Tennessee Medicaid Office

Tennessee Medicaid office (TennCare)

The Tennessee Division of TennCare runs the state's Medicaid program from a single statewide self-service portal — TennCare Connect — backed by a four-channel help network for people who can't or don't want to apply online. The agency itself sits in Nashville; intake and document collection happen through the Tennessee Department of Human Services (DHS), which operates an office in every one of Tennessee's 95 counties.

How to reach TennCare

• TennCare Connect — phone 855-259-0701 or online at tenncareconnect.tn.gov. The portal handles applications, renewals, status checks, change reporting, and document uploads. A mobile app mirrors the same functions.
• Local DHS office — call 866-311-4287 to find the office nearest to you. A trained staff member can walk through the application in person.
• Community organizations — call 866-475-7879 to be connected with a private group that helps with applications at no cost.
• Area Agency on Aging and Disability (AAAD) — 1-866-836-6678 connects residents to their regional AAAD. For applicants with a disability, AAAD can arrange a home visit to help with the application.
• Department of Disability and Aging (DDA) — 1-800-535-9725 for long-term care help when the applicant has an intellectual disability.
• Tennessee SHIP — 1-877-801-0044 for help applying for Medicare Savings Programs.

The agency's own Contact Us page groups its lines into three buckets: Member & Applicant Support (the channels above), Additional Help (provider, advocacy, MCO, dental, pharmacy, and non-emergency medical transportation contacts), and Other Contacts (estate recovery, fraud and abuse, public records). Address, income, and household-change reports route through TennCare Connect rather than the central office.

Who qualifies for TennCare?

TennCare splits into two products: TennCare Medicaid, the standard program that anyone meeting an eligibility category may apply for, and TennCare Standard, a closed-enrollment safety net that only accepts children who lose Medicaid coverage and roll over. Outside those two, the state runs CoverKids (separate CHIP for children age 18 and younger and pregnant women), the Medicare Savings Program for help with Medicare premiums, and the Katie Beckett Program for children with disabilities or complex medical needs who would not otherwise qualify because of parent income or resources.

Coverage categories

TennCare publishes its eligibility rules by coverage group rather than as one income threshold. The categories below come directly from the state's Eligibility Reference Guide.

• Children (age 0 to 19) — three age brackets at different FPL ceilings (highest for infants, stepping down for school-age children). Newborns born to a Medicaid-eligible mother are deemed eligible for one year. Medically Needy children may spend down with unreimbursed medical bills.
• Families — Caretaker Relatives of dependent children at 100% FPL; Transitional or Extended Medicaid for caretakers who lose coverage because of an income increase or spousal support change.
• Pregnant individuals — covered through pregnancy and the 12-month postpartum period. A Pregnant Medically Needy pathway uses a monthly spend-down.
• Former Foster Care up to age 26 — no income limit, no resource limit. Anyone who turned 18 on or after January 1, 2023, may have aged out of foster care in any state; earlier-aged-out adults must have left Tennessee foster care.
• Aged, Blind, and Disabled (ABD) — SSI recipients automatically qualify; separate Non-MAGI categories cover Institutional Medicaid, Katie Beckett, SSI-Related (Pickle/Pass Along, Disabled Adult Child, Widow/Widower), Breast or Cervical Cancer, and Employment and Community First (ECF) CHOICES.
• Medicare Cost Sharing — QMB, SLMB, QI 1, and QDWI, each at a different income band; resource limits apply.

What about expansion adults?

Tennessee is not an ACA Medicaid expansion state. Adults age 19 through 64 who are not pregnant, do not have a dependent child, and do not qualify under an ABD category generally have no income-only pathway into TennCare — even at very low income. The TennCare Standard category does not accept new childless adults; it only takes children who lose Medicaid eligibility.

Renewals run every 12 months

TennCare renews coverage annually. The state first attempts an electronic (ex parte) renewal using federal and state data. When that confirms eligibility, the household keeps coverage with no paperwork. When data does not match, the household receives a pre-populated renewal packet and must respond by the printed deadline or coverage ends.

TennCare income and resource limits

TennCare publishes a single Eligibility Reference Guide that shows monthly income limits across 100%–250% of the Federal Poverty Level alongside the rules that apply to each coverage group. The dollar figures below are pulled from that guide; the underlying FPL table updates each January when the federal poverty figures change — verify the current figure with the agency before relying on a specific number.

Federal Poverty Level snapshot (monthly income)

Children and pregnant individuals

Families

Caretaker Relatives of a dependent child under age 18 (or 18 and a full-time student) qualify at 100% FPL with no resource limit. Households that lose this coverage because of an income or spousal-support change may keep coverage under Transitional or Extended Medicaid by meeting the Caretaker Relative rules in three of the last six months.

Aged, Blind, and Disabled (ABD)

Medicare Cost Sharing

Former Foster Care

No income or resource test. Adults under age 26 who aged out of foster care while on Medicaid qualify automatically. Those who turned 18 on or after January 1, 2023, may have aged out in any state; those who turned 18 before that date must have aged out in Tennessee.

How to apply for TennCare

TennCare lists three application channels for Medicaid and Medicare Savings Programs: online, by phone, and on paper. The same submission also screens for CoverKids (CHIP for children and pregnant women). Plan on 30 to 60 minutes to complete the form; gathering pay stubs, Social Security numbers, and proof of citizenship or immigration status ahead of time usually shortens that.

Online: TennCare Connect

TennCare Connect handles new applications, status checks, change reporting, document uploads, and renewals from a single account. A mobile app mirrors the same functions. Katie Beckett applications can only be filed through TennCare Connect — there is no paper option for that pathway.

By phone

Call TennCare Connect at 855-259-0701. For hearing or speech assistance, call the Tennessee Relay Service (TNRS) at 800-848-0298 and ask to be connected.

Paper

TennCare publishes English and Spanish versions of the paper application, plus extra-pages forms for additional household members. Mail completed paper applications to:

TennCare Connect
P.O. Box 305240
Nashville, TN 37230-5240

Or fax to 1-855-315-0669 — keep the page that confirms the fax went through.

In-person help

• Any DHS office in any of Tennessee's 95 counties (locator: 866-311-4287).
• Local and Regional Health Departments — find your nearest office through the Department of Health.
• Private community organizations trained to help with applications — locator at 866-475-7879.
• For applicants with a disability, a worker from your local Area Agency on Aging and Disability (1-866-836-6678) can come to your home to help.

What to gather before you apply

• Current mailing address, phone, and email
• Social Security number and date of birth for everyone applying
• Income from jobs and any other source for every household member
• Citizenship and immigration status documentation
• The value of cars and other property (for ABD and long-term care applicants)
• Other health insurance information, if any

If your resources are over the TennCare limit

Print out the Conditional Assistance form, fill it out, and return it. You may qualify for temporary coverage called Conditional Assistance. TennCare Connect (855-259-0701) can help you complete the form.

How long does a decision take?

Federal rules give states up to 45 days to decide a non-disability application and up to 90 days for an application based on disability. Pregnancy and presumptive-eligibility decisions can be same-day at a qualified hospital or clinic. Coverage can be retroactive up to three months before the application month for qualifying medical bills.

What TennCare covers

Nearly every TennCare member receives care through a managed care organization (MCO). The state contracts with three statewide MCOs plus a separate fourth plan, TennCare Select, that serves specific populations. All three statewide MCOs have passed accreditation from the National Committee for Quality Assurance (NCQA), the most widely used health-plan quality program in the country. Each plan operates in West, Middle, and East Tennessee, and the plan choices in each region are the same.

The three statewide MCOs

• Wellpoint (formerly known as Amerigroup) — member services 833-731-2153
• BlueCare (BlueCross BlueShield of Tennessee) — member services 1-800-468-9698
• UnitedHealthcare Community Plan — member services 1-800-690-1606

TennCare Select is a fourth plan, also administered by BlueCross BlueShield of Tennessee, with member services at 1-800-263-5479. It covers narrower populations (for example, foster children and certain dual-eligibles) rather than the general member roll.

Core medical benefits

Each MCO covers the same federally required Medicaid benefit package plus a set of state-option services. Coverage runs through that MCO's network — the plan's name appears on the TennCare card. Members can use the state's provider-lookup tool to confirm which doctors take a specific plan before choosing one.

• Doctor visits, specialist care, urgent care, and emergency services
• Hospital inpatient and outpatient care, surgery, lab and imaging
• Pregnancy care: prenatal, delivery, postpartum, and the 12-month postpartum extension
• Behavioral health: outpatient counseling, crisis services, inpatient psychiatric care, substance use disorder treatment
• Family planning and reproductive health services
• Non-emergency medical transportation (NEMT) — managed separately under the Additional Help line
• Dental and pharmacy benefits — administered through their own dedicated TennCare contacts

Extra services for children under 21 (EPSDT)

Children enrolled in TennCare receive Early and Periodic Screening, Diagnostic, and Treatment benefits — a federal mandate that covers any medically necessary service for a child, including dental, vision, hearing aids, and behavioral health services that adult Medicaid in many states does not cover at the same level.

Long-term services and supports

TennCare's long-term care arm runs through the same managed care plans for older adults and adults with physical disabilities (CHOICES) and through Employment and Community First (ECF) CHOICES for people with intellectual and developmental disabilities. Members already on TennCare with long-term care questions can call the MCO number on their TennCare card; applicants who don't yet have TennCare can call the Area Agency on Aging and Disability at 1-866-836-6678, or the Department of Disability and Aging at 1-800-535-9725 for intellectual-disability cases.

Other state Medicaid pages