TennCare Tennessee Medicaid Eligibility


TennCare is the state-funded health insurance assistance program for low-income residents of Tennessee. The state’s Medicaid coverage, TennCare serves 1.2 million Tennessee residents and is one of the country’s longest-running Medicaid managed care programs. It is the only state health program in the nation to enroll the entire state Medicaid population in managed care. Members of TennCare may choose an MCO based on the region in which they live. Various health plans throughout Tennessee facilitate Medicaid benefits, as well as a pharmacy benefits manager for prescriptions and a dental benefits manager for children’s dental services.

The TennCare program is administered by the Bureau of TennCare within the Tennessee Department of Finance and Administration. In order to qualify for TennCare benefits, you must fit into one of several groups and meet income guidelines. You must also be a resident of Tennessee, a child, parent, pregnant woman, or aged, blind, or disabled. Income guidelines are based on the number of members living in one household and total earnings in relation to the Federal Poverty Level. Below are the current percentages of FPL a family or individual must meet to qualify for TennCare.

Group                                       Income (percent of FPL)

Infant                                                    185%

Child age 1-5                                        133%

Child age 6-19                                      100%

Parent (unemployed)                            38%

Parent (employed)                                69%

Pregnant Women                                  185%

Single Aged/Blind/Disabled                   75%

*$2,000 asset limit

Aged/Blind/Disabled Couple                  83%

*$3,000 asset limit

 

Other Eligible Groups

  • Families with income from Temporary Assistance for Needy Families (TANF)
  • Supplemental Security Income (SSI) recipients
  • Disabled individuals who no longer qualify for SSI benefits
  • Qualified Medicare Beneficiaries (QMB): Medicare members with income below the FPL. Medicaid covers your Medicare monthly premium, deductibles, and coinsurance if you meet the income guidelines.
  • Specified Low-Income Medicare Beneficiaries (SLMB): Medicare members whose income is under 120 percent of FPL can get their monthly premiums paid by Medicaid.
  • Medically Needy: Coverage for adults and children whose health care bills are so high that they qualify for Medicaid when medical costs are deducted from their total income.

 

Federal Poverty Level 2012

 

Resources

TennCare

Apply online for TennCare

Family Assistance Service Center: 866-311-4287

TTY or TDD: 877-779-3103