Tennessee Medicaid & Elder Care
Tennessee's TennCare CHOICES program offers comprehensive long-term care support for seniors, including home and community-based services, with income limits requiring a Miller Trust for many.
Medicaid Report Card
Overall State Performance Index
Based on CMS Nursing Home Compare + state Medicaid agency data
View Methodology arrow_forwardTennessee Monthly Costs
Tennessee's senior care costs, particularly for in-home care and assisted living, are generally 15-25% lower than the national average.
Waiver Programs
TennCare CHOICES in Long-Term Services and Supports Program
Also called: TennCare CHOICES in Long-Term Care
TennCare CHOICES provides long-term care services for elderly and physically disabled individuals who meet a nursing home level of care. It offers support in nursing homes, assisted living facilities, and in the community through home and community-based services.
- check_circle Adult Day Care
- check_circle Personal Care
- check_circle Home Modifications
- check_circle Personal Emergency Response Systems
- check_circle Transportation
- check_circle Live-in Caregiver (under specific conditions)
- check_circle Assistive Technology
- check_circle Home Delivered Meals
insights Program Snapshot
- Functional criterion
- Nursing Facility Level of Care (NFLOC) or at risk of needing NFLOC
- Administered by
- TennCare's Long-Term Services & Supports (LTSS) Division
- Enrollment
- Enrollment varies by group and appropriations
- Recertification
- Annual
2026 Eligibility Requirements
| Criteria | Individual Limit | Married (Both Applying) |
|---|---|---|
| Monthly Income | $2,982 | $5,964 |
| Asset Limit | $2,000 | $4,000 |
| Home Equity Limit | $752,000 | |
| Level of Care | Nursing Home Level of Care (NHLOC) | |
Estate Recovery Warning
Tennessee's Estate Recovery Program aggressively seeks reimbursement for long-term care costs from deceased Medicaid recipients' estates, though certain protections exist for surviving family members and hardship cases.
Spend-Down & Asset Protection
PROTECTED ASSETS
COMMON PITFALLS
- warning Look-back Period: Gifts and asset transfers made within 60 months prior to application can trigger penalties and delay coverage.
- warning Excess Income: Failing to establish a Miller Trust if monthly income exceeds the state's income cap for long-term care.
- warning Joint Accounts: The full balance of joint financial accounts is often counted as the applicant's asset, regardless of contribution.
First Steps for Families
Locate your ADRC
Contact your local Tennessee Aging and Disability Resource Center.
Gather 5 years of records
Bank statements, deeds, asset transfers for the Medicaid look-back period.
Financial assessment
Consult a Medicaid planner if assets exceed $2,000.
How to Apply for Tennessee Long-Term Care Medicaid
Assess Level of Care
Undergo a Pre-Admission Evaluation (PAE) to determine the need for a Nursing Facility Level of Care.
Gather Records
Collect 60 months of financial statements, medical records, identity documents, and property information.
Setup Miller Trust
Establish a Qualified Income Trust (Miller Trust) if monthly income exceeds the state's Medicaid income cap.
Submit Application
Apply for TennCare long-term care benefits online via TennCare Connect, by phone, mail, or in person at a local AAAD or DHS office.
Interviews
Attend required interviews and evaluations with caseworkers to review eligibility.
Approval & Care
Receive a final eligibility determination and activate long-term care benefits through the approved TennCare health plan.
Documents You'll Need
Financial Verification
- 60 months of bank statements
- Stock and bond certificates
- Retirement account information
- Life insurance policies
Income Verification
- Social Security award letters
- Pension statements
- VA benefit statements
- Other income sources
Medical/Identity
- Social Security card
- Medicare card
- Driver's license or state ID
- Doctor's clinical assessments (PAE)
Property/Residency
- Home deed and property tax statements
- Vehicle registration and title
- Proof of Tennessee residency
Frequently Asked Questions About Tennessee Medicaid
Does Tennessee Medicaid pay for assisted living?
Yes, Tennessee's TennCare CHOICES program covers services provided in assisted living facilities for eligible seniors who meet a nursing home level of care. However, it typically does not cover the cost of room and board in these facilities. Individuals must ensure their chosen assisted living facility is an approved TennCare provider.
What is the Tennessee Medicaid income limit for seniors in 2026?
For long-term care services through TennCare CHOICES or Nursing Home Medicaid, the individual income limit in Tennessee for 2026 is $2,982 per month. If a senior's income exceeds this amount, they may still qualify by establishing a Qualified Income Trust, also known as a Miller Trust.
How long is the HCBS waiver waitlist in Tennessee?
Tennessee's primary Home and Community-Based Services (HCBS) waiver for seniors, TennCare CHOICES, is not an entitlement program, meaning there can be limitations on enrollment. While specific, current waitlist numbers or average wait times for seniors are not consistently published, the program does have enrollment targets for certain groups, indicating that a waitlist may exist or capacity can be limited.
Will Medicaid take my parent's house in Tennessee?
During a parent's lifetime, their primary home is generally exempt from Medicaid's asset limit, provided their home equity is below $752,000 in 2026. However, after the Medicaid recipient's death, Tennessee's Estate Recovery Program may seek reimbursement for long-term care costs from their estate, which could include placing a lien on the home. Protections exist if a surviving spouse or permanently disabled child resides there.
Can I be paid to care for my parent through Tennessee Medicaid?
Yes, through the TennCare CHOICES program, eligible family members can be paid to provide care for their parents. This is typically done via the 'Consumer Direction' option, which allows the care recipient to hire and manage their own caregivers. Spouses and legal guardians are generally not eligible to be paid caregivers under this program.
Medicaid vs Medicare for long-term care in Tennessee?
Medicare primarily covers acute medical care and short-term skilled nursing or rehabilitation, not ongoing long-term care. In contrast, TennCare (Tennessee's Medicaid program) is the primary payer for long-term care services, including extended nursing home stays and a range of home and community-based services for eligible low-income seniors who meet specific medical and financial criteria.
TOPICAL GUIDES — HOW MEDICAID WORKS
EXPLORE TENNESSEE
Last updated: April 24, 2026. Sources: Tennessee Bureau of TennCare, CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.