Tennessee runs its Medicaid program under the name TennCare, and eligibility is more limited than in many states because Tennessee has not expanded Medicaid under the Affordable Care Act. That means most low-income adults without children do not qualify, regardless of how little they earn. Coverage is available primarily to children, pregnant women, parents or caretaker relatives of minor children, seniors, and people with disabilities.
Children: The Broadest Eligibility Group
Children have the widest path to TennCare coverage, though the income limit depends on the child’s age. Infants under age 1 qualify in families earning up to 195% of the federal poverty level (FPL). For children ages 1 through 5, the cutoff drops to 142% FPL. Children ages 6 through 18 qualify at 133% FPL.
If a child’s family earns too much for TennCare Medicaid but still has a modest income, the CoverKids program fills the gap. CoverKids covers children under 19 with household income at or below 250% FPL, as long as they aren’t eligible for TennCare and don’t have other coverage. There is also a category called TennCare Standard for children under 19 whose TennCare Medicaid is ending: they can stay covered if their family income is below 211% FPL and they don’t have access to employer-sponsored insurance.
Newborns born to a mother who had TennCare at the time of delivery are automatically covered for a full year after birth, with no separate application needed.
Pregnant Women
Pregnant women qualify for TennCare with household income up to 250% FPL, one of the more generous thresholds in the program. Because a pregnant woman is counted as a household of two (herself and the baby), a single woman with no other children qualifies with annual income up to $54,100 in 2026. A family of four can earn up to $82,500. Women who earn too much for TennCare Medicaid but fall within that same 250% FPL range may still get coverage through CoverKids.
Parents and Caretaker Relatives
If you’re a parent or caretaker relative of a child under 18 (or 18 and still in school full-time), you can qualify for TennCare, but the income threshold is significantly lower than for children or pregnant women. Your household income must be at or below 100% of the federal poverty level. For a family of three in 2025, that’s roughly $25,800 per year. This is the main reason many working-age adults in Tennessee fall into a coverage gap: they earn too much for TennCare but too little to qualify for marketplace subsidies.
Seniors, Blind, and Disabled Individuals
People who receive Supplemental Security Income (SSI) automatically qualify for TennCare. SSI is the federal benefit for people who are aged 65 or older, blind, or disabled and have very limited income and resources. If the Social Security Administration has already approved you for SSI, TennCare relies on that determination rather than conducting its own financial review.
For people with disabilities who are working, there is a separate pathway through the Employment and Community First CHOICES program. The Working Disabled group covers people with income at or below 250% FPL who would otherwise qualify for SSI if not for their earned income.
Long-Term Care Through CHOICES
Tennessee’s CHOICES program covers nursing home care and home-based services for people who need help with daily living activities. It’s divided into three groups:
- Group 1: People of all ages receiving nursing home care.
- Group 2: Adults 21 and older and seniors 65 and older who qualify for nursing home care but choose to receive services at home instead.
- Group 3: Adults and seniors who don’t yet need nursing home care but are at risk of needing it without home-based support.
Financial eligibility for CHOICES is strict. Your monthly income cannot exceed $2,982 (for 2026), and countable resources must stay under $2,000. Your primary home is excluded from that resource count, but home equity above $752,000 can make you ineligible unless a spouse or minor child lives there. If your income exceeds the monthly cap, you may still qualify by setting up a Qualifying Income Trust, which redirects the excess. There is also a five-year lookback on asset transfers: if you gave away property or sold it below market value in the past five years, it can affect your eligibility.
Breast or Cervical Cancer
Tennessee residents under 65 who are uninsured (or whose insurance doesn’t cover cancer treatment) and have been diagnosed with breast or cervical cancer through a CDC-funded screening site can qualify for TennCare with income up to 250% FPL. This coverage is specifically tied to the cancer diagnosis and screening pathway.
Former Foster Care Youth
If you were in foster care in Tennessee and aged out of the system, you qualify for TennCare up to age 26 with no income limit. This mirrors a federal requirement designed to prevent gaps in coverage for young adults leaving state care.
Medicare Savings Programs
If you’re already on Medicare but struggle with premiums and cost-sharing, TennCare administers several programs that can help, each with different income thresholds:
- Qualified Medicare Beneficiary (QMB): Income up to 100% FPL, with resources no higher than $9,950 for an individual or $14,910 for a couple. Covers Medicare premiums, deductibles, and copays.
- Specified Low-Income Medicare Beneficiary (SLMB): Income between 100% and 120% FPL, same resource limits. Covers the Medicare Part B premium.
- Qualifying Individual (QI): Income between 120% and 135% FPL. Also covers the Part B premium.
- Qualified Disabled Working Individual (QDWI): For people under 65 who lost Medicare Part A because they returned to work. Income must be at or below 200% FPL.
What Counts as Income
For most TennCare categories, income is calculated using the same method as federal tax returns. Wages, self-employment earnings, Social Security benefits, unemployment, pensions, rental income, capital gains, and alimony all count. What doesn’t count: SSI payments, child support, child tax credit payments, TANF benefits, and Veterans Affairs benefits. This distinction matters because some families assume their total household cash flow disqualifies them when, in reality, several common income sources are excluded.
Residency and Citizenship Requirements
All applicants must be Tennessee residents. You also need to be a U.S. citizen, U.S. national, or a qualified non-citizen as defined by federal immigration law. Qualified non-citizens generally include lawful permanent residents, refugees, and people granted asylum, though some categories have a five-year waiting period before they can access full Medicaid benefits.
How to Apply and What to Expect
You can apply for TennCare three ways: online through TennCare Connect, by phone at 1-855-259-0701, or with a paper application submitted to your local Department of Human Services office. If you apply online, you may receive an eligibility decision immediately. Otherwise, standard applications take up to 45 days. Applications involving long-term care services can take up to 90 days because medical eligibility must also be verified.
Your local DHS office has kiosks available if you want to complete the online application in person with staff nearby. Paper applications can also be mailed to TennCare Connect at P.O. Box 305240, Nashville, TN 37230-5240, or faxed to 1-855-315-0669.