Tennessee Medicaid for Seniors & Long-Term Care

TennCare long-term care uses non-MAGI financial eligibility rules — an income test and an asset test both apply. The income limit for nursing facility TennCare is 300% of the Social Security Federal Benefit Rate (FBR). Per TennCare's published 2026 standards, that is $2,982 per month (the FBR for 2026 is $994/month; 300% = $2,982). Income above this limit is applied toward the cost of nursing home care, and TennCare covers the remainder.

TennCare CHOICES divides long-term care into two groups based on care setting. CHOICES Group 1 covers all TennCare-eligible seniors and adults residing in a nursing facility — this group is an entitlement with no enrollment cap, so if you are in a nursing home and meet financial and clinical criteria, you cannot be waitlisted.

CHOICES Group 2 provides home-based alternatives to nursing home care for members who meet nursing facility level of care but prefer to remain at home. Enrollment has historically been capped, and a waitlist may apply — call 1-866-836-6678 to be assessed and placed on the list if needed.

TennCare (Tennessee Medicaid) covers skilled nursing facility care for seniors who meet clinical and financial criteria. Once approved, Medicaid pays the nursing home directly — the resident contributes most of their monthly income toward the cost of care, typically all income minus a personal needs allowance, and Medicaid covers the gap. If income exceeds the institutional Medicaid limit, Tennessee may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible.

When one spouse needs nursing home care, federal law protects the other spouse from complete impoverishment. The community spouse is entitled to keep a minimum amount of assets — the Community Spouse Resource Allowance (CSRA) — and a minimum monthly income, called the minimum monthly maintenance needs allowance (MMMNA), if their own income is insufficient.

Tennessee participates in Medicaid estate recovery. TennCare may seek reimbursement from the estate of a member who received long-term care services after age 55, or who was institutionalized (nursing home, ICF, or hospital). The family home is generally exempt while a surviving spouse, a child under 21, or a blind or disabled child lives there. Tennessee applies a 5-year (60-month) look-back period for asset transfers. Consult a Tennessee-licensed elder law attorney before making gifts or transferring assets if nursing home care may be needed.