TennCare or Medicaid is a long-term health insurance and medical assistance program for residents of Tennessee. This program aims to facilitate needy individuals who cannot afford private insurance.

The benefits for Medicaid are delivered through a managed care model. Individuals choose a local provider who provides necessary services. Individuals who qualify for mental health and substance abuse services receive their benefits through a local Behavioral Health Organization. Similarly, applicants qualified for dental services receive their benefits through local Dental Benefits Manager.

In order to receive Medicaid benefits in Tennessee, individuals need to file an application through either the online platform or via the local DHS office. Applicants will need to fall into one of the eligibility categories and meet income guidelines to receive the benefits. Once qualified applicant start receiving benefits through Medicaid, they will need to verify their eligibility at regular intervals in order to continue receiving the benefits.

The state of Tennessee has not accepted Medicaid expansion under the Affordable Care Act (ACA). As a result, the program still uses the old eligibility criteria and fails to provide coverage to the new categories under the ACA.

Eligibility Requirements

If you are living in Tennessee and you cannot afford private health care and basic medical coverage due to poverty, you can easily enroll for Medicaid. However, you will need to check if you meet the minimum eligibility criteria for the program.

General eligibility

Medicaid will pay for various long-term health care and medical services for applicants only if they fall into one of the Medicaid categories. Here are some groups covered under TennCare Medicaid.

- Children

- Pregnant women

- Parents and caretakers of dependent children

- Women living with breast and cervical cancer

- Elderly and disabled

Applicants who are enrolled in any long-term TennCare service or receive Supplemental Security Income (SSI) will automatically qualify for TennCare Medicaid.

Income eligibility

TennCare Medicaid pays for long-term health care and basic medical services for the residents of Tennessee who fall into any Medicaid group and meet the corresponding income guidelines.

The income guidelines for the program are based on Federal Poverty Level (FPL). You can check whether you meet income guidelines for the program by comparing your household size against the annual household income per year. The income limits provided in the table below are maximum limits.

Household sizeIncome limit

1 $15,800

2 $21,307

3 $26,813

4 $32,319

5 $37,825

6 $43,331

7 $48,851

8 $54,384

If there are more than eight members in your household, you can calculate you income limit by simply adding $5,533 for every additional person.

Medicaid Application Instructions

Residents of Tennessee can apply for TennCare and Medicaid benefits using different routes. One of the easiest ways to apply is to complete an online application.

You can explore different methods to enroll in Medicaid.

Apply online

To apply for Medicaid online, visit www.healthcare.gov and start Medicaid application online. You may have to create an account with HealthCare website before you can start your application.

Apply through DHS office

You can also apply through any DHS office in Tennessee. Use this tool to find an office closer to your location.

Apply over the phone

You can also start your enrollment application for Tennessee Medicaid over the phone. Dial 1-800-318-2596 to start your application.

For more information about the program, call at 1-866-475-7879 or contact a private group near you. Visit this link to locate a TennCare private group in your area.