Tennessee Medicaid Eligibility: Income Limits, Asset Rules & How to Apply

Tennessee’s Medicaid program is called TennCare — and it’s one of the most structured managed care Medicaid systems in the country, operating entirely through three contracted managed care organizations: UnitedHealthcare, BlueCare (BlueCross BlueShield of Tennessee), and Wellpoint.

Every TennCare enrollee receives care through one of these MCOs, which coordinate medical, behavioral health, and pharmacy benefits into a single plan.

What makes TennCare distinctly different from most non-expansion states is the depth of its long-term services infrastructure.

The CHOICES Waiver for seniors and disabled adults, the Employment and Community First (ECF) CHOICES program for people with intellectual and developmental disabilities, and the Katie Beckett Program for children with complex medical needs give Tennessee pathways that go well beyond what many non-expansion states offer.

Tennessee also has adult dental coverage — an unusual benefit for a non-expansion state — and CoverRx, a pharmacy assistance program for adults who earn too much for TennCare but can’t afford full coverage.

What Tennessee doesn’t have: Medicaid expansion.

Adults 19–64 without disabilities and without dependent children have no TennCare pathway — and because Tennessee is a non-expansion state, those earning below 100% FPL can’t get Marketplace subsidies either. That’s the coverage gap.

This guide covers every TennCare program, 2026 income limits, CHOICES, ECF CHOICES, Katie Beckett, CoverRx, and how to apply through TennCare Connect. For how Tennessee’s limits compare to expansion states, see Medicaid income limits across all 50 states.

TennCare Programs

Tennessee operates several distinct Medicaid programs — each with its own eligibility, benefits, and application pathway.

TennCare Standard covers the core TennCare population: children, pregnant women, parents and caretakers of dependent children, seniors, and people with disabilities.

Care is delivered through one of three MCOs — UnitedHealthcare, BlueCare, or Wellpoint. Members also receive a separate OptumRx pharmacy card — a distinct feature compared to states like Pennsylvania where all benefits run through a single card.

CoverKids (CHIP) covers children up to age 19 whose family income is above the TennCare limit but at or below 250% FPL.

CoverKids is Tennessee’s CHIP brand name. No asset test applies.

Adult Dental Coverage — TennCare added comprehensive dental benefits for all adult members, including exams, X-rays, fillings, crowns, and root canals.

This is notably generous for a non-expansion state. Most Medicaid programs that offer adult dental limit it to extractions and emergencies. Tennessee’s full adult dental benefit is available to all enrolled TennCare adults.

CoverRx is Tennessee’s pharmacy assistance program for adults aged 19–64 with income at or below 138% FPL who don’t qualify for full TennCare benefits.

CoverRx provides discounted access to over 200 generic medications. It’s designed specifically to help the coverage gap population afford prescriptions even when they can’t get full health coverage. Apply through TennCare Connect at tenncareconnect.tn.gov.

CHOICES is TennCare’s primary HCBS waiver for seniors (65+) and adults with physical disabilities who need nursing home-level care but want to remain at home.

CHOICES delivers personal care assistance, adult day services, home modifications, meal delivery, and emergency response systems. It is not an entitlement — slots are limited and waiting lists may apply. Call 1-800-342-3145 to begin the enrollment process.

Employment and Community First (ECF) CHOICES is TennCare’s program for people of all ages with intellectual or developmental disabilities (I/DD).

It is the successor to the state’s earlier HCBS waivers for I/DD, which closed to new enrollment in 2016. ECF CHOICES explicitly focuses on community integration and competitive employment as outcomes — not just care maintenance.

The program has multiple groups by age and care level, with income limits tied to level of care. Apply by completing the self-referral form online at tn.gov/disability-and-aging or by calling DDA regional offices.

Katie Beckett Program covers children under age 18 with significant disabilities or complex medical needs whose parents’ income or assets would otherwise disqualify them from TennCare.

Passed by the Tennessee General Assembly in 2019 as a result of parent-led advocacy, this program has two parts:

Part A — Full TennCare Medicaid benefits for children with the most complex medical needs (hospital, nursing home, or ICF/IID level of care). Delivered through TennCare Select (BlueCross BlueShield of Tennessee). Premiums apply for families above 150% FPL.

Part B — Medicaid diversion services for children with significant but lower-acuity needs.

Both parts require both medical and financial eligibility reviews by TennCare and the Department of Disability and Aging (DDA) simultaneously. Apply through TennCare Connect.

Regular Medicaid (Aged, Blind, and Disabled — ABD) covers low-income elderly, blind, or disabled Tennesseans not requiring nursing home care.

Income limit: $967/month (single). Asset limit: $2,000 (single).

Nursing Home / Institutional Medicaid covers long-term care in Medicaid-certified nursing facilities and ICF/IID facilities.

This is an entitlement — eligible applicants cannot be turned away. Income limit: $2,901/month (single). Asset limit: $2,000 (single).

PACE (Program of All-Inclusive Care for the Elderly) serves dual-eligible seniors who qualify for both Medicare and TennCare with high-level care needs.

PACE integrates Medicare and TennCare into a single coordinated plan for community-dwelling seniors.

D-SNPs (Dual Eligible Special Needs Plans) coordinate Medicare and TennCare benefits through specialized managed care plans, ensuring members’ coverage doesn’t fall through the gap between the two programs.

Income Limits — 2026

All figures are monthly gross income. The Federal Benefit Rate (FBR) is $967/month for 2026.

Key Notes on Tennessee’s Income Rules

The coverage gap at 30% FPL: Tennessee’s parent income limit of $391/month for a single parent is one of the lowest in the country and lower than any other state in this series.

A single parent earning $400/month has no TennCare pathway, no Marketplace subsidy eligibility (which starts at 100% FPL), and no expansion Medicaid. They fall into the same structural gap as in South Carolina, with one difference: unlike South Carolina’s 45% FPL threshold, Tennessee’s 30% FPL is even narrower.

Nursing Home/CHOICES: Income above $2,901/month goes toward care costs after protecting a Personal Needs Allowance of $50/month, Medicare premiums, and any applicable spousal allowance.

If income exceeds $2,901, a Qualified Income Trust (QIT) redirects the excess to restore eligibility.

Community Spouse Allowance: When one spouse enters a nursing facility or CHOICES, the other may keep income up to $3,948/month as a MMMNA if housing and utility costs exceed $793.13/month (effective July 1, 2025 – June 30, 2026).

ECF CHOICES income limits by care level:

• Nursing facility level of care: $2,982/month
• At-risk level of care: $1,995/month
• Working with less than $994/month unearned income: $3,325/month

These are distinct from the standard Nursing Home limit and reflect ECF CHOICES’ employment-focused design.

Pregnant Women: Coverage extends 12 months postpartum. No asset test.

Federal Poverty Level Reference — 2026

Use the federal poverty level calculator to find the exact threshold for your household size.

Asset Rules for Tennessee Medicaid

No asset test applies to children, pregnant women, parents, or CoverRx. Asset limits apply to nursing home, CHOICES, and ABD programs.

Home equity limit: The primary home is exempt while the applicant or spouse resides there or intends to return. Tennessee’s home equity cap is $730,000.

Exempt (Non-Countable) Assets

• Primary home (within the $730,000 cap)
• One vehicle
• Household goods and personal effects
• Irrevocable Funeral Trusts (IFTs)
• Medicaid Compliant Annuities
• Life insurance with face value $1,500 or less

Tennessee’s 60-Month Look-Back Period

Tennessee enforces a 60-month (5-year) look-back for Nursing Home Medicaid and all HCBS Waivers including CHOICES.

When you apply, TennCare reviews all asset transfers from the 5 years before your application date. Transfers below fair market value — gifts, below-market sales, or certain trust transfers — trigger a penalty period of ineligibility calculated from when you otherwise meet all eligibility criteria.

Exempt transfers:

• Transfers to a spouse
• Transfers to a blind or disabled child
• Home transfer to a caregiver child who lived there at least 2 years before institutionalization and whose care delayed nursing home placement
• Transfer to a sibling with an equity interest who lived in the home at least 1 year before institutionalization

No look-back applies to ABD Regular Medicaid, children, pregnant women, parents, CoverRx, or ECF CHOICES.

Medical and Functional Requirements

To qualify for Nursing Home Medicaid or CHOICES, applicants must demonstrate Nursing Facility Level of Care (NFLOC) through documented limitations in:

ADLs: Mobility, bathing, dressing, eating, and toileting.

IADLs: Cooking, shopping, managing finances, medication management.

Cognitive or behavioral issues: Alzheimer’s, dementia, or other conditions — diagnosis alone is not sufficient; functional limitations must be formally assessed.

For ABD Regular Medicaid, proof of disability or blindness per SSA standards is required — NFLOC is not necessary.

For ECF CHOICES, the relevant standard is intellectual or developmental disability diagnosis, with care level assessed separately by DDA.

Medicaid Estate Recovery

Tennessee’s Estate Recovery Program seeks reimbursement from a beneficiary’s estate after death for long-term care costs paid by TennCare.

Recovery most commonly targets the primary home when not protected through a surviving spouse, qualifying disabled child, or caregiver child exemption.

Options If You Exceed the Limits

Qualified Income Trusts (QITs): If income exceeds the limit for Nursing Home or CHOICES, a QIT redirects excess into an irrevocable trust, restoring eligibility while protecting the $50/month Personal Needs Allowance and spousal income allowance.

TennCare must be named as the trust beneficiary.

Irrevocable Funeral Trusts (IFTs): Pre-paid funeral costs in an irrevocable trust are exempt from asset limits.

Spend Down: Convert countable assets into exempt ones — home improvements, vehicle purchase, paying off debt, medically necessary equipment.

Medicaid Compliant Annuities: Convert excess assets into an income stream, reducing countable assets while directing income toward care costs.

What to Do If You’re in the Coverage Gap

If you’re an adult without dependent children, not disabled, and earning below 100% FPL in Tennessee, you fall into the Medicaid coverage gap.

Your options:

CoverRx — If you earn up to 138% FPL and primarily need prescription coverage, CoverRx provides discounted access to over 200 generic medications. Apply at tenncareconnect.tn.gov.

Federally Qualified Health Centers (FQHCs) — Community health centers throughout Tennessee provide primary care on a sliding fee scale. Find the nearest location at findahealthcenter.hrsa.gov.

HealthCare.gov Marketplace — Marketplace subsidies begin at 100% FPL. If you’re close to that threshold, check whether any income sources would bring you above 100% FPL and into subsidy eligibility.

Hospital charity care — Tennessee hospitals provide financial assistance programs for uninsured patients. Contact the financial services office at any hospital.

Federal Policy Changes Coming to TennCare

Work Requirements (January 2027): Tennessee has not expanded Medicaid, so the OBBBA work requirements primarily targeting expansion adults do not directly apply here.

Tennessee parents on TennCare may face state-specific work rule considerations — check with TennCare directly. For context on how these requirements function in expansion states, see SNAP work requirements — the Medicaid version follows similar logic. Full policy details: how the One Big Beautiful Bill affects Medicaid and SNAP.

Reduced Retroactive Coverage (January 2027): Medicaid will cover only 2 months prior to application, down from 90 days.

Apply as soon as you believe you qualify.

More Frequent Renewals (December 2026): Renewals shift to every 6 months for most enrollees.

Use TennCare Connect at tenncareconnect.tn.gov to renew online and track your status.

New Cost-Sharing (October 2028): Non-exempt enrollees may face up to $35 per specialist visit. Primary care and preventive services remain free.

Children, pregnant women, nursing facility residents, and seniors are exempt.

TennCare and SNAP: Two Agencies, One Application Portal

TennCare Medicaid is administered by the Division of TennCare.

Tennessee SNAP (branded “Families First Food Assistance”) is administered by the Department of Human Services (DHS) — a separate state agency. However, the TennCare Connect portal handles TennCare applications, while SNAP applications go through DHS at dhs.tn.gov.

Many Tennessee families with children or seniors qualify for both programs simultaneously.

Tennessee SNAP uses BBCE, which removes the asset test for most households while keeping the 130% FPL income floor.

Useful links for Tennessee residents:

• Tennessee SNAP monthly benefits and eligibility
• How to apply for SNAP (Families First Food Assistance) in Tennessee
• Tennessee WIC income guidelines
• Whether seniors on Social Security can also qualify for food stamps
• Summer EBT and summer food benefits for Tennessee children

How to Apply for TennCare

Online: Apply through TennCare Connect at tenncareconnect.tn.gov.

TennCare Connect allows you to create an account, apply, check application status, report changes, upload documents, and read notices. Use it to track your application from submission through approval.

By Phone: Call TennCare Connect Customer Service at 1-855-259-0701.

For hearing or speech impairments: Call the Tennessee Relay Service (TNRS) at 1-800-848-0298 and ask them to connect you with TennCare Connect.

By Mail: Download a paper application from tn.gov/tenncare. Return completed applications to:

Division of TennCare, P.O. Box 305240, Nashville, TN 37230-5240

Or fax to your local DHS office (find the fax number at the DHS Office Locator).

In Person: Visit your nearest Department of Human Services (DHS) office. Find locations at the DHS Office Locator — Family Assistance page on tn.gov.

CHOICES / Long-Term Care: Call 1-800-342-3145 to initiate NFLOC assessment. Assessment must be completed before CHOICES enrollment.

ECF CHOICES: Complete the online self-referral at tn.gov/disability-and-aging, or call DDA regional offices:

• West TN: 1-866-372-5709
• Middle TN: 1-800-654-4839
• East TN: 1-888-531-9876

Katie Beckett: Apply through TennCare Connect. The system initiates both TennCare’s financial review and DDA’s medical review simultaneously.

For a complete step-by-step walkthrough: the full Tennessee TennCare application guide.

Documents You’ll Need

• Tennessee residency proof (utility bill, lease, or official mail)
• U.S. citizenship or qualifying immigration status documentation
• Income proof: pay stubs, SSA award letters, pension statements
• SSNs for all household members
• For LTC / ABD: bank statements, property records, 60 months of financial history
• For disability: SSA disability documentation or physician letter
• For Katie Beckett: child’s medical records; physician documentation of disability/complex medical needs

Processing Times

• Standard applications: Up to 45 days
• Disability-based applications: Up to 90 days
• Children / pregnant women: Expedited — TennCare targets 15-day processing

Frequently Asked Questions

What is the TennCare coverage gap in Tennessee?

Tennessee has not expanded Medicaid, so non-disabled adults without dependent children have no TennCare pathway regardless of income.

The gap is especially harsh at the low end: adults earning below 100% FPL don’t qualify for TennCare AND can’t receive Marketplace subsidies (which start at 100% FPL). A single adult earning $800/month has no affordable coverage option through either program.

What is the CHOICES Waiver in Tennessee?

CHOICES is TennCare’s primary HCBS program for seniors 65+ and physically disabled adults who require nursing facility-level care but want to remain at home or in a community setting.

Services include personal care assistance, adult day services, home modifications, meal delivery, and emergency response systems. Enrollment is limited — contact 1-800-342-3145 to begin. Income limit: $2,901/month. Asset limit: $2,000 (single).

What is ECF CHOICES and how does it differ from CHOICES?

Employment and Community First (ECF) CHOICES is TennCare’s program for people of all ages with intellectual or developmental disabilities (I/DD).

Unlike CHOICES — which primarily targets elderly and physically disabled adults — ECF CHOICES centers on competitive employment and community integration as explicit goals. Income limits vary by care level (ranging from $1,995/month to $3,325/month depending on the person’s assessed need). All new I/DD enrollment in Tennessee now goes through ECF CHOICES, as prior waivers closed to new enrollment in 2016.

What is the Katie Beckett Program and who qualifies?

The Katie Beckett Program covers children under age 18 with significant disabilities or complex medical needs whose family income or assets would otherwise make them ineligible for TennCare.

Part A provides full Medicaid benefits for children with the most severe needs (hospital, nursing home, or ICF/IID level of care) through TennCare Select (BCBS). Premiums apply above 150% FPL. Part B covers children with significant but lower-acuity medical needs. Both parts require simultaneous medical and financial eligibility reviews. Apply through TennCare Connect.

What is CoverRx and who should consider it?

CoverRx is a pharmacy assistance program for Tennessee adults aged 19–64 with income at or below 138% FPL who don’t qualify for full TennCare.

It provides discounted access to over 200 generic medications. It’s not full health coverage — but for uninsured adults in the coverage gap whose primary need is prescription access, it fills a meaningful gap. Apply through TennCare Connect at tenncareconnect.tn.gov.

Does TennCare cover adult dental?

Yes — Tennessee covers comprehensive adult dental through TennCare, including exams, X-rays, fillings, crowns, and root canals.

This is notably broader than most Medicaid programs, which typically limit adult dental to emergency extractions. Dental services are accessed through your TennCare health plan card (not the OptumRx pharmacy card).

How do TennCare and SNAP work together in Tennessee?

TennCare is administered by the Division of TennCare; Tennessee SNAP (“Families First Food Assistance”) is administered separately by the Department of Human Services.

You apply for TennCare at tenncareconnect.tn.gov and for SNAP at dhs.tn.gov — two separate portals and agencies. However, many Tennessee families with children or elderly members qualify for both simultaneously. See Tennessee SNAP benefits and eligibility for income limits and how to apply.

What is the parent income limit for TennCare?

30% FPL — approximately $391/month for a single parent.

This is one of the lowest parent income thresholds in the country. A single parent earning $400/month earns too much for TennCare and too little for Marketplace subsidies. Tennessee’s 30% FPL threshold is lower than South Carolina (45% FPL) and South Dakota (18% FPL as of this writing) and reflects the state’s decision not to expand coverage as a Medicaid expansion state.

Last updated: 2026 | Sources: Tennessee Division of TennCare, Tennessee Department of Disability and Aging (DDA), TennCare FAQs, CMS.gov, USDA FPL guidelines. Verify current figures at tenncareconnect.tn.gov or by calling TennCare Connect at 1-855-259-0701. This guide is for informational purposes only — eligibility is determined by the Tennessee Division of TennCare.