Tennessee Medicaid, known as TennCare, provides health coverage to eligible residents including children, pregnant women, parents with dependent children, seniors, and individuals with disabilities. If you are trying to figure out whether you or your family qualifies for TennCare in 2026, this guide breaks down the income limits, eligibility categories, new benefits, and how to apply.
One critical fact to understand: Tennessee has not expanded Medicaid under the Affordable Care Act. This means that low income alone does not guarantee eligibility. You must fall into a specific category and meet income requirements to qualify. Approximately 95,000 Tennesseans fall into what is called the "coverage gap," earning too little for marketplace subsidies but not fitting into a TennCare eligibility category.
Want a quick answer? Check your eligibility in minutes with our free screener.
Who Qualifies for TennCare in 2026?
TennCare eligibility is based on both your demographic category and your household income. Here are the groups that may qualify:
- Parents and caretaker relatives with a dependent child under 18
- Pregnant women (coverage extends 12 months after delivery)
- Children under 19 (through TennCare Medicaid or CoverKids)
- Seniors age 65 and older who need assistance with daily living
- Individuals with disabilities who require long-term care
- SSI recipients (automatically eligible for TennCare)
Who does not qualify: Non-disabled adults without dependent children generally cannot get TennCare, regardless of income level. This is the coverage gap unique to states that have not expanded Medicaid.
2026 TennCare Income Limits by Category
The income limits below are based on the 2026 Federal Poverty Level (FPL) guidelines, effective January 14, 2026.
Parents and Caretaker Relatives (105% FPL)
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|---|---|
| 2 | $22,722 | $1,894 |
| 3 | $28,686 | $2,391 |
| 4 | $34,650 | $2,888 |
| 5 | $40,614 | $3,385 |
| Each additional | +$5,964 | +$497 |
Pregnant Women (250% FPL)
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|---|---|
| 2 | $54,100 | $4,508 |
| 3 | $68,300 | $5,692 |
| 4 | $82,500 | $6,875 |
| 5 | $96,700 | $8,058 |
| Each additional | +$14,200 | +$1,183 |
Children (TennCare Medicaid)
| Age Group | FPL Percentage | Annual Limit (Family of 4) |
|---|---|---|
| Infants (0 to 1) | 195% FPL | $64,350 |
| Young Children (1 to 5) | 142% FPL | $46,860 |
| Older Children (6 to 18) | 133% FPL | $43,890 |
CoverKids (CHIP) for Children Under 19
Children in families earning too much for TennCare Medicaid but up to 250% FPL may qualify for CoverKids, Tennessee's Children's Health Insurance Program. For a family of four, that is up to $82,500 per year.
CoverKids has no premiums or deductibles. Copays vary by income and are capped at 5% of annual household income.
Seniors and Individuals with Disabilities
For elderly and disabled individuals who need long-term care services through the CHOICES program:
| Category | Monthly Income Limit | Asset Limit |
|---|---|---|
| Single individual | $2,982 | $2,000 |
| Married couple (both applying) | $5,964 | $4,000 |
| SSI recipients | $994 | $2,000 |
The spousal impoverishment protection allows a non-applicant spouse to retain up to $162,660 in assets.
What TennCare Covers in 2026
TennCare provides comprehensive health coverage including:
- Doctor visits and preventive care
- Hospital stays and emergency services
- Prescription medications
- Mental health and substance abuse services
- Maternity and postpartum care (full 12 months)
- Lab work, X-rays, and imaging
- Home health services
- Long-term care (for eligible individuals)
New and Enhanced Benefits
TennCare has added several valuable benefits in recent years that many residents still do not know about:
Adult Dental Coverage: All adult TennCare members now have access to dental care including routine exams, X-rays, fillings, crowns, root canals, and extractions. This benefit alone can save families hundreds of dollars each year.
Free Diapers: TennCare and CoverKids provide up to 100 diapers per month for enrolled children under age 2. At typical retail prices, this saves families $70 to $80 or more each month.
12-Month Postpartum Coverage: Pregnant women who qualify for TennCare now receive coverage for a full 12 months after giving birth, a permanent extension from the previous 60-day limit. This ensures access to critical postpartum care, mental health services, and family planning.
How to Apply for TennCare: Step by Step
Follow these steps to apply for TennCare in 2026:
Step 1: Gather Your Documents
Before you start, have the following ready:
- Social Security numbers for all household members
- Proof of income (pay stubs, tax returns, or employer letter)
- Proof of Tennessee residency (utility bill, lease, or ID)
- Proof of citizenship or immigration status
- Date of birth for all applicants
- Information about current health insurance (if any)
Step 2: Choose Your Application Method
You can apply through any of these channels:
- Online: Visit TennCare Connect or HealthCare.gov
- By Phone: Call TennCare Connect at 855-259-0701 or the federal marketplace at 1-800-318-2596
- In Person: Visit any of Tennessee's 95 DHS county offices
- By Mail: Download and mail a paper application from the TennCare website
Step 3: Complete the Application
When filling out your application, provide accurate information about:
- Everyone in your household
- All sources of income
- Any current health coverage
- Whether anyone is pregnant, disabled, or has a chronic condition
Step 4: Submit and Follow Up
After submitting your application:
- You will receive a confirmation number (save this)
- TennCare will process your application, typically within 45 days
- You may be asked to provide additional documentation
- Check your application status at TennCare Connect or by calling 855-259-0701
Step 5: Choose a Managed Care Plan
If approved, you will need to select a managed care organization (MCO). Tennessee's TennCare MCOs include BlueCare Tennessee, Amerigroup, and UnitedHealthcare Community Plan. If you do not choose within 30 days, one will be assigned to you.
The Coverage Gap: What If You Do Not Qualify?
Because Tennessee has not expanded Medicaid, many low-income adults fall into the coverage gap. If you do not qualify for TennCare, you still have options:
- CoverRx: A prescription assistance program for uninsured adults earning below approximately $15,960 per year (single individual). CoverRx provides access to medications at reduced cost.
- Marketplace Insurance: If your income is above 100% FPL ($15,960 for an individual in 2026), you may qualify for subsidized health insurance through HealthCare.gov. Premium tax credits can significantly reduce your monthly costs.
- Community Health Centers: Federally qualified health centers throughout Tennessee provide care on a sliding fee scale based on your ability to pay.
- Tennessee 2-1-1: Dial 211 for referrals to local health services and assistance programs.
Not sure where you stand? Use our free benefits screener to check all the programs you might qualify for, including SNAP, LIHEAP, and more.
Other Benefits You May Qualify For
If you qualify for TennCare, you may also be eligible for other assistance programs in Tennessee:
- SNAP (Food Stamps): Up to $298 per month for individuals, $994 for a family of four
- WIC: Nutrition assistance for pregnant women, infants, and children under 5
- LIHEAP: Help paying heating and cooling bills (applications open November 1 each year)
- Families First (TANF): Cash assistance for families with children
- Childcare Assistance (Smart Steps): Help paying for childcare while you work or attend school
Learn more about all available programs on our Tennessee Benefits Overview page.
Frequently Asked Questions
Does Tennessee have expanded Medicaid?
No. Tennessee has not expanded Medicaid under the Affordable Care Act. This means eligibility is limited to specific categories such as children, pregnant women, parents with dependent children, seniors, and people with disabilities. Low-income adults without children generally do not qualify.
How long does it take to get approved for TennCare?
TennCare applications are typically processed within 45 days. Applications for pregnant women and children may be processed more quickly. If you need immediate care, ask about presumptive eligibility when you apply.
Can I apply for TennCare if I already have insurance?
You can apply, but TennCare is generally for people who do not have access to affordable employer-sponsored insurance. Children may qualify for CoverKids even if a parent has employer coverage, as long as the child is not enrolled.
What is the difference between TennCare and CoverKids?
TennCare is Tennessee's Medicaid program with lower income limits. CoverKids is the state's CHIP program for children under 19 whose family income is too high for TennCare but below 250% FPL. CoverKids has no premiums and minimal copays.
Is dental care covered by TennCare?
Yes. As of 2023, TennCare covers comprehensive dental care for all adult members, including exams, fillings, crowns, and root canals. Children's dental care has always been covered.
What happens if my income changes after I am approved?
You must report changes in income, household size, or other circumstances to TennCare within 10 days. Your eligibility will be reviewed, and your coverage may change based on updated information. TennCare also conducts annual eligibility redeterminations.
Can undocumented immigrants get TennCare?
TennCare requires U.S. citizenship or qualified immigration status. Undocumented immigrants are not eligible for full TennCare benefits. However, emergency Medicaid may cover emergency medical services regardless of immigration status.
How do I renew my TennCare coverage?
TennCare sends a renewal form before your coverage period ends. You can renew online through TennCare Connect, by phone at 855-259-0701, or by returning the paper form by mail. Respond promptly to avoid a gap in coverage.
Take the Next Step
Figuring out your eligibility for TennCare and other Tennessee benefits does not have to be complicated. Try our free benefits screener to see all the programs you may qualify for in just a few minutes. You can also explore our Tennessee Benefits Overview for a complete look at state assistance programs.
