BlueCare is a Medicaid plan, not a Medicare plan. It is one of three managed care organizations that deliver TennCare, Tennessee’s Medicaid program, and it is run by BlueCross BlueShield of Tennessee under a state contract. If you have a card that says BlueCare, you have TennCare Medicaid coverage administered by a private insurer. A separate plan called BlueCare Plus does involve Medicare, but only for people who qualify for Medicaid and Medicare at the same time.
Why a Private Insurer’s Name Is on a Public Plan
Tennessee launched TennCare in 1994 as its version of Medicaid. Instead of running the program directly, the state contracts with private insurers, called managed care organizations, to handle claims, build provider networks, and coordinate care. BlueCare, formally known as Volunteer State Health Plan, is one of three MCOs the state has selected through competitive procurement to deliver TennCare services.1Medicaid.gov. Managed Care in Tennessee
The money behind BlueCare comes from state and federal tax dollars. Medicaid was created under Title XIX of the Social Security Act, which requires the federal government and each participating state to share the cost of coverage for eligible residents.2Medicaid.gov. Program History and Prior Initiatives That shared funding is what makes BlueCare a public health program even though a private insurer’s logo sits on your membership card.
The distinction matters because Medicare and Medicaid are different programs with different rules. Medicare is a federal health insurance program tied largely to age 65 or a qualifying disability. Medicaid is a joint federal-state program based on income and category of need. BlueCare belongs to the second group.
What BlueCare Covers
Because BlueCare is Medicaid, its benefits follow TennCare rules rather than Medicare rules. All members receive medical care, behavioral health services (including mental health and substance-use treatment), and prescription drug coverage. Care generally has to be medically necessary to be covered.3BlueCross BlueShield of Tennessee. Plans and Programs – BlueCare Tennessee
- Doctor and hospital visits, emergency room care, inpatient stays, and follow-up treatment are included. Children and young adults under 21 receive free well-care checkups, vaccines, and follow-up care.
- Dental services, including cleanings and fillings, are covered at no cost. Pregnant women and new mothers receive dental benefits for 12 months after giving birth.
- Vision benefits vary. Children generally have broader coverage, while adults 21 and older are typically limited to medical eye evaluations and one pair of cataract glasses after surgery.4TN.gov. TennCare Benefit Packages
- Some benefit packages cover unlimited prescriptions. Others limit adults to five prescriptions per month, with no more than two brand-name drugs.4TN.gov. TennCare Benefit Packages
Your exact coverage depends on the benefit indicator letter (A through M) printed on your member card. You can check that letter through TennCare Connect or by calling your plan.
Who Qualifies for BlueCare
Because BlueCare is Medicaid, eligibility turns on household income, age, and category rather than on being 65 or disabled for Medicare purposes. Tennessee has not expanded Medicaid under the Affordable Care Act, so non-disabled adults without minor children generally cannot qualify for TennCare, even at very low incomes.
The main eligibility groups and their income ceilings, measured as a percentage of the federal poverty level (FPL), are:5TN.gov. TennCare Eligibility Reference Guide
- Children under 1: up to 195% FPL
- Children ages 1–5: up to 142% FPL
- Children ages 6–18: up to 133% FPL
- CoverKids: up to 250% FPL
- Pregnant women: up to 250% FPL
- Caretaker relatives (parents or guardians of minor children): up to 100% FPL
- Aged, blind, or disabled individuals: limits tied to Supplemental Security Income thresholds or specific program rules
For context, 100% of the 2025 FPL is $15,650 per year for a single person and $32,150 for a family of four. The figures are updated each January.
Applicants in the aged, blind, or disabled categories also face an asset test. The general resource limit is $2,000 for one person or $3,000 for a couple, with your primary home and up to $4,600 in vehicle equity excluded.6TN.gov. Eligibility Reference Guide7TN.gov. Countable and Excluded Resources for Medically Needy Categories Children, pregnant women, and caretaker relatives are evaluated using Modified Adjusted Gross Income rules and do not face an asset test.
When Medicare Enters the Picture: BlueCare Plus
The reason the Medicaid-or-Medicare question comes up at all is that BlueCross BlueShield of Tennessee also runs a plan called BlueCare Plus, and the two names get confused. BlueCare Plus is a separate plan for people who qualify for both Medicare and TennCare Medicaid at the same time, a status known as dual eligibility. It is classified as a Dual Eligible Special Needs Plan (D-SNP), which is a type of Medicare Advantage plan designed to coordinate benefits from both programs through a single point of contact.8TN.gov. Dual Eligible Special Needs Plan (D-SNP)
To qualify for BlueCare Plus, you must:8TN.gov. Dual Eligible Special Needs Plan (D-SNP)
- Have Medicare Part A and Part B, or receive help from a qualifying Medicare Savings Program
- Be enrolled in TennCare Medicaid
- Live in Tennessee
Most people become Medicare-eligible at 65 or through a qualifying disability. The Medicaid side requires meeting TennCare’s income and asset standards. When you qualify for both, BlueCare Plus combines the two so you deal with one plan instead of two.
Cost-sharing is minimal. For the 2026 plan year, there are no deductibles for medical services and no annual out-of-pocket costs for covered medical care. Copays for most covered services, including hospital stays, doctor visits, dental checkups, and skilled nursing care, are $0.9BlueCross BlueShield of Tennessee. 2026 Summary of Benefits BlueCare Plus (HMO D-SNP) For prescription drugs under Medicare Part D, preferred generics are $0, though other drug tiers may carry 25% coinsurance depending on your level of low-income subsidy.
Medicare Savings Programs for Those Who Just Miss Medicaid
If your income is too high for full TennCare Medicaid but you have limited resources, you may still qualify for a Medicare Savings Program that helps pay your Medicare premiums and cost-sharing. Tennessee’s Qualifying Individuals (QI) program covers your Medicare Part B premium if your income falls between 120% and 135% of the FPL and your resources are under $9,950 as an individual or $14,910 as a couple.10TN.gov. Non-Financial Eligibility Requirements – Qualifying Individuals 1 You apply through the same TennCare application process.
How to Tell Which Plan You Have
Look at the plan name on your member card. A card that reads “BlueCare” or “BlueCare Tennessee” is TennCare Medicaid coverage. A card that reads “BlueCare Plus” is the dual Medicare and Medicaid plan. The benefit indicator letter on a BlueCare card tells you which TennCare benefit package applies to you.
If you are not yet enrolled, apply for TennCare first; BlueCare is assigned as one of the three managed care options after the state approves your eligibility. Tennessee offers three ways to apply:11TN.gov. How Do I Apply for TennCare
- Online through TennCareConnect.TN.gov
- By phone at 855-259-0701
- By paper application, mailed to TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240, or faxed to 1-855-315-0669
In-person help is available at any Department of Human Services office in Tennessee’s 95 counties. The state generally makes an eligibility decision within 45 days of receiving your completed application.12TN.gov. Members and Applicants – Learn More and Apply
Once you are enrolled, you keep coverage by completing an annual renewal. TennCare first attempts to auto-renew using data it already has, such as tax records and SNAP eligibility. If auto-renewal fails, the state mails or emails you a pre-populated renewal packet, and you have 40 days to return it.13TN.gov. Preparing for Renewals Changes in income, household, or address should be reported within 10 days.14TN.gov. TennCare Renewals Frequently Asked Questions
If you are specifically looking for Medicare coverage and you are not dually eligible, BlueCare is not the plan you want. BlueCross BlueShield of Tennessee offers separate Medicare Advantage and Medicare Supplement products outside the TennCare system, and standard Medicare enrollment runs through the federal government rather than TennCare Connect.