Is TennCare Medicaid, Medicare, or Something Else?

TennCare is Tennessee's Medicaid program, not Medicare

TennCare is the name Tennessee uses for its Medicaid program. It is state and federally funded health coverage for people with low income, not a separate program. When you hear "TennCare" in Tennessee, it means Medicaid — the two terms refer to the same coverage.

Medicare is different. Medicare is a federal program for people age 65 and older, regardless of income, and for some younger people with disabilities or end-stage renal disease. You do not apply for Medicare through TennCare. If you are under 65 and not disabled, you will not be on Medicare.

Some people are on both TennCare and Medicare at the same time. This happens when someone is 65 or older and also has low enough income to may have access to for TennCare. In that case, Medicare is primary (it pays first), and TennCare covers costs Medicare does not pay.

Key Takeaways

TennCare is Tennessee's name for Medicaid, funded by both the state and federal government.
Medicare is a separate federal program for people 65 and older or with certain disabilities, and you do not apply for it through TennCare.
You can be on both TennCare and Medicare at the same time if you meet the income and age requirements for each.
TennCare covers doctor visits, hospital stays, prescriptions, and other medical services for low-income Tennesseans.
The Tennessee Department of Human Services handles TennCare enrollment and may be able to access, not a federal Medicare office.

How TennCare coverage works

TennCare covers inpatient and outpatient hospital care, doctor visits, prescription drugs, mental health services, and emergency care. The exact services covered depend on which TennCare plan you are on — there are several options, including managed care plans run by private insurers and fee-for-service coverage run directly by the state.

You pay little or nothing out of pocket for most services. Some plans have small copays for doctor visits or prescriptions, but these are capped at amounts the state sets. If you have no income or very low income, you may pay nothing at all.

TennCare is administered by the Tennessee Department of Human Services, not by Medicare or a federal office. When you need to report a change in income, add a family member, or renew your coverage, you contact TennCare directly through their website or a local office.

Who can get TennCare

TennCare is open to Tennessee residents with income below a certain level. The income limit depends on your household size and which category you fall into. Parents and caretakers of children, pregnant people, children, and people with disabilities each have different income thresholds.

You must be a U.S. citizen or may have access to immigrant to get TennCare. You must also live in Tennessee and provide proof of residency. If you are already on Social Security, Supplemental Security Income (SSI), or Temporary Assistance for Needy Families (TANF), you may be automatically enrolled in TennCare or have an easier path to coverage.

Age alone does not make you may be able to access for TennCare. Unlike Medicare, which covers everyone 65 and older, TennCare requires low income. If you are 65 or older and your income is too high for TennCare, you would be on Medicare only.

The difference between TennCare and Medicare in practice

Medicare is a federal insurance program you pay into through payroll taxes during your working years. You become may be able to access at 65 without a means test — your income does not matter. You can also get Medicare before 65 if you have been on Social Security Disability Insurance (SSDI) for two years or have end-stage renal disease or ALS.

TennCare is a needs-based program. You must have low income to may have access to, no matter your age. It is funded by federal and state tax dollars, not by individual payroll contributions. TennCare is available to people of any age who meet the income and residency requirements.

If you turn 65 while on TennCare, you do not automatically lose coverage. Instead, you become may be able to access for Medicare, and TennCare may continue as a secondary payer to help cover costs Medicare does not pay. This is called dual coverage, and it is common in Tennessee.

How to tell which program you are on

Your insurance card will tell you which program covers you. A TennCare card will say "TennCare" and the name of your managed care plan (if you are in one), or it will identify you as a fee-for-service member. A Medicare card is red, white, and blue and has "MEDICARE" printed on it along with your Medicare number.

If you have both, you will have two separate cards. Your Medicare card is your primary insurance, meaning it processes claims first. Your TennCare card is secondary and covers what Medicare does not pay.

You can also check your coverage status by logging into your TennCare account online through the Tennessee Department of Human Services website, or by calling TennCare directly. They can tell you which plan you are on and when your coverage renews.

What happens if you lose TennCare coverage

TennCare coverage can end if your income rises above the limit, if you move out of Tennessee, or if you fail to renew when your coverage period ends. Tennessee has continuous enrollment for some groups (like children and pregnant people), meaning coverage does not end as long as you remain may be able to access. Other groups must renew their coverage periodically.

If you lose TennCare and are not yet 65, you may be able to get coverage through the federal health insurance marketplace (healthcare.gov) or through your employer. If you are 65 or older, you are automatically may be able to access for Medicare, and you should enroll if you have not already.

If you lose TennCare due to a change in income or household, you may have a special enrollment period to sign up for marketplace coverage without waiting for open enrollment. Contact TennCare or a local health department to understand your options.

Frequently Asked Questions

Can I be on TennCare and Medicare at the same time?

Yes. If you are 65 or older and have low enough income to meet TennCare's limits, you can have both. Medicare pays first, and TennCare covers costs Medicare does not pay. This is called dual coverage and is common in Tennessee.

Do I pay into TennCare like I pay into Medicare?

No. TennCare is funded by state and federal tax dollars, not by payroll contributions. You do not pay into TennCare during your working years. Medicare is funded partly by payroll taxes (FICA), which is why you become may be able to access at 65 without a means test.

What if I am 65 but my income is too high for TennCare?

You would be on Medicare only. Medicare does not have an income limit, so you are covered at 65 regardless of how much money you earn. You would not be on TennCare because TennCare requires low income.

How do I know if I should apply for TennCare or Medicare?

If you are under 65 and not disabled, you can only get Medicare if you have end-stage renal disease or ALS. Otherwise, check whether you meet TennCare's income limits. If you are 65 or older, you are automatically may be able to access for Medicare and should enroll. You may also be may be able to access for TennCare if your income is low enough.

Where do I apply for TennCare?

You apply through the Tennessee Department of Human Services, either online at their website or in person at a local office. You do not apply for TennCare through Medicare or a federal office. If you are already on SSI or TANF, you may be automatically enrolled.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.