What is TennCare?
TennCare is the state Medicaid program in Tennessee administered jointly by the federal government and the Tennessee state government. TennCare was established in 1994 under a federal waiver that authorized states to come up with their own Medicaid rules. TennCare serves low-income families, individuals, and children who need help paying their medical bills.
What are the TennCare eligibility requirements?
Income requirements are different based on your needs. In 2018, the limits are as follows:
If you receive SSI (Supplemental Security Income):
- Family of one cannot exceed $750 in monthly income and $2,000 in monthly assets
- Family of two cannot exceed $1,125 in monthly income and $3,000 in monthly assets
If your income ends up at or below the following after you pay your medical bills (Standard Spend Down):
- Family of one cannot exceed $241 in monthly income and $2,000 in monthly assets
- Family of two cannot exceed $258 in monthly income and $3,000 in assets
- Family of three cannot exceed $317 in monthly income
- Family of four cannot exceed $325 in monthly income
If you are in a nursing home or have a home nurse:
- Cannot exceed $2,205 in monthly income and $2,000 in monthly assets
If you have breast or cervical cancer:
- Cannot have Medicare, and must be below 250% of the Federal Poverty Level.
TennCare Standard is for kids under the age of 19 who have TennCare Medicaid but are losing eligibility and do not have access to other health insurance.
TennCare Medicaid Plans Eligibility
There are twelve TennCare Medicaid eligibility categories (not including TennCare Standard):
A: Kids under 21 who don’t have Medicare
B: Adults over 21 who do not have Medicare and are not receiving long-term care
C: Adults aged 21 who do not have Medicare, are not receiving long-term care, and are not enrolled in SSD (Standard Spend Down)
D: Adults over 21 who do not have Medicare, are not receiving long-term care, and are not enrolled in SSD (Standard Spend Down)
E: Adults over 21 who do not have Medicare and get long-term care through CHOICES
F: Adults over 21 who have Medicare and are receiving long-term care
G: Adults over 21 who have Medicare and are getting long-term care but not through CHOICES
H: Kids under 21 with Medicare
J: Adults over 21 who do not have Medicare and have CHOICES 1 or 2
K: Adults over 21 who have Medicare and have CHOICES 1 or 2
L: Adults over 21 who do not have Medicare and have CHOICES 3
M: Adults over 21 who have Medicare and CHOICES 3
TennCare Medicaid and Medicare Together
If you are eligible for Medicaid and are over the age of 65, you may qualify for a Medicare Savings Program:
Qualifying Individuals Program:
For those who fall between 120% and 135% of the federal poverty level have a yearly income of:
- Family of 1 – $14,568 – $16,389
- Family of 2 – $19,752 – $22,221
Qualified Disabled Working Individuals (QDWI) Program:
For those who are disabled, employed, at 200% or less of the Federal Poverty Limit, and fall under the following limits:
- Family of 1 – Income limit of $24,280 and have asset limit of $4,000
- Family of 2 – Income limit of $32,920 and asset limit of $6,000
Qualified Medicare Beneficiaries (QMB) Program:
For those who are at 100% or less of the Federal Poverty Level and meet the following limitations:
- Family of 1 – Income limit of $1,012 and asset limit of $7,560
- Family of 2 – Income limit of $1,372 and asset limit of $11,340
Specified Low-Income Medicare Beneficiaries (SLMB) Program:
For those who are between 100% and 120% of the Federal Poverty Level and meet the following limits:
- Family of 1 – Income limit of $12,140-$12,568 and asset limit of $7,560
- Family of 2 – Income limit of $16,460-$19,752 and asset limit of $11,340
If you qualify for both Medicaid and Medicare in Tennessee, you can enroll in a dual-eligible Medicare Advantage plan! If you are over the age of 65 or are diagnosed with ALS or ESRD, you can qualify for Tennessee Medicare. Click here to learn more about dual-eligible plans .
Anastasia graduated from Belmont University with a Bachelor's degree in Songwriting. When she's not writing, she's on a mission to visit all 50 states in the U.S (and to date has reached 41). Anastasia loves writing music, hiking, and playing with her pets (hedgehog, cat, and dog). She loves animals (but not so much bugs) and spends her free time volunteering for The Elephant Sanctuary in Tennesee.
How do I know if I have TennCare?
You can call TennCare Connect at 855-259-0701
if you already have TennCare, but you have questions. Or if you don't have TennCare, but you have questions. more
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