Tennessee Medicaid Eligibility and Enrollment

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  • TennCare is Tennessee's state Medicaid program. Learn about how it works, who qualifies for it and other helpful details in this article from HelpAdvisor.

TennCare is Tennessee’s Medicaid program that provides medical service for approximately 1.7 million eligible individuals and their families who lack access to healthcare insurance. TennCare provides healthcare and medical benefits to low-income individuals, pregnant women, parents and caretakers of minor children, older adults and disabled people. Eligibility is dependent on income, assets, personal property, household size and medical need. TennCare covers approximately 20 percent of the state’s population.

What Benefits Does Tennessee Medicaid Cover?

TennCare utilizes a managed care model to deliver benefits to enrollees. Established in 1994, it is one of the oldest and well-known Medicaid managed care programs in the United States. It is the only medical system of its kind in the country to enroll the entire state’s Medicaid population in managed care. 

The list of covered medical services is extensive. Beneficiaries can receive mental health and substance abuse resources, dental care and pharmacy drug prescription services. All applicants are required to verify that they continue to meet eligibility criteria for the program at regular intervals.

Who Is Eligible for Medicaid in Tennessee?

Tennessee residents are qualified for TennCare if they meet all the federal requirements, including income and asset limits. Those who may be eligible for TennCare include:

  • Children under 21
  • Pregnant women
  • Parents and caretaker relatives residing and caring for a dependent child under the age of 18
  • Individuals who need treatment for breast or cervical cancer
  • Applicants who receive an Supplemental Security Income (SSI) check
  • People who have received an SSI and Social Security check in the same month at least once since April 1977 and who still receive a Social Security check
  • Anyone that resides in a nursing home and has a monthly income below $2,742 

Applicants in Tennessee must meet income and asset limits, which is established using the federal poverty level. For a one-person household, the maximum qualifying income is $19,392. For two and four people, those figures are $26,228 and $39,900, respectively. 

How Do I Enroll in Medicaid in Tennessee?

If you are eligible for Medicaid in Tennessee, you can enroll in several ways. Applications are available online through the self-service portal that allows you to create an account, apply for benefits, check your status and report changes. 

Collect all your documents and information before starting the online application. You will be prompted to give the following: 

  • Current address, phone number and email address 
  • Social security number and dates of birth for everyone applying
  • Income from jobs and other work sources
  • Citizenship and immigration status
  • The value of your vehicles and property
  • Other health insurance and medical coverage information

If you need help with your application, or if you prefer to apply by phone, Medicaid offices in Tennessee can be reached at (855) 259-0701.

In-person assistance is available at any Department of Human Services office in Tennessee. More than 350 trained staffers can help you apply and answer any questions for you. Applicants can also get help by logging onto an online private group or by calling (866) 475-7879. 

Contact Information for Tennessee Medicaid

Telephone inquiries about specific Medicaid services, the TennCare application, emergency matters and eligibility concerns can be made by calling (855) 259-0701. Applications and general correspondence may be sent to the state’s Division of TennCare at: 

310 Great Circle Road

Nashville, TN 37243

If you believe you  have information about fraud, you can contact the Tennessee Medicaid’s Fraud Toll Free Hotline at (800) 433-3982.