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Eligibility

There are two (2) kinds of TennCare:

To be eligible for TennCare as a new applicant, you must qualify for TennCare Medicaid

Need help applying?  There are at least three ways that you can get help:

  1. You can go to any DHS office in any of Tennessee’s 95 counties.  A trained staff person there will help you apply.  Over 350 state employees are trained to help you.  Click here to find the DHS office in your county.

  2. You can get help from private groups.  Click here to find someone near you.  You can also call 1-866-720-1711.

  3. You can call also 1-800-318-2596 to apply directly over the phone. 

 

Do you need help with TennCare?

 

If you need help getting Long Term Care or you want to apply the Medicare Savings Program, click here.

TennCare Medicaid

TennCare Medicaid is for Tennesseans who are eligible for a Medicaid program. You can apply anytime for TennCare Medicaid.

There are several different groups of people that may qualify. And, each group has different income limits. Some of the groups also have limits on how much you own-your "resources." These are things like bank accounts, cars, and land. The number of people who live in your household count too.

Some of the groups TennCare Medicaid covers are:

  • Children under age 21
  • Women who are pregnant
  • Parents or caretakers of a minor child (The child must live with you and be a close relative.)
  • Women who need of treatment for breast or cervical cancer
  • People who get an SSI check (Supplemental Security Income)
  • People who have gotten both an SSI check and a Social Security check in the same month at least once since April, 1977 AND who still get a Social Security check
  • A person who:
    • Lives in a nursing home and has income below $2,199 per month, or
    • Gets other long term care services that TennCare pays for

To apply, please visit https://www.healthcare.gov/

TennCare Standard

TennCare Standard is only available for children under age 19 who are already enrolled in TennCare Medicaid and:

  • Who lack access to group health insurance through their parents' employer, or
  • Their time of eligibility is ending and they don't qualify anymore for TennCare Medicaid.

There are two ways they can qualify and be able to keep their healthcare benefits:

Uninsured

To qualify as uninsured:

  • The child's eligibility through TennCare Medicaid is ending,
  • The child must be under the age of 19,
  • Lacks access to group health insurance through their own job or a parent's job, and
  • The family income is at or below 211% of poverty.

If the family's income is above 211% of poverty, the child may qualify for TennCare Standard as Medically Eligible.

Medically Eligible

To qualify as "medically eligible";

  • The child must be under the age of 19,
  • Have a health condition which makes the child "uninsurable", (or unable to access private health insurance because of their health condition.) and
  • Lacks access to group health insurance through their job or a parent's job

Once screened for this category, TennCare will mail a Medical Eligibility packet to the child's caregiver to complete. The packet asks for specific information about the child's health and from the information, a determination of eligibility is made.