Tennessee TennCare

Centers for Medicare & Medicaid Services (CMS) in

Medicaid/Medicare


December 19, 2018

Overview

TennCare is a program providing health insurance to people who are eligible for Medicaid and to certain other people who lack access to insurance. A managed care model is used for delivering program benefits. Enrollees choose a Managed Care Organization for most of their health and acute care needs. They receive covered mental health and substance abuse services through a Behavioral Health Organization. They receive covered dental services through a Dental Benefits Manager and covered pharmacy services through the state's Pharmacy Benefits Manager. Enrollees must verify at regular intervals that they continue to meet the eligibility criteria for the program.

Administration

Tennessee TennCare is administered by Centers for Medicare & Medicaid Services (CMS).

Program Requirements:

In order to qualify for this benefit program, you must be a resident of the state of Tennessee and you must also be a U.S. citizen or qualified alien. You must be either pregnant, a child under age 19, a parent or relative caretaker of a dependent child(ren) under age 21, disabled, elderly, or uninsurable. You must also meet the financial eligibility criteria that go with each category. Generally, your financial situation would be characterized as either low income or very low income.

In order to qualify, you must have an annual household income (before taxes) that is below the following amounts:

Household Size* Maximum Income Level (Per Year)
1 $16,040
2 $21,599
3 $27,159
4 $32,718
5 $38,277
6 $43,837
7 $49,396
8 $54,956

*For households with more than eight people, add $5,559 per additional person. Always check with the appropriate managing agency to ensure the most accurate guidelines.

 

Application Details

None

Contact:

1-800-342-3145

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