Tennessee Medicaid for Seniors
“With age comes wisdom, but sometimes age comes alone,” said 19th-century poet and playwright Oscar Wilde, who died before experiencing aging. Were he to experience aging in 21st-century Tennessee, he might amend his famous quote to state, “With age comes wisdom, but sometimes age comes alone, and sometimes with great costs.”
Those significant costs for aging in Tennessee Medicaid for seniors become readily apparent to seniors who need long-term care. The cost of in-home senior care in Nashville, Franklin, and across Middle Tennessee can range from $21,000 to $54,000, depending on needs. Meanwhile, a private room in a nursing home can easily top $100,000 per year.
Fortunately, Tennessee Medicaid for seniors can help offset these significant costs. Operated by the state as “TennCare,” this federal program provides healthcare coverage for low-income individuals, including those who need long-term care, like many seniors. With lenient Medicaid eligibility requirements, any Tennessee senior facing long-term care should investigate TennCare as soon as possible to avail themselves of its potential benefits effectively. Here is step-by-step guidance for seniors and their families on how to navigate Tennessee Medicaid.
Step 1: Explore Available TennCare Medicaid for Seniors Programs
TennCare’s CHOICES program provides Medicaid long-term care support to seniors 65 and older. With three support levels, CHOICES provides support to seniors:
- In nursing homes.
- Who need a nursing home level of care within their own home.
- Who don’t qualify for nursing home care but are at risk of needing that level of care absent home care.
Seniors 65 and over may also be eligible to receive Medicaid benefits from other TennCare programs, including the 1915(c) waiver program for Home and Community Based Services and programs supporting the aged, blind, and disabled. If eligible, these programs can provide additional support for seniors, so they are worth investigating.
Step 2: Understand TennCare Medicaid Eligibility
Seniors applying for CHOICES must meet distinct medical and financial eligibility criteria. Medical criteria must show that the senior needs help with daily living activities and needs the level of care provided by a nursing home. Those not qualifying may be eligible if they can medically prove that they are at risk of needing a nursing home level of care if they do not receive home care.
Financial eligibility criteria under CHOICES cover income and assets. The maximum income limit is computed annually at 300% of the Federal Benefit Rate. In 2025, this is $2,901 per month for individuals or double that for married applicants who are jointly applying. If only one spouse applies, the income of the non-applicant spouse is not included, ensuring they have sufficient income for living expenses.
Asset limits are $2,000 for individuals and $4,000 for jointly applying married applicants. If only one spouse applies, the non-applicant spouse can keep $148,620 in assets as spousal impoverishment protection. The primary home, one car, and personal possessions are generally exempt from asset limits.
Asset limits are retroactive in that applicants cannot have given away or sold anything for less than what it was worth in the past five years.
Step 3: Choose the Right Plan and Services
Seniors planning to avail themselves of Medicaid support and benefits through TennCare must balance medical needs, financial considerations, and personal preferences to choose the right plan and services. This might start with determining whether the senior’s health, comfort, and social life would be best served in a nursing home or at their house with community-based services. Aside from this, the senior and/or his family must consider what benefits each TennCare program offers and which the senior is eligible for. With an intimate working knowledge of Medicaid and TennCare programs, an elder lawyer can prove invaluable in helping a senior choose the right plan, ensure eligibility, and secure optimal Medicaid benefits.
Step 4: Apply for TennCare
Before applying for TennCare Medicaid benefits, the senior needs to gather the necessary documents to submit as part of the application process. These include:
- Proof of identity and citizenship
- Medical records
- Financial records
- Income statements
Applications can be completed online through the TennCare website, by phone through TennCare Connect, through mailed-in forms downloaded from the website, or in person at your local Department of Human Services office. In filling out the forms, it’s essential to ensure all requested information is correctly completed and the required supporting documents are included. Any mistakes or missing documents can lead to extensive processing delays. However, an elder law attorney can ensure that application forms are correctly completed and submitted for smooth processing.
Step 5: Utilize TennCare Benefits Effectively
The more you know about TennCare Medicaid benefits, the more effective you will be at securing and managing them. It’s never too early for seniors and their families to start learning about TennCare programs. There are strategies—like asset spend downs and setting up a “Miller Trust” to reduce income streams—you can take now to ensure future eligibility and optimize benefits. Additionally, in-depth familiarity with the programs helps determine which will best serve the senior’s near- and longer-term needs and will make it easier to adjust services and benefits with changes in health.
Step 6: Review Annually and Adjust Plans as Warranted
Once approved for TennCare coverage, reviewing the programs and senior’s healthcare status annually is imperative to determine whether services need to be modified or eligibility criteria have changed. As seniors age, their healthcare needs inevitably change, but a proactive approach helps ensure TennCare benefits continue to help provide effective long-term care.
Navigate Tennessee Medicaid with an Experienced Elder Lawyer in Nashville
Navigating the complexities of Tennessee Medicaid programs for long-term senior care is challenging. However, experienced elder law attorneys are adept at reviewing TennCare programs to determine how to optimize benefits to secure the best long-term care support for seniors while preserving assets and protecting spouses or family members.The legal experts at Elder Law of Nashville have a stellar record of compassionately helping Middle Tennessee-area families establish effective long-term care planning with Medicaid support for their clients. To help guide you through the Medicaid benefits process for assistance with any elder law issues, schedule a consultation with us today.