TennCare

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TennCare is a program that provides health coverage to some low-income Tennessee residents.  Medicaid covers families with children and pregnant women, medically needy individuals, the elderly, and people with disabilities, if state and federal guidelines are met. Legal residents who are not U.S. citizens may be eligible for TennCare Medicaid.  Non-citizens who do not have immigration documents cannot enroll in TennCare Medicaid. 

  • For certain categories of people, eligibility for TennCare Medicaid is based on the amount of your household income.

You may be eligible for TennCare Medicaid if you are an infant, a child, pregnant, the parent of a dependent, elderly, or disabled and your family meets the Medicaid income standards.

Income eligibility levels for these categories are described below.  Your assets and some expenses also make be taken into account, so you should contact the Tennessee

Low income persons eligible for Medicaid in Tennessee
Category –  Income eligibility (as percent of federal poverty level)
Infant — 185%
Child 1-5 — 133%
Child 6-19 — 100%
Pregnant woman — 185%
Parents
     Working – 80%
     Non-Working — 70%
* Eligibility information was compiled from State Health Facts Online, the Kaiser Family Foundation, and may have changed since this guide was published.  Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

To get an idea of how your income compares to the federal poverty level, use the federal poverty guideline issued by the U.S. Department of Health and Human Services for the year 2007:

Size of Family Unit                       Poverty Guideline (annual income)
               1                                                       $10,210
               2                                                       $13,690
               3                                                       $17,170

 - For larger families add $3,480 for each additional person
 - So, for example, using this guideline, 185% of the federal poverty level for a family of 3 would be an annual income of $31,765, or a monthly income of $2,647.
 - Contact your state Medicaid program for the most up to date information and for other eligibility requirements that may apply.

Families who get cash benefits from TANF (also know as Families First) can get Medicaid.  Parents should know that when you get a job and your TANF benefits end, you generally can stay on Medicaid for a 12-month transitional period. 

In addition, your children may qualify for TennCare Medicaid if your family’s income meets certain income standards.

  • Very poor elderly or disabled people who get Supplemental Security Income (SSI) benefits can qualify for Medicaid.
  • Disabled individuals should know that if your income earned from a job increases so that you no longer qualify for SSI, you may be able to continue your TennCare coverage at least for a limited time.
  • People who have high medical expenses may also qualify for TennCare. You may qualify as medically needy if you have high medical expenses that, when subtracted from your income, would make you eligible for TennCare coverage. For example, people who have to pay a lot for prescription drugs, nursing home care, or other long term care services sometimes qualify as medically needy if they don’t have health insurance that covers these services.
  • Retired or disabled people who have low incomes and are enrolled in TennCare may also qualify for help from TennCare. Even though your income may be too high to qualify for TennCare insurance coverage, there may be other ways TennCare can help you.

If your household income is below the poverty level, TennCare will pay your Medicare monthly premium and your Medicare deductibles and coinsurance.  This is called the Qualified Medicare Beneficiary (QMB) program. 

If your household income is below 120% of the poverty level, TennCare will pay for your monthly Medicare premiums only.  This is called the Specified Low-Income Medicare Beneficiary (SLMB) program.

Contact the Bureau of TennCare for more information about other eligibility requirements.

  • There may be other ways that TennCare can help. To find out if you or other members of your family qualify for Medicaid, please contact the Tennessee Department of Finance and Administration.
  • If you are not eligible for TennCare Medicaid, you may be eligible for TennCare Standard, a state program which provides benefits to children under the age of 19 who meet the eligibility requirements. For more information about TennCare Standard, contact TennCare at (866) 311-4287.


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