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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 6 When carrying over unused medical expenses for use in another spenddown period, do not allow any amount that TennCare or a third party will pay.

g. Carry Forward Example Ms. Smith, a pregnant woman, and her 1 year old child apply for coverage. Ms. Smith has no unearned income. Her Net Countable Earned Income is $5,000. Ms. Smith pays $400 per week for childcare. She has $50,000 of incurred allowable medical expenses. Ms. Smith’s Net Countable Income is over the MNIS for an EDG size of 3. A spenddown of her allowable medical expenses of $4,393 is applied. She will have a Future Carry Forward Amount of $45,607 that will be considered when her eligibility is reassessed. Spenddown Budget Calculation

Total Net Countable Income (after allowable budget deductions) $ 4,710.00 Income Limit - $ 317.00 Spenddown = $ 4,393.00 Current Year’s Medical Expenses - $ 50,000.00 Previous Year’s Carry Forward Amount + $ 0.00 Total Medical Expenses = $ 50,000.00 Remaining Spenddown Needed = $ 0.00 Future Carry Forward Amount = $ 45,607.00