TennCare eligibility in Tennessee is built around specific categories, not a single income cutoff. You generally qualify if you are a child, a pregnant woman, a parent or caretaker relative of a minor child with income at or below 100 percent of the federal poverty level, or an aged, blind, or disabled adult who meets the program’s income and asset rules. Childless adults without a qualifying disability do not qualify, no matter how low their income. Tennessee has not expanded Medicaid under the Affordable Care Act, so the broad “up to 138 percent of poverty for any adult” rule that applies in expansion states does not apply here.
Children
Children make up the largest share of TennCare enrollment, and the income limit depends on age. Infants under one qualify at household incomes up to 195 percent of the federal poverty level. Children ages one through five qualify up to 142 percent. Children ages six through eighteen qualify up to 133 percent.1TennCare. Eligibility Reference Guide
If your child’s family income sits above the TennCare limit but at or below 250 percent of the poverty level, CoverKids, Tennessee’s Children’s Health Insurance Program, covers uninsured children under 19. Children in the “medically needy” category can qualify up to age 21 if unreimbursed medical expenses bring them down to the required income limits.
Pregnant Women
Pregnant women qualify with household incomes up to 250 percent of the federal poverty level. Women who fall outside TennCare’s other criteria can also access coverage through CoverKids, which covers the unborn children of pregnant women at the same threshold.2TennCare. CoverKids Eligibility
Coverage now continues for 12 months after delivery, replacing the previous 60-day postpartum cutoff.3Centers for Medicare and Medicaid Services. CMS Approves Extension of Medicaid and CHIP Coverage for 12 Months After Pregnancy for Tennessee and South Carolina Newborns born to Medicaid-eligible mothers are automatically eligible for one year.1TennCare. Eligibility Reference Guide
Parents and Caretaker Relatives
Parents or caretaker relatives of minor children qualify with household incomes up to 100 percent of the federal poverty level. For a family of three in 2025, that works out to roughly $25,820 per year in gross income.
This category was expanded in mid-2024. Before that, the parent threshold was much lower, and the change gave many low-income parents a path into TennCare that didn’t previously exist. Tennessee’s parent limit still sits well below the 138 percent threshold used by states that adopted ACA expansion.
Aged, Blind, and Disabled Adults
If you receive Supplemental Security Income, you automatically qualify for TennCare. Tennessee accepts the eligibility determination made by the Social Security Administration, so there is no separate income or asset test to redo.1TennCare. Eligibility Reference Guide
Other adults may qualify through related pathways. People with breast or cervical cancer qualify up to 250 percent of the federal poverty level. The Employment and Community First CHOICES program serves people with intellectual and developmental disabilities. Elderly individuals who need nursing facility care or home-and-community-based long-term care services may qualify through institutional Medicaid, which uses different income and asset tests than the categories above.
Medicare Savings Programs
If you have Medicare and a limited income, Tennessee runs three Medicare Savings Programs that help pay premiums, deductibles, and copayments. Qualified Medicare Beneficiaries have income below 100 percent of the poverty level. Specified Low-Income Medicare Beneficiaries fall between 100 and 120 percent. Qualified Individuals fall between 120 and 135 percent.1TennCare. Eligibility Reference Guide These programs reduce Medicare out-of-pocket costs but do not provide full TennCare benefits.
Who Does Not Qualify
Adults without children and without a qualifying disability cannot enroll in TennCare, regardless of income. That’s the practical result of Tennessee not expanding Medicaid.
People in this situation also often can’t get subsidized coverage on the ACA marketplace. Premium tax credits were built to start above the federal poverty level because Congress assumed every state would cover people below it through Medicaid expansion. In Tennessee, roughly 82,000 to 95,000 residents fall into that coverage gap. Community health centers, charity care programs, and hospital financial assistance are usually the only fallbacks, and none provide the comprehensive coverage Medicaid would.
How to Apply for TennCare
You can submit a TennCare application in three ways: online through the TennCare Connect portal, by phone, or by mailing a paper application to TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240.4TennCare. How Do I Apply for TennCare The online portal is the fastest option and gives you an electronic record of your submission.
Gather your documents before you start. You will need:
- Social Security numbers and dates of birth for everyone applying
- Income information from jobs and other sources
- Citizenship or immigration status for each applicant
- Information about any other health insurance you carry
- Property and vehicle values, if you are applying under an aged, blind, or disabled category that uses an asset test
- Current mailing address and contact information
The online application typically takes 30 to 60 minutes.4TennCare. How Do I Apply for TennCare Have everything at hand so the portal doesn’t time out.
Counting Your Household
Your household size sets your income limit, and Medicaid’s counting rules aren’t always intuitive. If you file taxes, your household includes you, your spouse if you file jointly, and anyone you claim as a dependent. If you don’t file taxes and you’re an adult, the household includes you, your spouse if you live together, and any children under 19 in the home. For a non-filing child under 19, the household includes their parents and any siblings under 19 who live with them. An incorrect count can lead to a wrong determination, so work through it carefully.
Apply Right Away If You Think You Qualify
Under standard federal Medicaid rules, coverage can reach back up to three months before your application date. TennCare’s current waiver eliminates that retroactive eligibility for most beneficiaries.5Centers for Medicare and Medicaid Services. CMS Letter to Tennessee TennCare Your coverage starts when you’re approved, not before.
If you had a hospital stay last month and apply for TennCare today, those earlier bills won’t be covered even if you would have qualified at the time. Waiting costs you coverage days you cannot recover.
Processing Times and Appeals
Federal regulations require TennCare to issue an eligibility determination within 45 days of receiving a complete application, or within 90 days if the application is based on a disability.6eCFR. 42 CFR 435.912 – Timely Determination of Eligibility During that window, TennCare may ask for additional documents to verify income or other details. Respond quickly so your application doesn’t stall.
If TennCare denies your application or ends your coverage, you will receive a written notice explaining why. You have 40 calendar days from the date on that notice to request a fair hearing. That count includes mailing time, so don’t wait until the final day.7Tennessee Secretary of State. Tennessee Administrative Rules 1240-05-03 – Fair Hearing Requests If you request the hearing before your existing coverage is terminated, you may be able to keep receiving benefits while the appeal is pending. The hearing is an administrative proceeding where you can present evidence and argue that the denial was wrong.