Tennessee Medicaid Income Limits
Updated August 2026
Tennessee's TennCare income limits are significantly more restrictive than in Medicaid expansion states. Per the Bureau of TennCare and TennCare eligibility reference guide, the following income thresholds apply. These figures reflect 2025–2026 eligibility standards.
Tennessee is a non-expansion state with very narrow adult income limits
Tennessee did not expand Medicaid under the ACA. Most adults ages 19–64 without children and without a qualifying disability have no income limit that would make them eligible — they simply do not fit an eligible category. Even parents have much lower income thresholds than in expansion states. If you are an adult without children or a disability, you likely do not qualify for TennCare regardless of income.
TennCare income limits by coverage group (2026)
| Coverage group | Income limit (approx.) | Notes |
|---|---|---|
| Children ages 0–18 (TennCare) | up to ~133% FPL | Age and income-based |
| Children (CoverKids — CHIP) | up to 250% FPL | Separate application; small premium |
| Pregnant women | Varies — family of 3: less than $66,625/yr | Includes CHIP-funded maternity coverage |
| Parents and caretaker relatives | ~95% FPL (very low) | Must have child under 18 in home |
| SSI recipients | SSI limit ($943/mo individual in 2025) | Automatic TennCare eligibility |
| Adults without children (non-expansion) | No income limit applies | Not eligible — no qualifying category |
| Nursing home / long-term care | 300% FBR (~$2,829/mo) | Asset limit applies separately |
Children ages 0–18 (TennCare)
- Income limit (approx.)
- up to ~133% FPL
- Notes
- Age and income-based
Children (CoverKids — CHIP)
- Income limit (approx.)
- up to 250% FPL
- Notes
- Separate application; small premium
Pregnant women
- Income limit (approx.)
- Varies — family of 3: less than $66,625/yr
- Notes
- Includes CHIP-funded maternity coverage
Parents and caretaker relatives
- Income limit (approx.)
- ~95% FPL (very low)
- Notes
- Must have child under 18 in home
SSI recipients
- Income limit (approx.)
- SSI limit ($943/mo individual in 2025)
- Notes
- Automatic TennCare eligibility
Adults without children (non-expansion)
- Income limit (approx.)
- No income limit applies
- Notes
- Not eligible — no qualifying category
Nursing home / long-term care
- Income limit (approx.)
- 300% FBR (~$2,829/mo)
- Notes
- Asset limit applies separately
The coverage gap in Tennessee
Tennessee's non-expansion status creates a significant gap in coverage. Adults between roughly 50% and 100% of the FPL — too poor to afford private insurance but earning too much for the very limited TennCare adult categories — have few options. They do not qualify for TennCare, and they cannot receive ACA marketplace premium tax credits (which start at 100% FPL).
If you fall into this gap, contact the Tennessee State Health Insurance Assistance Program (SHIP) at 1-877-801-0044 for guidance on what options may exist for your situation. Federally Qualified Health Centers (FQHCs) provide sliding-scale care to uninsured patients — use the HRSA Health Center Finder at findahealthcenter.hrsa.gov to locate one near you.
How TennCare counts income
For most TennCare categories, Tennessee uses Modified Adjusted Gross Income (MAGI) methodology — the same standard used in expansion states. MAGI includes wages, salaries, self-employment income, and certain other income. SSI benefits are generally excluded from MAGI for the purpose of determining eligibility for MAGI-based TennCare categories.
Long-term care programs, nursing home eligibility, and CHOICES waiver eligibility use non-MAGI rules with separate asset tests. For these programs, the asset limit is $2,000 for a single applicant. Contact TennCare Connect at 1-855-259-0701 or your local Area Agency on Aging and Disability at 1-866-836-6678 for LTC financial eligibility guidance.
Medicare Savings Programs (QMB) in Tennessee
Tennessee's TennCare eligibility rules are famously tight for working-age adults, as the callout above explains — but Medicare Savings Programs are a separate eligibility track for anyone already on Medicare, and the income limits are considerably higher than TennCare's standard adult categories. These programs are still administered through TennCare, Tennessee's Medicaid agency, not through Medicare itself; apply through TennCare Connect at 1-855-259-0701.
| Program | Situation | Monthly income limit |
|---|---|---|
| QMB | Individual | $1,350 |
| QMB | Married couple | $1,824 |
| SLMB | Individual | $1,616 |
| SLMB | Married couple | $2,184 |
| QI | Individual | $1,816 |
| QI | Married couple | $2,455 |
QMB
- Situation
- Individual
- Monthly income limit
- $1,350
QMB
- Situation
- Married couple
- Monthly income limit
- $1,824
SLMB
- Situation
- Individual
- Monthly income limit
- $1,616
SLMB
- Situation
- Married couple
- Monthly income limit
- $2,184
QI
- Situation
- Individual
- Monthly income limit
- $1,816
QI
- Situation
- Married couple
- Monthly income limit
- $2,455
The strongest tier, Qualified Medicare Beneficiary (QMB), pays the Part A premium if one is owed, the full $202.90 monthly Part B premium in 2026, and all Medicare deductibles, coinsurance, and copayments. Providers are barred by federal law from billing a QMB enrollee for any Medicare cost-sharing, a protection that holds even if the provider doesn't otherwise take TennCare.
Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) enrollees get the Part B premium covered but nothing more. QI has a capped annual budget awarded first-come, first-served and must be renewed every year, so Tennesseans near that income line should apply as soon as the calendar year opens. Anyone approved for QMB, SLMB, or QI is automatically enrolled in Extra Help, which limits 2026 covered-drug costs to $12.65 per prescription.
TennCare (Tennessee Medicaid)
Visit the official Tennessee Medicaid websiteIncome Limits in Nearby States
Related guides
Income Limits
Current income cutoffs by state and household size, tied to the Federal Poverty Level.
Read more →Spend-Down
How to qualify by deducting medical bills from income that's above the limit.
Read more →QMB Program
What the QMB program covers, what a QMB card proves, and how to apply.
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