TennCare eligibility in Tennessee turns on two things: whether you fit one of the program’s covered groups, and whether your household income falls under that group’s limit. The covered groups are pregnant women, children under 19, parents or caretaker relatives of a minor child, people who receive Supplemental Security Income, and adults who are 65 or older or have a qualifying disability. You also need to be a Tennessee resident and a U.S. citizen or lawful immigrant.1Justia Law. Tennessee Code 71-5-120 – Residency Requirement – Determination – Appeal Tennessee has not expanded Medicaid under the Affordable Care Act, so most adults without dependent children cannot qualify no matter how low their income is.
Who Qualifies for TennCare
TennCare is category-first. You have to fit a covered group before income even matters. The groups, and the income ceilings that come with them:2TN.gov. TennCare Medicaid
- Pregnant women with household income up to 250% of the federal poverty level. Coverage continues for 12 months after the pregnancy ends, even if income changes.3Centers for Medicare & Medicaid Services. CMS Approves Extension of Medicaid and CHIP Coverage For 12 Months After Pregnancy In Tennessee, South Carolina
- Children under 19. Income limits step down with age: 195% FPL for infants under one, 142% FPL for ages one through five, and 133% FPL for ages six through 18. Children in households up to 250% FPL who fall over those lines may qualify for CoverKids, Tennessee’s CHIP program.4TN.gov. Eligibility Reference Guide
- Parents and caretaker relatives of a child under 18 (or 18 if a full-time student), with household income up to 100% FPL.
- SSI recipients. If you get Supplemental Security Income, Tennessee enrolls you in TennCare automatically. No separate application.5TN.gov. SSI Cash Recipient
- Adults 65 or older, or with a qualifying disability, who are not on SSI. Eligibility here runs through the CHOICES long-term services program and uses both income and asset tests.
Newborns born to a mother enrolled in TennCare are automatically covered for their first year.4TN.gov. Eligibility Reference Guide
You don’t need to have lived in Tennessee for any set length of time, but you do have to intend to remain in the state.
2026 Income Limits in Dollars
For most groups, TennCare uses Modified Adjusted Gross Income — essentially your federal taxable income with certain deductions added back.6Cornell Law Institute. Tennessee Comp R Regs 1200-13-20-.06 – Financial Eligibility Determinations The 2026 federal poverty level is $15,960 per year for a single person and $33,000 for a family of four.7Federal Register. Annual Update of the HHS Poverty Guidelines Translated into dollars for a one-person household:
- 100% FPL, parents and caretakers: $15,960 per year, or $1,330 per month
- 133% FPL, children ages 6–18: $21,227 per year
- 142% FPL, children ages 1–5: $22,663 per year
- 195% FPL, infants under one: $31,122 per year
- 250% FPL, pregnant women and CoverKids: $39,900 per year, or $3,325 per month
Larger households get proportionally higher limits. A family of four with two children ages one through five, for example, would look at $46,860 per year at 142% FPL for the children’s coverage.8TN.gov. TennCare Eligibility Reference Guide
Federal rules add a 5-percentage-point income disregard on top of every MAGI-based limit. A parent whose income sits just above 100% FPL — up to about 105% — may still qualify. And for MAGI-based groups, there is no asset test at all. Your savings, car, and home don’t count.
One narrow exception on income: pregnant women and children under 21 whose income runs above the standard limits can subtract unpaid medical bills from their countable income under Tennessee’s medically needy spend-down, potentially bringing them under the line.9Cornell Law Institute. Tennessee Comp R Regs 1240-03-03-.06 – Income Limitations for the Medically Needy and Standard Spend Down This path is not available to parents, caretakers, or childless adults.
If You’re an Adult Without Kids or a Disability
This is where most people find out they don’t qualify. Because Tennessee has not adopted ACA Medicaid expansion, adults under 65 who are not pregnant, don’t care for a dependent child, and don’t have a qualifying disability generally cannot get TennCare regardless of income. Policy analysts call this the coverage gap: too little income to qualify for subsidized ACA marketplace insurance (which starts at 100% FPL in non-expansion states) but no route into Medicaid either.
If that describes you, your realistic alternative is a marketplace plan through healthcare.gov, purchased during open enrollment or after a qualifying life event.
Long-Term Care Eligibility Works Differently
If you are 65 or older or have a qualifying disability and need nursing home care or home- and community-based services, TennCare’s CHOICES program applies both an income test and an asset test. The MAGI rules above do not govern this group.
The income ceiling is 300% of the SSI federal benefit rate, which worked out to $2,901 per month for a single person as of 2025 and is updated each January. Countable resources — bank accounts, investments, and other non-exempt assets — cannot exceed $2,000 for a single applicant.10TN.gov. TennCare Long Term Services and Supports Financial Rules Guide
Your home is usually exempt, but Tennessee caps home equity at $752,000 for long-term care applicants. Above that, you won’t qualify unless a spouse, a child under 21, or a blind or disabled child of any age lives in the home. TennCare also reviews any assets you sold or gave away in the 60 months before applying. Transfers for less than fair value during that window trigger a penalty period of ineligibility.
Protecting a Spouse Who Stays Home
When one spouse enters a nursing facility and the other stays in the community, federal rules stop the at-home spouse from being wiped out. Tennessee lets the community spouse keep half of the couple’s combined countable resources measured at the time the other spouse enters the facility, with a floor of $32,532 and a ceiling of $162,660 as of January 2026.11TN.gov. Resource Assessment – Institutional Medicaid On $200,000 in combined resources, the community spouse keeps $100,000. On $40,000, the spouse still keeps at least $32,532.
How to Apply
You have three ways to file:12TN.gov. How Do I Apply for TennCare?
- Online at TennCareConnect.TN.gov, where you can also upload documents and track status.
- By mail to TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240.
- In person at a local Department of Health office.
Have these ready before you start:
- Government-issued photo ID
- Proof of Tennessee residency, such as a utility bill or lease
- Recent pay stubs, tax returns, or benefit statements showing income
- Social Security numbers for everyone applying, or proof you’ve applied for one13Cornell Law Institute. Tennessee Comp R Regs 1200-13-14-.02 – Eligibility
- For long-term care applications, bank statements, property deeds, and records of any asset transfers in the past five years
Online applications sometimes produce an immediate decision when TennCare can verify your data electronically. When it can’t, standard applications take up to 45 days. Long-term care applications can take up to 90 days because medical eligibility also has to be confirmed.14TN.gov. TennCare Frequently Asked Questions Respond quickly if TennCare asks for more documents; slow responses can turn into a denial for failure to provide information.
What Happens If You’re Denied
A denial arrives in writing and states the reason. You have 40 days from the date on that notice to appeal. Appeals go to Tennessee Health Connection by phone at 1-855-259-0701, by fax at 1-855-315-0669, or by mail to the P.O. Box 305240 address in Nashville.15TN.gov. Appeals
If you already have TennCare and the notice is a termination rather than an initial denial, the timing shifts. Filing your appeal within 20 days of the notice, or before your coverage end date if that’s later, keeps your benefits active while the appeal is decided. Miss that 20-day window and coverage stops even if the appeal is still pending. An administrative judge holds the hearing, and you can get help preparing your case.
Keeping Coverage After Approval
Once you’re on TennCare, eligibility gets redetermined at least once every 12 months, as federal rules require.16eCFR. 42 CFR Part 435 Subpart J – Redeterminations of Medicaid Eligibility TennCare first tries to renew you automatically from tax records and wage data. If it can, you get a notice and don’t have to act unless something is wrong. If it can’t, you get a pre-filled renewal form and at least 30 days to correct and return it. Not returning the form ends your coverage even if you still qualify. Watch your mail near your renewal date, and report changes — a new job, a move, a change in household size — as they happen rather than at renewal.