Haris Ashley
TennCare is Tennessee's Medicaid program, providing healthcare to low-income pregnant women, parents or caretakers of a minor child, children, and individuals who are elderly or have a disability. Enrollment in TennCare is year-round, and there is no need to wait for an open enrollment period. However, starting in 2010, TennCare members can only change their health plan during one month of the year, depending on their location in Tennessee. For those in West Tennessee, the month is March; for Middle Tennessee, it's May; and for East Tennessee, it's July.
| Characteristics | Values |
|---|---|
| Name of Tennessee's Medicaid program | TennCare |
| Eligibility | Low-income pregnant women, parents or caretakers of a minor child, children, and individuals who are elderly or have a disability |
| Enrollment | Year-round; no need to wait for an open enrollment period |
| Open enrollment month | Depends on where you live in Tennessee. March, May, or July |
| West Tennessee | Benton, Carroll, Chester, Crockett, Decatur, Dyer, Fayette, Gibson, Hardeman, Hardin, Haywood, Henderson, Henry, Lake, Lauderdale, Madison, McNairy, Obion, Shelby, Tipton and Weakly counties |
| Middle Tennessee | Bedford, Cannon, Cheatham, Clay, Coffee, Cumberland, Davidson, Dekalb, Dickson, Fentress, Giles, Hickman, Houston, Humphreys, Jackson, Lawrence, Lewis, Lincoln, Macon, Marshall, Maury, Montgomery, Moore, Overton, Perry, Pickett, Putnam, Robertson, Rutherford, Smith, Stewart, Sumner, Trousdale, Van Buren |
| East Tennessee | Anderson, Bledsoe, Blount, Bradley, Campbell, Carter, Claiborne, Cocke, Franklin, Grainger, Greene, Grundy, Hamblen, Hamilton, Hancock, Hawkins, Jefferson, Johnson, Knox, Loudon, Marion, McMinn, Meigs, Monroe, Morgan, Polk, Rhea, Roane, Scott, Sequatchie, Sevier, Sullivan, Unicoi, Union and Washington counties |
| Renewal | Once a year |
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What You'll Learn
Medicaid eligibility in Tennessee
TennCare is the state of Tennessee's Medicaid program. It provides healthcare to low-income individuals of all ages, including children, pregnant women, parents or caretakers of a minor child, elderly people, and individuals with disabilities.
To be eligible for TennCare, an individual must first fall into one of TennCare's covered categories. Each category has different household income limits for determining eligibility. The Affordable Care Act (ACA) allows states to expand Medicaid eligibility to all adults with incomes up to 138% of the federal poverty level (FPL) regardless of their health or parental status. Tennessee has not expanded TennCare eligibility under the ACA, so very few non-disabled, childless adults are eligible for TennCare.
The income limit for single applicants is $2,901 per month, while for married couples, the combined income limit is $5,802 ($2,901 per spouse). Income exceeding this limit can be placed in a Qualified Income Trust (QIT), also known as a Miller Trust, to maintain eligibility. Single applicants are limited to $2,000 in countable assets, while married couples with both spouses applying are limited to $4,000 ($2,000 per spouse).
TennCare also covers uninsured women with household incomes below 250% of FPL who have had breast or cervical cancer detected by the Tennessee Breast and Cervical Cancer Screening Program.
In addition to income and asset limits, applicants must meet residency and citizenship requirements. They must be Tennessee residents and U.S. citizens or have proper immigration status.
Regarding changing insurance plans on TennCare/Medicaid in Tennessee, individuals can only change their health plan during one month of the year, depending on where they live in the state. Those in West Tennessee can only change their health plan during March, those in Middle Tennessee during May, and those in East Tennessee during July.
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Open enrollment months
TennCare is the state of Tennessee's Medicaid program. It provides healthcare to mostly low-income pregnant women, parents or caretakers of a minor child, children, and individuals who are elderly or have a disabled family member. To get Medicaid, you must meet the income and resource limits.
Since 2010, TennCare members have only been able to change their health plan during one month of the year, which depends on where they live in Tennessee. This is known as their "open enrollment month". The open enrollment months are split up by region:
- West Tennessee: March
- Middle Tennessee: May
- East Tennessee: July
For example, if you live in West Tennessee, you can only change your health plan during the month of March. This includes the following counties: Benton, Carroll, Chester, Crockett, Decatur, Dyer, Fayette, Gibson, Hardeman, Hardin, Haywood, Henderson, Henry, Lake, Lauderdale, Madison, McNairy, Obion, Shelby, Tipton, and Weakly.
If you live in East Tennessee, you can only change your health plan during the month of July. This includes the following counties: Anderson, Bledsoe, Blount, Bradley, Campbell, Carter, Claiborne, Cocke, Franklin, Grainger, Greene, Grundy, Hamblen, Hamilton, Hancock, Hawkins, Jefferson, Johnson, Knox, Loudon, Marion, McMinn, Meigs, Monroe, Morgan, Polk, Rhea, Roane, Scott, Sequatchie, Sevier, Sullivan, Unicoi, Union, and Washington.
It is important to note that you have until the last day of your county's month to change your health plan. You can ask to change your health plan by calling TennCare Member Medical Appeals at 1-800-878-3192.
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TennCare Connect
Enrollment in TennCare is year-round, and applications can be made online via TennCare Connect, over the phone, or in person at one of the state's 95 Department of Human Services offices. If you are eligible for Medicaid, you can enroll through the federally-run insurance marketplace at HealthCare.gov or use their call center at 1-800-318-2596.
However, if you are already enrolled in TennCare and wish to change your health plan, you can only do so during your "open enrollment month," which depends on where you live in Tennessee. If you live in West Tennessee, your open enrollment month is March; for Middle Tennessee residents, it is May; and for East Tennessee, it is July. You have until the last day of your county's designated month to change your health plan. To request a change, you can call the TennCare Member Medical Appeals line at 1-800-878-3192.
TennCare, like all Medicaid agencies, is required to renew each member's coverage annually. TennCare will attempt to renew your healthcare coverage using the information they already have. If approved, you will receive a letter confirming the continuation of your health coverage. If TennCare cannot renew your coverage with the existing information, you will be notified by letter or email, and a renewal packet will be sent to you. You must complete and submit this renewal packet by the specified date.
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Annual renewal
TennCare, Tennessee's Medicaid program, is required to renew every member's coverage annually. This involves reviewing members' information to ensure they still qualify for coverage. If you are approved, you will receive a letter confirming the continuation of your health coverage.
If TennCare cannot renew your coverage with the information they have, you will receive a letter and renewal packet by mail. This packet will include information that you have previously provided to TennCare. You must review and update any changes to this information and complete your renewal packet by the date specified in the letter.
It is important to note that your "open enrollment month" for changing your health plan will depend on where you live in Tennessee. For those in West Tennessee, including counties like Benton, Carroll, Crockett, Fayette, and Shelby, March is the designated month to make changes to your health plan. Middle Tennessee residents in counties such as Bedford, Cheatham, Coffee, Davidson, and Rutherford can only change their health plans during May. If you reside in East Tennessee, which encompasses counties like Anderson, Blount, Campbell, Knox, and Washington, July is the month when you can modify your health plan.
Tennessee allows for year-round enrollment in TennCare, and you can apply anytime if you meet the income and resource limits. Enrollment options include applying online via TennCare Connect, contacting their call center, visiting one of the state's Department of Human Services offices, or utilizing the "find local help" link on HealthCare.gov.
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Medicaid financial assistance
In Tennessee, Medicaid is known as TennCare. TennCare provides healthcare to low-income pregnant women, parents or caretakers of a minor child, children, and individuals who are elderly or have a disability. To qualify for TennCare, applicants must meet income and resource limits, which vary depending on the applicant's specific circumstances and household composition. Resources refer to assets such as bank accounts, cars, and land.
TennCare members can only change their health plan during one month of the year, depending on their county of residence. For those living in West Tennessee, the open enrollment month is March; for Middle Tennessee, it is May; and for East Tennessee, it is July. To change your health plan, you can call the TennCare Member Medical Appeals line at 1-800-878-3192.
Regarding financial assistance, Medicaid is a federal and state program that provides health coverage to those who meet the eligibility criteria, which typically includes low-income individuals, families, children, pregnant women, and people with disabilities. Each state has its own Medicaid office that can provide specific information on eligibility and enrollment. Additionally, the official U.S. government website for Medicaid and CHIP (Children's Health Insurance Program) offers resources to help individuals renew their health coverage or explore other healthcare options.
Beyond healthcare, the U.S. government provides various other forms of financial assistance through programs like Social Security, rental and buyer assistance, welfare benefits, and grants or loans. These programs can help with basic living expenses, such as food, housing, phone and internet bills, and energy costs. To learn more about these programs and their specific eligibility requirements, individuals can contact their state social service agencies or refer to the official government website, USA.gov.
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Frequently asked questions
TennCare is the state of Tennessee's Medicaid program. It provides healthcare to mostly low-income pregnant women, parents or caretakers of a minor child, children, and individuals who are elderly or have a disability.
Starting in 2010, you can only change your health plan during one month of the year, depending on where you live in Tennessee. March, May, or July will be your “open enrollment month”.
You can ask to change your health plan by calling TennCare Member Medical Appeals at 1-800-878-3192.
TennCare, like all Medicaid agencies, is required to renew every member’s coverage once a year. When it is your time to renew, TennCare will try to renew your health care coverage using the information they already have.
