individual, a member of the individual’s EDG, or the individual’s FRR, or are the legal responsibility of the individual, her family or FRR and not subject to payment in full or part by a third party; iv. Recognized under state law but not covered under the state’s TennCare Medicaid plan or waiver (continuously eligible individuals); and/or v. Covered under TennCare Medicaid but incurred during the spenddown period (new applicants).

NOTE: Medical expenses that will be covered by TennCare Medicaid during an eligible period are not allowable expenses. b. Allowable Medical Expenses The following are types of medical expenses considered Allowable Medical Expenses for the Medically Needy categories:

i. Acupuncture services ii. Bed hold at a Long Term Care Facility (Medicaid rate) iii. Dental expenses iv. Doctor’s fees - Practitioners and others providing medical services, physicians, surgeons, dentists, optometrists, chiropractors, osteopaths, podiatrists, psychiatrists, psychologists, and Christian Science providers. v. Drugs prescribed by a physician (prior to TennCare eligibility) - Medicines and drugs prescribed by a doctor incurred prior to establishing TennCare Medicaid eligibility and which remained unpaid or paid in the month under consideration (i.e., spenddown month). vi. Guide dogs - Guide dogs for the blind or deaf and the costs of their maintenance. vii. Hospital charges viii. Medical care charges included in tuition costs - Charges for medical care included in the tuition fee of a college or private school which is paid on a monthly basis, provided that a breakdown of the charges is included in the bill or is furnished separately by the institution. ix. Nursing home costs x. Nursing services - Nursing services include nursing care in an individual’s home, if for the purpose of treatment or alleviation of a physical, mental, or emotional disorder and ordered by a provider acting within the provider’s scope of practice. The care needed must be medical, e.g., administering medication or therapy. Cost of services solely domestic in nature, such as the preparation of meals and the performance of housework is not deductible. xi. Organ transplant expenses xii. Prosthetic devices - Artificial teeth, limbs, hearing aids and component parts, eyeglasses and crutches. xiii. Psychiatric care - Psychiatric care primarily for alleviating a mental illness or defect; the cost of maintaining a mentally ill individual at a specially equipped medical center where the individual receives continual medical care. xiv. Special education for handicapped - Special school for mentally or physically handicapped individuals if for the alleviation of handicap. Example: The costs of sending a