TennCare is the state Medicaid program in Tennessee, providing health care services to eligible low-income individuals and families, including children, pregnant women, parents, and caretakers. It offers a wide range of coverage, including primary care, hospital services, behavioral health treatment, and prescription drugs. TennCare emphasizes integrated care and strives to improve health outcomes for Tennesseans by coordinating physical and behavioral health services. The program is known for its innovative approach to Medicaid, utilizing managed care organizations to deliver cost-effective and comprehensive healthcare services.

Your health plan or MCO (Managed Care Organization) card will have a Benefit Indicator letter on the front (A to M). The Benefit Indicator tells you what kind of care TennCare covers for you and what kind of doctors you can see. 

Here's the list of services generally covered under TennCare:

• Behavioral health crisis services (mental health, alcohol and drug abuse services)
• Behavioral Health Intensive Community-Based Treatment
• Chiropractic services
• Community health clinic services
• Dental services
• Durable medical equipment (DME)
• Emergency air and ground ambulance
• Home health services
• Hospice care
• Inpatient and outpatient substance abuse benefits
• Inpatient hospital services
• Lab and X-ray services
• Medical supplies
• Non-emergency transportation
• Occupational therapy
• Organ transplant and donor procurement
• Outpatient hospital services
• Outpatient behavioral health services (mental health, alcohol and drug abuse services)
• Pharmacy services
• Physical therapy services
• Physician services
• Private duty nursing
• Psychiatric inpatient facility services
• Psychiatric rehabilitation services
• Psychiatric residential treatment services
• Reconstructive breast surgery
• Renal dialysis services
• Speech therapy services
• Vision services
  

Note that some services, like Home Health Services, Pharmacy Services, Private Duty Nursing, and Vision Services, have certain limits and notes attached.

Find your letter on the TennCare benefits chart to learn more about your specific benefits.

The eligibility requirements for TennCare can be summarized based on various factors such as age, income, resources, household size, and specific health needs. Here are the key criteria:

Age and Specific Groups

TennCare covers different groups based on age and specific needs:

• Children under age 21: Young individuals under 21 are eligible.
• Pregnant Women: Special coverage for expectant mothers.
• Parents or Caretakers: Adults who are parents or caretakers of a minor child (the child must live with them and be a close relative) are eligible.
• Individuals Needing Breast or Cervical Cancer Treatment: Coverage for those requiring treatment for breast or cervical cancer.
• Recipients of Supplemental Security Income (SSI): People who receive SSI checks are covered.
• Former SSI Recipients: Individuals who have received both an SSI check and a Social Security check in the same month at least once since April 1977 and continue to receive a Social Security check.

Income and Resource Limits

Eligibility depends on income and resources (like bank accounts, cars, and land). Each group has different income limits, and some groups also have resource limits.

Household Size

The number of people living in the household is a factor in determining eligibility.

Special Conditions for Institutionalized Persons

1. A person living in a medical institution (like a nursing home) with a monthly income below $2,829.
2. Individuals receiving other long-term care services that TennCare pays for.

For more detailed information about eligibility and income limits, visit tenncareconnect.tn.gov.

To apply for TennCare, follow these steps using TennCare Connect, the self-service portal:

Create a TennCare Connect Account

Start by creating an account on TennCare Connect. This portal allows you to apply for benefits, check your status, report changes, read letters, and more.

Gather Necessary Information‍

Be prepared with information about:

• Current address, phone number, and email address (if available)
• Social Security numbers and dates of birth for everyone applying
• Income details from jobs and other sourcesCitizenship and immigration status
• The value of cars and other property
• Other health insurance information

Completing the Application‍

• The application process involves answering questions about people in your home who are applying, residents in your household, your income, expenses, and assets.
• It typically takes 30 to 60 minutes to complete the application.
• The more information you provide initially, the quicker the process may be.
• If additional information is required, TennCare will contact you.

How to Apply

• ‍‍Online: Visit tenncareconnect.tn.gov to apply online.
• ‍Phone: Call 855-259-0701 to apply over the phone.
• ‍Paper Application: Download and fill out the application, which is available in English or Spanish. There are additional pages for extra family members if needed. Send your paper application to TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240, or fax it to 1-855-315-0669.

The process for renewing TennCare coverage can be summarized as follows:

Automatic Renewal Attempt

TennCare will initially try to renew your healthcare coverage using the information they already have on file. If this succeeds, you'll receive a letter confirming your health coverage will continue.

Manual Renewal Process

If TennCare cannot automatically renew your coverage, you will receive a renewal packet and letter by mail. If you receive TennCare communications via email, you'll be notified to check your TennCare Connect account. The renewal packet will contain information you've previously provided to TennCare. You need to review this information and update it with any changes.

It's crucial to ensure that TennCare has your current address. You can update or confirm your address at TennCareConnect.TN.gov or by calling TennCare Connect at 855-259-0701.