TennCare is Tennessee's name for its Medicaid program
TennCare is Tennessee's version of Medicaid. When the federal government created Medicaid in 1965, each state was allowed to run its own program under federal rules and funding. Tennessee chose the name TennCare for its program, just as some states call theirs Medi-Cal (California) or Badgercare (Wisconsin). The coverage, may be able to access rules, and how you enroll differ from state to state, but they are all Medicaid.
If you live in Tennessee and hear someone mention TennCare, they are talking about the same program you would call Medicaid in another state. The federal government pays part of the cost; Tennessee pays the rest. Both levels of government set the rules for who can enroll and what services are covered.
Key Takeaways
- TennCare is Tennessee's Medicaid program—the state's name for the federal-state health insurance program for people with low income.
- Coverage and may be able to access rules are set by both Tennessee and the federal government, so they differ from other states' Medicaid programs.
- You enroll in TennCare through Tennessee's Division of TennCare, not through a federal office or Healthcare.gov.
- TennCare covers doctor visits, hospital care, prescription drugs, and other services, but the exact list of covered services can change by enrollment group.
How TennCare differs from Medicaid in other states
TennCare and Medicaid are the same program in name and structure, but Tennessee has made choices about income limits, covered services, and enrollment groups that are different from neighboring states. For example, Tennessee's income threshold for a single adult may differ from Kentucky's or Georgia's. The list of prescription drugs covered, the copay amounts you pay at the doctor's office, and whether dental or vision care are included can all vary.
If you moved to Tennessee from another state where you had Medicaid, your coverage will not automatically transfer. You will need to enroll in TennCare separately, and your may be able to access may change based on Tennessee's rules. The same is true if you move out of Tennessee—you would need to enroll in that state's Medicaid program.
Who runs TennCare and how to contact them
TennCare is run by the Tennessee Department of Finance and Administration, Division of TennCare. This is the state agency that processes enrollments, handles questions about coverage, and manages the program day to day. You do not apply through Healthcare.gov or a federal office; you apply directly to TennCare.
You can reach TennCare by phone at 1-800-342-3145, or you can visit their website at tn.gov/tenncare. Local health departments and community health centers in Tennessee can also help you understand your options and walk through the enrollment process.
What TennCare covers
TennCare covers the services that federal Medicaid requires all states to cover: doctor visits, hospital stays, emergency care, lab work, X-rays, and prescription drugs. Tennessee has also chosen to cover some optional services, such as dental care and vision care for certain groups, though the exact coverage depends on which TennCare enrollment group you are in.
TennCare has several enrollment groups—such as children, pregnant women, parents, and people with disabilities—and each group may have slightly different covered services. When you enroll, you will learn which services are covered under your specific group. If a service is not covered by TennCare, you are responsible for the full cost.
Income limits and may be able to access for TennCare
TennCare has different income limits depending on which group you fall into. For example, children may have a higher income limit than adults, and pregnant women may have a different threshold than parents. These limits change periodically, and they are set by Tennessee in line with federal Medicaid rules.
To find out whether your income qualifies, you can contact TennCare directly or use their online screening tool. You will also need to provide proof of Tennessee residency, citizenship or immigration status, and other documents depending on your situation. The exact documents required depend on which enrollment group you are applying to.
TennCare enrollment groups and plans
TennCare is divided into enrollment groups based on who you are—children, pregnant women, parents, elderly people, people with disabilities, and others. Within some of these groups, you may be able to choose between different managed care plans, each run by a private health insurance company. The plan you choose affects which doctors and hospitals are in your network and how much you pay when you use them.
If you are assigned to a plan automatically and do not want it, you can usually request a change. TennCare will tell you which plans are available in your area and how to switch if you want to. Some people are exempt from managed care and receive coverage directly from TennCare instead.
How TennCare is funded
TennCare receives money from both the federal government and the state of Tennessee. The federal government pays a percentage of the cost (called the Federal Medical Assistance Percentage, or FMAP), and Tennessee pays the rest. This split varies by service and by enrollment group, but the federal government always pays a significant share.
Because TennCare is jointly funded, changes to federal Medicaid law or federal funding can affect the program. Similarly, changes to Tennessee's state budget can affect TennCare. This is why coverage and may be able to access rules sometimes change from year to year.
Frequently Asked Questions
Is TennCare free?
TennCare is low-cost or free depending on your income. Most people pay nothing for coverage, but some pay a small monthly premium. When you use services, you may have a copay—a small amount you pay at the time of the visit—but copays are usually low or waived for certain services like preventive care.
Can I have TennCare and private insurance at the same time?
Yes. If you have both TennCare and private insurance (such as through an employer), TennCare becomes your secondary insurance and covers costs that your private plan does not. You must report any private insurance to TennCare when you enroll or when your situation changes.
What happens to my TennCare if I move out of Tennessee?
Your TennCare coverage ends when you move out of state. You will need to enroll in your new state's Medicaid program. Contact that state's Medicaid office as soon as you move to understand the enrollment process and any differences in coverage.
How do I renew my TennCare coverage?
TennCare requires you to renew your coverage periodically—usually once a year. TennCare will send you a notice telling you when to renew and what documents to submit. You can renew by mail, phone, or online through TennCare's website. If you do not renew by the deadline, your coverage may end.
Does TennCare cover dental and vision care?
TennCare covers dental and vision care for children and some other groups, but coverage varies by enrollment group and age. Contact TennCare or check your coverage documents to see what dental and vision services are covered under your specific group.