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Learn About Requirements for Medicaid in Tennessee

Medicaid eligibility requirements in Tennessee are a set of guidelines created for the state’s Medicaid program, which is referred to as TennCare Medicaid. Understanding how to qualify for Medicaid is vital for potential beneficiaries seeking assistance. TennCare Medicaid is state and federally funded with certain guidelines established on a national level, and it is administered by local officials. Aid from TennCare includes many health-related services. “What are the requirements for Medicaid in TN?” is a common question asked by prospective applicants. Medicaid benefits eligibility guidelines may depend on a number of circumstances, but the program has some basic requirements.

Who qualifies for Medicaid in Tennessee?

To qualify for Medicaid in Tennessee, an applicant must meet one of several eligibility criteria. For instance, one group of applicants eligible for Medicaid is children who are younger than 21 years of age. Other categories include pregnant women and women who need treatment for breast or cervical cancer. Medicaid eligibility is extended to parents or caretakers of a minor child who lives in the household, as well as individuals who get a Supplemental Security Income (SSI) check. Residents may qualify for Medicaid benefits if they have received both an SSI check and a Social Security check in the same month at least once over the past four decades. Applicants will meet basic TN Medicaid eligibility guidelines if living in a nursing home or receive other long-term care services typically paid for by TennCare. Several other groups may qualify for other Medicaid programs.

To meet eligibility requirements for Tennessee Medicaid, most petitioners will have to demonstrate a household income that is below a certain threshold. The Affordable Care Act (ACA) expanded Medicaid eligibility requirements to allow some candidates to qualify based on income alone. However, Tennessee has yet to accept the guidelines for this ACA Medicaid expansion. Accordingly, applicants cannot qualify on income alone, and instead, they must qualify in one of the categories listed above.

What are the requirements for Medicaid in Tennessee?

Some basic requirements for Medicaid in Tennessee apply to all candidates for the program. Eligibility for Medicaid benefits is only extended to applicants who are U.S. citizens or legal non-citizens. Furthermore, applicants must be permanent residents of Tennessee. Failing to meet either one of these eligibility markers will disqualify a request for Medicaid. Qualifying for Medicaid in Tennessee in terms of citizenship and residency requires acceptable documentation from the petitioner. For instance, proof of citizenship demands that applicants provide a Social Security Number (SSN) to officials on the application form. Additionally, immigrants must show proof of legal status within the country. Satisfying TN Medicaid eligibility requirements may not be possible for all types of legal immigrants.

What are the income requirements for Medicaid in Tennessee?

Income requirements for Medicaid in Tennessee are a vital factor determining if potential beneficiaries will receive much-needed assistance. Specific Medicaid income requirements depend on the applicant’s eligibility category and particular Medicaid program. For instance, low income pregnant women need to demonstrate a household income that is at or below 195 percent of the federal poverty level (FPL) to receive Medicaid health care benefits. In order to qualify for Medicaid benefits, children between six and 19 years of age must demonstrate a household income that is at or below 133 percent of the FPL. When calculating income to determine eligibility for Tenncare, some applicants will be required to include assets or resources such as cash or other items of value. To learn more about Medicaid income requirements, download our free Medicaid guide.

What are the Medicaid application guidelines in Tennessee?

Qualifying for Medicaid in Tennessee includes additional provisions beyond citizenship, residency or income. Medicaid application guidelines require applicants to provide documents and information required for Medicaid. For applicants to qualify for Medicaid benefits, they must provide a broad range of details to officials. Applying for TN Medicaid benefits requires applicants to provide officials with accurate and up-to-date information. State agents that review applicants will attempt to verify all information provided and may contact potential beneficiaries regarding details on the application form. Petitioners can apply for Medicaid in Tennessee online or by phone. Those who need help completing an application can visit a Tennessee Department of Human Services office in person. To learn more about Medicaid application guidelines, download our free guide today.