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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 4 blind child to school to learn Braille, or a deaf child to lip-reading classes, are medical expenses. The costs of meals and lodging, if supplied by the institution, and/or ordinary education furnished incidental to the special services are medical expenses. xv. Substance abuse treatment - Treatment at a therapeutic center for drug addicts or alcoholics, including meals and lodging furnished as a necessary incident to the treatment. xvi. Transportation for medical/remedial purposes - Transportation essential to medical care, e.g., bus, taxi, train, or plane fares, and 72.5 cents for each mile that the individual’s car is used for medical purposes, in addition to parking fees and tolls. xvii. Over the counter (non-prescription) medicine - Deduct up to $10 per month for over- the-counter (non-prescription) medicine without verification, using only the individual’s statement. All of these expenses must be verified if the amount is more than $10 per month.

Expenses may be allowed if payment is made by a public program of a state or political subdivision that is other than a Medicaid program and there is a cost for the service. Free service to the public cannot be deducted.

Medical expenses related to maternity care (e.g., global fee) are considered incurred the month the physician presents a bill once services have begun (i.e., initial examination by the physician at a minimum). All other medical expenses are considered incurred the date the service is provided.

New bills, if incurred within the spenddown period, are deductible for the period in which they are incurred whether or not they have been paid with loan proceeds or a credit card. No carry forward expense will be allowed at the next spenddown review because the bill has been paid in full. The loan or credit card payments are not allowed as a medical expense at the next review.

If spenddown is not met by the medical bills presented at application or redetermination, the daily countable medical expenses incurred during the application month will be added until spenddown liability is reached. Use only the portion of the medical expense that is necessary to meet spenddown. c. Non-Allowable Expenses The following incurred expenses cannot be deducted from income in order to meet the spenddown requirement: i. Expenses incurred prior to the individual becoming eligible for TennCare Medicaid or in a prior period for charges that have been written off as uncollectible or have been forgiven by the provider; ii. Expenses that are covered by the State’s TennCare Medicaid plan and are incurred during a period of eligibility:

1. Costs incurred during a period of TennCare eligibility due to co-pays or services not covered such as dental, hearing and eye care for adults are allowable as a medical expense.