How to Get Tennessee Medicaid Benefits | Best Answers

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We have scoured the internet to provide all you need to know about the Tennessee  Medicaid Benefits.

Medicaid is a joint federal-state program that provides health insurance to low-income individuals who meet specific requirements, including kids, pregnant women, the elderly, and individuals with disabilities. Applying for Medicaid in person, via telephone, or online is simple.

This post will teach you all you need to learn about Medicaid in Tennessee.

What is the Tennessee Medical Program?

Tennessee  Medicaid is a service for people and families with income and resources within specific parameters. Resources primarily apply to the elderly, blind, or disabled population within the bounds of specified rules.

Who is eligible for the Tennessee  Medical Program?

Tennessee  Medicaid offers limited Medicare beneficiaries who are not eligible for the entire Medicaid benefit package some partial financial help with Medicare premiums and copayments or coinsurance through the Medicare Savings Plan.

  • Expectant mothers
  • People who are blind or disabled or who have a spouse who is blind or disabled; 
  • People whom someone adopts;
  • People whom someone adopted; 
  • People who are blind or disabled or have a spouse who is disabled.

The Annual Household Income Limits (before taxes)

Household Size*The Maximum Income Level (Per Year)
1$18,075
2$24,353
3$30,630
4$36,908
5$43,186
6$49,463
7$55,741
8$62,018

*For households with more than eight people, add $6,277 per additional person.

How do I contact Medicaid in Tennessee?

Phone

855-259-0701

Mailing Address

TennCare Connect

P.O. Box 305240

Nashville, TN 37230-5240

Website: https://www.tn.gov/

What are the Medicaid plans in Tennessee?

TennCare Program

TennCare, Tennessee’s Medicaid managed care program, was established. All coverage groups are required to participate in its statewide managed care scheme. 

Over time, the program has changed to include or omit (“carve out”) different services from the contracts with managed care organizations (MCOs). The state started providing mental health treatments to managed care subscribers in 1996 through a limited benefit prepaid plan. 

Still, it later started reintegrating mental health services under the medical MCO contracts.

TennCare CHOICES program

Through the TennCare CHOICES program, the MCOs started to pay for long-term services and assistance for seniors and people with physical impairments. 

TennCare MCOs now offer coverage, mental health services, and long-term care facilities, thanks to the addition of CHOICES.

Program of AllInclusive Care for the Elderly

Additionally, Tennessee has run the Program of All-inclusive Care for the Elderly (PACE) initiative, which offers all Medicaid and Medicare services to residents of Hamilton County over the age of 55 who need care comparable to that found in nursing homes.

How do I apply for Tennessee  Medicaid?

Call 855-259-0701 to enroll. 

Apply in person at TennCare Connect

Online:  Download and print the application.

Mail: To BP.O. Box 305240, Nashville, TN 37230-5240

Website: https://www.tn.gov/

What is covered by Tennessee  Medicaid?

Tennessee  Medicaid covers the following services:

Ambulatory surgeryHospital stays
Audiology servicesLaboratory tests
Behavioral health servicesVision care
Women’s health careNon-emergency transportation
DialysisOrthotic and prosthetic devices
Doctor visitsOccupational therapy
Smoking cessation servicesPharmacy (medications)
Emergency carePhysical rehabilitation
Family planning servicesPreventive care
Hearing aidsHospital outpatient care
Home health careX-rays and other radiology services

Can I have both Tennessee  Medicaid and Medicare?

If you are over 65, have a diagnosis of either ALS or ESRD, and fulfill the income eligibility standards for TennCare, you are eligible for both Medicare and Medicaid.

Tennessee  Waiver

  • The Statewide Waiver 
  • The Arlington Waiver 
  • The Self-Determination Waiver 
  • TennCare CHOICES

Copayments?

They do not have to pay a copayment. When a member is 

  • under 21 years old; 
  • pregnant; 
  • Held by the state
  • Placed under government supervision
  • Native American participants who qualify for Contract Health funding
  • Services or Tribal Union of Indian Health Services
  • The hospital (inpatient)
  • A facility for skilled nursing
  • A nursing home

What is not covered by Tennessee  Medicaid?

In Tennessee, Medicaid is not mandated to offer in-home caregiving services or private nursing coverage. Bandages, adult diapers, and other disposable items are frequently excluded from insurance coverage, as are cosmetic surgery and other elective procedures.

What is the highest income limit for Tennessee  Medicaid?

The highest income limit for Tennessee Medicaid is $18,075 for an individual and $24,353 for a family of two per year.

What if a person’s income is too high to qualify for regular Medicaid benefits?

If your income is too high, you may still be eligible for Tennessee  Medicaid, thanks to the asset spend down option.

What documents do I need to apply for Medicaid?

The following documents are required with the application:

  • The Social Security Number;
  • Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
  • Evidence of all income sources, both legal and illegal 
  • Proof of origin 
  • Proof of residency 
  • Including the Medicare card, any insurance cards
  • Pregnancy;
  • When non-parents apply for Medicaid on their behalf, they must provide evidence of their financial position.

What is the best Medicaid in Tennessee?

The best plan for you is the one that meets your demands and offers the most benefits in terms of health insurance and monetary help because it varies from person to person.

Where do I find the letter showing the reason(s) for denial or discontinuance from Tennessee  Medicaid?

By signing into your account at Portal, you can see the progress of your Tennessee Medicaid application.


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Editor
Sabrina is a former campaign manager who has decided to focus her effort to help people contact senators and get help. She leads our Editorial Team with Ronald and Lawrence to curate content and resources that help us navigate the system.

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