TennCare Income and Asset Limits in Tennessee: The Complete 2026 Guide to Tennessee Medicaid Eligibility

The first time most Tennessee families read about TennCare income and asset limits is the week a parent is being discharged from the hospital. The discharge planner asks a question the family was not ready for: who is paying for the nursing home. Private-pay rates in Middle Tennessee now exceed $100,000 a year, and the answer for most families is some combination of Social Security, savings, and TennCare. Whether TennCare will pay depends on a small set of numbers that change every January and that almost no family knows by heart. Tennessee Medicaid eligibility for long-term care turns on those numbers, and Tennessee Medicaid eligibility for everyday healthcare for seniors and other low-income groups turns on a related but different set.

This article is the maintained reference. We update the Federal Poverty Level grid, the CHOICES income limit, the Community Spouse Resource Allowance, the home equity cap, and the asset thresholds each January when TennCare publishes the annual eligibility reference guide. We also explain how the numbers actually work, who they apply to, and what to do when a family is over the limits. For the deeper question of how transfers and gifts inside the five years before an application can change eligibility, we cover that in our companion article on the TennCare 5-year look-back. For Tennessee Medicaid planning generally, see Tennessee Medicaid planning.

Is Medicaid the same as TennCare in Tennessee? Tennessee Medicaid eligibility, in one paragraph.

Yes. TennCare is the brand name for Tennessee's Medicaid program. Tennessee Medicaid eligibility, the income and asset limits, the look-back rules, the long-term care benefits for seniors, and the application process are all the federal Medicaid framework, administered by the state of Tennessee through the Division of TennCare. The federal-state cost split, the federal Medicaid eligibility floors at 42 USC §1396a, and the Tennessee statute at Tenn. Code §71-5 together define who qualifies and what TennCare pays for.

That is the answer to the search. The substance is in the rest of the article.

How TennCare differs from Medicare for Tennessee Medicaid long-term care

Medicare is the federal health insurance program for people age 65 and over, and for certain younger people with disabilities. Medicare does not pay for long-term custodial care in a nursing home beyond a limited skilled nursing benefit. TennCare is Tennessee's Medicaid program, jointly funded by the state and federal government, and TennCare does pay for long-term care for Tennessee residents who meet the income and asset limits. Many Tennessee seniors are enrolled in both Medicare and TennCare and are described as dual eligible. Medicare is the primary payer for medical care, and Tennessee Medicaid pays for long-term services and supports that Medicare does not cover. For seniors with limited income, the combination of Medicare and Tennessee Medicaid covers nearly every category of care a family is likely to encounter.

TennCare runs through managed care organizations

TennCare delivers benefits through a small number of managed care organizations under contract with the state. BlueCare, Wellpoint (the successor to Amerigroup in Tennessee), and UnitedHealthcare Community Plan are the three statewide MCOs. The MCO handles the network of providers, the prior authorizations, and the day-to-day care management. Eligibility, however, is set by the Division of TennCare and the Department of Human Services, not by the MCOs.

The four functional categories of TennCare

TennCare is one program in name, four programs in practice.

• TennCare Medicaid. The standard category for low-income Tennessee residents who meet one of the covered groups, which include pregnant women, parents and caretaker relatives of minor children, children, individuals who are aged 65 and over, and individuals with disabilities. Tennessee has not expanded TennCare under the Affordable Care Act, so non-disabled childless adults are generally not eligible.
• TennCare CHOICES in Long-Term Services and Supports. The long-term care program for adults age 65 and over, and for adults 21 and over with physical disabilities. CHOICES pays for nursing home care, home and community-based services, and at-risk supports. CHOICES is where the $2,000 asset limit, the $2,982/month single income limit, and the Community Spouse Resource Allowance live.
• CoverKids. Tennessee's CHIP program, which provides health coverage to children in households with income up to approximately 211% of the Federal Poverty Level.
• Employment and Community First CHOICES. A separate long-term services program for adults and children with intellectual or developmental disabilities, structured to support employment and community-based living.

The income and asset limits differ across these four programs. The remainder of this article focuses on TennCare Medicaid and TennCare CHOICES, because those are the categories that drive the family questions we hear most often.

Three pathways inside TennCare long-term care: nursing home Medicaid, HCBS waivers, and Aged Blind and Disabled

Inside TennCare CHOICES, federal Medicaid law distinguishes three pathways that Tennessee seniors and their families should understand by name. Nursing home Medicaid is the institutional pathway that pays for full-time care in a Medicaid-certified Tennessee nursing home. Home and community based services (HCBS) waivers are the pathway that pays for at-home and community-based care for Tennessee residents who medically qualify for nursing home Medicaid but choose to remain at home. Aged Blind and Disabled (ABD) Medicaid is a separate Tennessee Medicaid category for seniors aged 65 and over, individuals who are blind, or individuals with a qualifying disability who live in the community and need basic healthcare coverage rather than full long-term care.

Each pathway has its own asset limit and income limit, with the look-back period applying to nursing home Medicaid and HCBS waivers but not to ABD Medicaid. The choices program structure inside CHOICES, with Groups 1, 2, and 3, sits on top of the nursing home Medicaid and HCBS waivers pathways and determines what services TennCare actually delivers. The remainder of this guide explains each one in plain language.

What are the TennCare income and asset limits in Tennessee for 2026?

TennCare income and asset limits in Tennessee for 2026 fall into two answer sets. For TennCare CHOICES long-term care, the 2026 income limit is approximately $2,982 per month for a single applicant and the asset limit is $2,000 in countable resources. For Tennessee Medicaid covering pregnant women, children, and parents, the income limits run from approximately 105% to 250% of the Federal Poverty Level by household size, with no asset test for the MAGI categories.

That paragraph is the answer to the search. The rest of this article is the substance behind it.

What is the income limit for TennCare in Tennessee?

The TennCare income limit depends on which category of TennCare the applicant is applying under. For TennCare Medicaid, the income limit follows the Federal Poverty Level by household size and by category: 138% FPL for parents and caretaker relatives in some pathways, up to 195% FPL for children, and 250% FPL for the breast and cervical cancer pathway. For TennCare CHOICES long-term care, the 2026 income limit for a single applicant is approximately $2,982/month, which is 300% of the SSI Federal Benefit Rate per SSA POMS; confirm against the current TennCare bulletin.

The reason there is no single answer is that TennCare uses different income tests for different groups. The rest of this section walks through each.

The 2026 Federal Poverty Level grid for TennCare Medicaid

The Federal Poverty Level is the federal income benchmark used to set Medicaid eligibility for most non-elderly TennCare categories. The 2026 FPL figures are issued by the U.S. Department of Health and Human Services in January each year and applied by TennCare for the federal fiscal year. The grid below shows the 2026 thresholds at 100%, 138%, 185%, and 250% of FPL, for households of one through six, the four breakpoints that map to the most common TennCare eligibility categories.

Household size	100% FPL (annual)	138% FPL (annual)	185% FPL (annual)	250% FPL (annual)
1
2
3
4
5
6

gov/content/dam/tn/tenncare/documents/eligibilityrefguide.pdf and the HHS poverty guidelines published in the Federal Register.

These percentages map to TennCare's covered groups. Adults with dependent children are eligible for TennCare Medicaid with household income up to approximately 105% of FPL. Pregnant women qualify up to 185% FPL. Children qualify up to 195% FPL through TennCare Medicaid and up to higher percentages through CoverKids. Tennessee residents diagnosed with breast or cervical cancer through the Tennessee Breast and Cervical Cancer Screening Program qualify up to 250% FPL.

Why different Tennessee groups have different income limits

TennCare income limits are not one number. They are a set of category-specific thresholds that reflect the federal Medicaid statute's required and optional eligibility groups. The federal statute sets a floor for each mandatory group. Tennessee can elect to cover optional groups and can set the income test for each within federal limits. The result is that a pregnant Tennessee resident, a parent of a minor child, an aged or disabled adult, and a CHOICES applicant in a nursing home all see a different number on the eligibility worksheet.

Two practical implications follow. First, the income limit on the kitchen table is not the right number until the family knows which category applies. Second, a Tennessee family that does not qualify under one category may qualify under another, including the long-term care category that uses the 300% SSI Federal Benefit Rate test rather than a percentage of FPL.

The TennCare CHOICES long-term care income limit

The income limit that drives most of our work at Lancaster Law is the CHOICES long-term care income limit. The figure is set at 300% of the SSI Federal Benefit Rate, which the Social Security Administration publishes each January. For 2026, third-party reporting places the figure at approximately $2,982/month, or about $35,784/year, per medicaidplanningassistance.org and medicaidlongtermcare.org; confirm against the current TennCare CHOICES bulletin. For married couples where both spouses apply, the limit is doubled to approximately $5,964/month combined. For married couples where one spouse applies, only the applicant's income is counted, and the non-applicant spouse's income is generally protected.

The CHOICES income limit applies separately from the asset limit. An applicant who meets the asset test but exceeds the income limit can still qualify by routing the excess income through a Qualified Income Trust, often called a Miller Trust. We address Miller Trusts in the income-cap section below and in our Tennessee Medicaid planning overview.

What "income" means for TennCare

TennCare uses two different income definitions depending on the category. For TennCare Medicaid categories that follow the Affordable Care Act framework, income is Modified Adjusted Gross Income (MAGI), which counts taxable income from wages, business, retirement distributions, Social Security (for some pathways), interest, dividends, and capital gains, and which uses tax-filing household composition rather than physical residence. For non-MAGI categories, which include CHOICES, the income definition tracks the SSI rules: nearly all gross income is counted, with narrow exclusions for certain VA payments, Holocaust restitution, and a small amount of earned income.

For a CHOICES applicant, the practical income list is short and is almost always over before the family looks twice:

• Social Security retirement and disability benefits
• Pension or 401(k) distributions
• IRA required minimum distributions
• Rental income
• Wages, if any
• Interest, dividends, and other investment income
• Annuity payments
• Alimony (in some categories)

What does not count for CHOICES purposes:

• HUD housing assistance and most other non-cash federal benefits
• VA Aid and Attendance payments above the basic VA pension, per the Tennessee TennCare treatment
• Holocaust reparations
• Income held in a properly drafted Qualified Income Trust

A 2026 Tennessee retiree drawing $2,400 in Social Security, $300 in a small pension, and $400 in an IRA distribution is at $3,100 a month, over the CHOICES limit. The Miller Trust is the standard tool to bring that applicant under the cap. The trust does not shield assets. It solves the income problem.

TennCare Medicaid vs TennCare CHOICES income limits at a glance

Category	Single income limit	Married income limit	Test type
TennCare CHOICES (long-term care)			300% SSI FBR
Aged, Blind, Disabled (ABD) Medicaid			SSI floor
Parents/Caretaker Relatives	~105% FPL	Household-based	MAGI
Pregnant Women	~185% FPL	Household-based	MAGI
Children (TennCare Medicaid)	~195% FPL	Household-based	MAGI
Breast/Cervical Cancer pathway	~250% FPL	n/a	MAGI

What is the asset limit for TennCare in Tennessee?

The asset limit for a single applicant under TennCare CHOICES long-term care is $2,000 in countable resources. The limit for a married couple where both spouses apply is $4,000 combined. The limit for a married couple where only one spouse applies is $2,000 for the applicant, with the non-applicant spouse able to keep a Community Spouse Resource Allowance of up to approximately $162,660 for 2026. The home and certain other assets are exempt and are not counted toward the $2,000.

The mechanics of the asset test deserve more attention than the headline figure usually receives, because the asset limit is where Tennessee families either preserve resources or watch them spend down.

Countable assets, the items that count toward the $2,000

The countable side of the asset test is broad. TennCare counts everything that can be turned into cash to pay for care, with a short list of exceptions. The items that count toward the $2,000 limit include:

• Checking, savings, money market, and certificates of deposit
• Brokerage accounts, stocks, bonds, mutual funds
• Cryptocurrency
• Cash on hand
• The cash surrender value of permanent life insurance (whole life, universal life) above $1,500 face value
• Second homes, rental property, vacation property, and any real estate the applicant does not occupy
• IRAs, 401(k)s, and other retirement accounts in Tennessee. Some states exempt retirement accounts in payout status; Tennessee generally counts them, so the IRA is part of the resource calculation in most cases.
• Annuities that are not properly structured as Medicaid-compliant

The countable list reaches into joint accounts. TennCare treats a joint account as fully owned by the applicant unless the co-owner can prove the source of the deposits. A daughter who was added to a parent's checking account a decade ago for convenience does not, in TennCare's eyes, own half the balance.

Exempt assets, the items that do not count

The exempt side is narrow but meaningful.

• The primary home, if the applicant or the applicant's spouse, minor child, or blind or disabled child of any age lives in it. The home equity cap for 2026 is approximately $752,000 per third-party reporting; confirm against current federal guidance and any TennCare-specific election. Equity above the cap is countable unless a spouse or qualifying child lives in the home.
• One vehicle, regardless of value, if used for the applicant's transportation.
• Household goods and personal effects.
• Wedding and engagement rings.
• An irrevocable burial trust up to $6,000, or an irrevocable funeral arrangement.
• Term life insurance with no cash value.
• Permanent life insurance with combined face value up to $1,500 per insured person.
• Property essential to self-support.
• Assets held in a properly drafted Medicaid Asset Protection Trust funded more than 60 months before the application. The five-year clock controls. We cover the MAPT mechanics in Medicaid Asset Protection Trust and the five-year clock in TennCare 5-year look-back.

The Community Spouse Resource Allowance for a married couple

When one spouse applies for TennCare CHOICES and the other does not, federal law lets the non-applicant spouse, called the community spouse, keep a substantial share of the couple's combined countable assets. The Community Spouse Resource Allowance for 2026 is set within a federal floor and ceiling. Third-party reporting places the figures at approximately $32,532 and approximately $162,660, with the community spouse generally entitled to 50% of the couple's countable assets up to the ceiling. If the couple's combined countable assets are below the floor, the community spouse keeps 100% up to the floor.

For most Tennessee couples we see, the CSRA is the single most powerful preservation tool the rules already provide. A couple with $250,000 in combined countable assets and one spouse entering long-term care can typically preserve the federal-ceiling share for the community spouse without any aggressive planning. The work is in documenting the snapshot date, valuing the assets correctly, and making sure the transfer between spouses is timed properly.

The Minimum Monthly Maintenance Needs Allowance

Alongside the CSRA, the Minimum Monthly Maintenance Needs Allowance lets the community spouse keep enough income to live on. The 2026 MMMNA in Tennessee is approximately $2,643.75 effective 7/1/2025-6/30/2026, with an additional shelter standard of approximately $793.13/month that can raise the allowance for households with higher housing costs, up to a maximum of approximately $4,066.50/month. If the community spouse's own monthly income falls below the MMMNA, income can be transferred from the applicant spouse to bring the community spouse up to the allowance. This shift directly reduces the applicant's Patient Liability, which is the portion of income TennCare requires the applicant to contribute to the cost of care.

Tennessee's Caregiver Child Exemption

A specific transfer that does not count against the asset test, and does not trigger the five-year look-back penalty, is the Caregiver Child Exemption. When an adult child has lived in the parent's home for at least two years before the parent's nursing home admission, and during those two years has provided care that delayed institutional placement, the home can be transferred to that adult child without a TennCare penalty. The rule is at 42 CFR §435.231 and is applied in Tennessee under the CHOICES rule chapter 1200-13-01. The documentation requirements are strict. Done correctly, the exemption moves the family home, often the most valuable asset, outside the asset calculation entirely.

A worked example for a Tennessee married couple

A 78-year-old husband enters a Middle Tennessee nursing home. His wife, age 75, remains in their home, valued at $385,000 with $0 mortgage. The couple's combined countable assets sit at $215,000 across a brokerage account, two CDs, and a checking account. His monthly income is $2,700 (Social Security plus a small pension); hers is $1,400 (Social Security).

The home is exempt because the community spouse lives in it. Of the $215,000 in countable assets, the community spouse can retain up to the CSRA ceiling of, leaving roughly $52,340 over the limit. That excess can be spent down on legitimate purposes (home repairs, a newer vehicle for the community spouse, prepaid funeral arrangements), or restructured through a Medicaid-compliant annuity. The husband's $2,700 income is under the CHOICES cap, so no Miller Trust is required. Because his wife's $1,400 income is below the MMMNA, his income is partly transferred to her to bring her up to the, with the rest going to his Patient Liability.

The result is that the family preserves the home and most of the $215,000, the community spouse has predictable monthly income, and TennCare picks up the nursing home bill. None of that requires aggressive planning. It requires correct application of the rules already in the statute.

How much money can I have in the bank and still get TennCare?

For TennCare CHOICES long-term care, a single applicant can have up to $2,000 in total countable resources, including the bank balance, brokerage accounts, and CDs. Married applicants where both spouses apply share a $4,000 limit. Married applicants where only one spouse applies have a $2,000 limit for the applicant and a Community Spouse Resource Allowance of up to for the well spouse. For TennCare Medicaid non-long-term-care categories, the resource test varies by category and, for many MAGI-based pathways, does not include an asset test at all.

A few practical points families ask us in the first meeting:

• $0 in the checking account is not the rule. The rule is that total countable resources sit at or below the limit on the snapshot date. Most families need some operating cash, and a small balance is fine.
• The snapshot date controls. For a married couple, TennCare looks at the couple's combined countable resources on the date the applicant entered a Medicaid-paid institution, or on a specific date set by the state. Decisions made after the snapshot do not change the figure.
• TennCare verifies. The state can demand 60 months of statements, brokerage records, deeds, and tax returns. The bank statements are the primary record. We cover the verification mechanics in TennCare 5-year look-back.
• Closed accounts still get pulled. If the applicant closed an account inside the look-back window, TennCare can ask the bank for the closed-account transaction history.

For most families the answer to "how much can I have in the bank" is not "exactly $2,000." It is "we work the asset snapshot to the right number, and we use the exemptions to keep the rest." That is the planning conversation we have with every TennCare family.

What does TennCare CHOICES cover?

TennCare CHOICES is the long-term services and supports program inside TennCare, and it pays for three different levels of care depending on the applicant's functional need. CHOICES Group 1 pays for nursing facility care. CHOICES Group 2 pays for home and community-based services for Tennessee residents who could be in a nursing home but choose to remain at home. CHOICES Group 3 pays for at-risk services for Tennessee residents who do not yet need a nursing facility level of care but are likely to without intervention.

The Group structure matters because it determines what TennCare actually pays for in a given case.

CHOICES Group 1: nursing home Medicaid coverage

Group 1 is institutional. The applicant lives in a Medicaid-certified Tennessee nursing home, and TennCare pays room and board, personal care assistance with the Activities of Daily Living, skilled nursing services, medication management, and most medical care. The applicant contributes nearly all monthly income to the cost of care, keeping a Personal Needs Allowance of $70/month, Medicare premium amounts if dual eligible, and any MMMNA transfer to a community spouse.

Group 1 is an entitlement. Every Tennessee resident who meets the financial and functional tests is guaranteed by law to receive coverage. The catch is that not every Tennessee nursing home accepts TennCare, and those that do may not have an open bed when the family needs one.

CHOICES Group 2: HCBS waivers and home and community based services

Group 2 pays for in-home and community-based care for Tennessee residents who medically qualify for a nursing facility level of care but want to stay home. CHOICES Group 2 services delivered through HCBS waivers include personal care assistance, adult day care, home-delivered meals, respite care, home modifications, Personal Emergency Response Systems, and transportation. The benefit package is set by the applicant's care plan and delivered through the MCO.

Group 2 is not an entitlement. The state caps Group 2 enrollment in HCBS waivers, and a waitlist applies once the cap is reached. Tennessee families considering home and community based services through Group 2 should apply as early as eligibility permits.

CHOICES Group 3: ABD Medicaid at-risk services

Group 3 is the smallest of the three. It pays for limited home and community based services for Tennessee residents who are enrolled in Aged Blind and Disabled (ABD) Medicaid and who do not yet need a nursing facility level of care but are at risk of needing one. The benefit package is narrower than Group 2 and is intended to delay the move to a higher level of care. For seniors who qualify under ABD Medicaid rather than the nursing home Medicaid pathway, Group 3 is the most common entry point into TennCare-funded long-term care support.

How the MCO assesses functional eligibility

Functional eligibility for CHOICES is determined through the Pre-Admission Evaluation, a structured assessment that scores the applicant's ability to perform the Activities of Daily Living and the Instrumental Activities of Daily Living. The PAE is conducted by the nursing facility, by the MCO, or by the local Area Agency on Aging and Disability. A minimum score on a 26-point scale is required to establish a nursing facility level of care for Group 1 and Group 2. A diagnosis of dementia or Alzheimer's disease does not by itself produce a qualifying score. The score is functional, not diagnostic.

Is $33,000 a year considered low income in Tennessee?

By the 2026 federal poverty guidelines, $33,000 in annual household income is approximately at the 100% FPL line for a family of four. That places a Tennessee household at the borderline of federal "low income" for most program purposes. Whether $33,000 qualifies for TennCare depends on household size and on which TennCare category applies. For a family of four with two minor children, $33,000 places the household near 100% FPL and within the eligibility range for TennCare Medicaid for the children and for the parents in some pathways.

The "low income" definition varies by program. The federal FPL is one benchmark. SNAP, Section 8 housing assistance, LIHEAP, and the Medicare Savings Programs each set their own thresholds, often at 130%, 150%, or 200% of FPL. For TennCare specifically, the threshold depends on the category. The $33,000 question is best answered against the FPL grid above and against the applicant's category.

For Tennessee retirees concerned about long-term care, the $33,000 number is also relevant in a different way. A retiree drawing $2,750/month in Social Security and pension income is at $33,000/year, which is below the 2026 CHOICES income limit of. That retiree's income is unlikely to be the problem. The asset test typically is.

How to apply for TennCare in Tennessee

A Tennessee resident can apply for TennCare four ways. The state's preferred channel is the online portal at tenncareconnect.tn.gov. Applicants can also apply by phone at 1-855-259-0701, by paper application submitted through the same portal, or in person at any local Department of Human Services office. CHOICES applicants typically apply through TennCare Connect, with the long-term services assessment scheduled through the MCO or the local Area Agency on Aging and Disability.

The application process for CHOICES is documentation-heavy.

Required documents

The TennCare CHOICES application asks for:

• Tennessee driver's license or state ID
• Proof of Tennessee residency
• Social Security card or number
• Birth certificate or proof of citizenship
• Medicare card if enrolled
• All bank statements for the previous 60 months for every account, open and closed
• Brokerage and retirement account statements for the previous 60 months
• Most recent two years of federal tax returns
• Deeds to any real estate
• Most recent life insurance policy declarations
• Vehicle titles
• Burial or funeral arrangement documents
• Pension and Social Security award letters

The 60-month documentation requirement is what produces the look-back review. Every gift, every transfer, every check above a caseworker threshold is visible in the statements. Closed-account histories are visible too.

TennCare Connect timeline

TennCare's published timeline is 45 days for standard applications and 90 days for applications that require a disability determination. The 45-day clock often slips for CHOICES applications because the Pre-Admission Evaluation must be scheduled and scored before financial eligibility can be finalized. Families should plan for the longer end of the range, and should treat the application date itself as the relevant date for the asset snapshot.

What to do if TennCare denies the application

Denials are appealable. The applicant has 30 days from the denial notice to request an appeal, and 60 days to request a fair hearing before an administrative law judge. The appeal can be submitted through TennCare Connect or by mail. The most common reasons for denial are an asset count over the limit on the snapshot date, an undocumented transfer inside the 60-month look-back, and an unmet functional eligibility threshold. Each of these has a different appeal path. The wrong path produces a denied appeal.

The role of an elder-law attorney

For a CHOICES application, the attorney's job is to set the asset snapshot to the right number on the right date, to document every transfer inside the 60 months, to structure the Miller Trust if income is over the cap, to capture the CSRA correctly for a married couple, to set up the irrevocable burial arrangement and the spend-down on exempt assets, and to coordinate the MMMNA transfer. None of that is mechanical. It is the difference between an approval and a denial, and between a family that preserves resources and a family that does not.

Common Tennessee TennCare eligibility mistakes

The most expensive errors we see at Lancaster Law are the ones that come from instinct rather than rules. Four show up repeatedly.

Counting the home above the equity cap

Tennessee families often own a long-held home with substantial appreciation. If the community spouse or a qualifying child lives in the home, the equity cap does not apply and the home is fully exempt. If neither lives in the home and the equity is above the approximately $752,000 for 2026, the excess is countable. Tennessee families with appreciated property need to confirm the cap on the application date and confirm who occupies the home.

Forgetting the cash value of permanent life insurance

A common surprise. A whole life or universal life policy on the applicant, purchased decades ago, may have accumulated cash surrender value above $1,500 face value, which makes it countable. The right move is to inventory every life insurance policy on the applicant before the application, surrender or restructure where appropriate, and document the proceeds.

Recent gifts to children inside the 5-year look-back period

Christmas gifts, wedding gifts, tuition assistance, a check to help with a down payment. All of those count as transfers for less than fair market value if they occur inside the 60-month look-back period, and all of them are visible in the bank statements. The TennCare look-back period applies to nursing home Medicaid and HCBS waivers applications, and the test is whether the transfer was at fair market value. A gift, by definition, is below fair market value. A sale of a Tennessee home to an adult child for $1 is also below fair market value. Both produce a penalty. For the full discussion of how the look-back period operates, the penalty mechanics, the fair market value standard, and the legitimate exemptions, see our TennCare 5-year look-back article.

Failing to set up a Qualified Income Trust when income exceeds the cap

Tennessee is an income-cap state. An applicant whose monthly income exceeds the CHOICES cap cannot simply spend the excess. The applicant qualifies only if the excess income is routed through a properly drafted Qualified Income Trust, also called a Miller Trust, with the State of Tennessee as the remainder beneficiary up to the value of benefits paid. The QIT must be in place before the application, and the income must run through it consistently. A QIT signed but not funded does not solve the income problem.

Frequently asked questions about TennCare income and asset limits

What is the income limit for TennCare in Tennessee in 2026? For TennCare CHOICES long-term care, the 2026 single-applicant income limit is, equal to 300% of the SSI Federal Benefit Rate. The married-both-applying limit is. For other TennCare Medicaid categories, the limit is set by category as a percentage of the Federal Poverty Level, ranging from approximately 105% FPL for parents and caretakers to approximately 250% FPL for the breast and cervical cancer pathway. Confirm the current figures against the TennCare Eligibility Reference Guide.

Is Medicaid the same as TennCare in Tennessee? Yes. TennCare is the brand name for Tennessee's Medicaid program. The federal Medicaid framework at 42 USC §1396a applies, and Tennessee administers the program through the Division of TennCare and the Tennessee statute at Tenn. Code §71-5.

What is the asset limit for TennCare CHOICES? $2,000 in countable resources for a single applicant, $4,000 combined for a married couple with both spouses applying, and $2,000 for the applicant spouse plus a Community Spouse Resource Allowance of up to for the non-applicant spouse where only one spouse applies.

How much money can I have in the bank and still get TennCare? The bank balance is one part of the $2,000 countable resources limit for TennCare CHOICES. Total countable resources, including bank accounts, brokerage, CDs, retirement accounts, and cash, must sit at or below the limit on the snapshot date. The home, one vehicle, household goods, an irrevocable burial trust up to, and assets held in a properly drafted Medicaid Asset Protection Trust funded more than five years out are exempt.

What does TennCare CHOICES cover? TennCare CHOICES pays for long-term services and supports for Tennessee residents who medically and financially qualify. CHOICES Group 1 pays for nursing facility care. Group 2 pays for home and community-based services. Group 3 pays for at-risk services to delay the need for nursing home care.

What are the four types of Medicaid in Tennessee? TennCare Medicaid (standard low-income coverage), TennCare CHOICES (long-term services and supports for adults), CoverKids (children's CHIP), and Employment and Community First CHOICES (for adults with intellectual or developmental disabilities).

Is $33,000 a year considered low income in Tennessee? At the 2026 federal poverty guidelines, $33,000 is approximately the 100% FPL line for a family of four. Whether $33,000 qualifies a Tennessee household for TennCare depends on household size and category. For a family of four, $33,000 places the household at the borderline for TennCare Medicaid coverage of the children and, in some pathways, the parents.

How do I apply for Medicaid in TN? Apply online at tenncareconnect.tn.gov, by phone at, by paper application, or in person at a local Department of Human Services office. CHOICES applications typically require the Pre-Admission Evaluation to be scheduled through the MCO or the local Area Agency on Aging and Disability.

What happens if my income is over the TennCare CHOICES limit? A Qualified Income Trust, also called a Miller Trust, lets a Tennessee CHOICES applicant whose monthly income exceeds the cap still qualify. The excess income is routed through the irrevocable QIT, with the State of Tennessee named as the remainder beneficiary up to the value of benefits paid. The QIT must be drafted and funded before the application.

Why the TennCare income and asset limits reward Tennessee families who plan early

The pattern that runs through every family we have worked with at Lancaster Law is that the families who learn the income and asset limits five years before the first long-term care application preserve the most TennCare-protected assets, and the families who learn the limits the week of admission preserve less. Both groups preserve more than the families who try to figure the limits out alone. The TennCare limits are not a punishment. They are a budget. Knowing the budget, and knowing the exemptions inside it, is what lets a Tennessee family pay for long-term care without spending down everything they built.

If you are reading this in advance of a long-term care need, the highest-value next step is a thirty-minute conversation about whether a Medicaid Asset Protection Trust, a Caregiver Child plan, or a CSRA-anchored strategy fits your family's situation. If you are reading this in a TennCare crisis, the highest-value step is the same conversation, on a faster calendar. We work with Tennessee families on both timelines, and we work as an attorney-CPA practice, which means the tax consequences of every long-term care planning step are scoped at the same time as the legal structure of every TennCare transfer.

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