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TennCare Medicaid Eligibility for New Applicants

To qualify in a TennCare Medicaid group, your income must be below the limit for THAT group.

They are NOT all the same. It may also depend on how many people live in your household.

Some of the groups also have limits on how much you can own, also known as your “resources.”

Resources are things like bank accounts, cars, and land.

If you have questions, you can call TPAL at 1-800-758-1638 for general information about whether you qualify. However, ultimately it is The Department of Human Services that determines your eligibility.

Here are some of the Medicaid groups: (remember there are income limits):

• Children under age 21
• Women who are pregnant
• Single parents or caretakers of a minor child (The child must live with you and be a relative).
• Two-parent families with a minor child living at home when one of the parents:
  • Has lost their job or had their work hours cut, OR
  • Has a health or mental health problem expected to last 30 days (DHS will need proof from your doctor).
Women who need treatment for breast or cervical cancer
• People who get an SSI check (Supplemental Security Income)
• People who stopped getting SSI since November 13, 1987 while living in Tennessee- you don’t have to be getting SSI now
• People who have gotten both an SSI check and a Social Security check in the same month at least once since April 1977 AND who still get a Social Security Check
• A person who:
  • Lives in a nursing home AND has an income below $2,022 per month OR
  • Gets other long term care services that TennCare pays for
    

What if you don’t tell DHS about what you own (your resources)or you’re over the limit?

You won’t qualify for Medicaid in any group that has a resource limit.

An individual applying for TennCare for the first time must:

1. Complete an application
2. Submit it to their local Department of Human Services (DHS)
3. Schedule an interview with a DHS caseworker

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