TennCare Income Limits 2026: Tennessee Medicaid Eligibility Guide

If you typed "TennCare income limit" into Google and got back a single number, you got bad information. TennCare (Tennessee's Medicaid program) does not have one income limit. It has at least five, and the rules for assets, the home, and a spouse's income are different in each one.

A senior who looks "over the limit" under one TennCare pathway may sail through another. A married couple where one spouse needs nursing-facility care has a totally different test than a single person on Social Security trying to fill in Medicare's gaps. A child with a complex medical condition is judged on rules that ignore most of the parents' income entirely.

This guide walks through every TennCare eligibility pathway a Tennessee senior or family caregiver is likely to encounter in 2026, Standard Aged/Blind/Disabled, CHOICES (the long-term-care pathway), ECF CHOICES (the I/DD pathway), Katie Beckett (the children's pathway), and the three Medicare Savings Programs, with the actual 2026 dollars, the asset rules, the spousal protections, and the parts most third-party calculators miss.

The 30-Second Answer: Five TennCare Income Limits

The single most important thing to understand about TennCare is that "income limit" is the wrong question. The right question is which TennCare program am I applying for, because each one runs its own income and asset test.

Here are the five pathways most Tennessee seniors and families will encounter, with the 2026 limits side by side.1,2,3,4

If your numbers are above one limit, scroll down to the next pathway. There is a non-trivial chance one of them fits.

Pathway 1: Standard ABD Medicaid (Regular TennCare for Seniors)

This is the "regular Medicaid" pathway for Tennessee seniors who are 65+, blind, or disabled, and who do not need long-term services and supports (no nursing facility, no home-care waiver). It's the lowest-income pathway and follows federal SSI rules almost word for word.1

2026 income limit: $994/month for an individual (the federal SSI Federal Benefit Rate, set by Social Security each January). For an eligible couple where both are aged/blind/disabled, the FBR is $1,491/month.1

2026 asset limit: $2,000 for an individual / $3,000 for a couple. "Assets" means countable resources, bank accounts, investments, second vehicles, second homes, and the cash value of certain life insurance. The primary home, one vehicle, household goods, burial plots, and a small burial fund are exempt.1

What §1634 means in plain English: Tennessee is one of the §1634 states, meaning Social Security and TennCare have a federal agreement under which anyone approved for SSI is automatically enrolled in TennCare Medicaid. There is no separate state application; the SSA sends the eligibility data directly to TennCare. If you're applying for SSI, you do not need to also apply for TennCare separately.

The big trap: Tennessee does not operate a medically-needy program for adults. In states like Michigan or Illinois, an adult whose income is over the SSI limit can still qualify for Medicaid by "spending down" their income on medical bills each month. Tennessee does not have that pathway for adults, medically-needy in Tennessee is restricted to children under 21 and pregnant women.

This means if you are an aged/blind/disabled adult and your income is over $994/month but you don't need long-term care, you generally cannot qualify for full TennCare Standard Medicaid.1 Your fallback is the Medicare Savings Programs (if you're on Medicare), Marketplace coverage, or an employer plan.

Two protective rules to know about:

1. Pickle Amendment. If you used to receive SSI and lost it solely because of a Title II Social Security cost-of-living adjustment that pushed you over the SSI limit, your TennCare continues under Pickle protections, even though you're not technically SSI-eligible anymore. The math: TennCare strips out the post-loss COLAs and asks "would you still be SSI-eligible if those COLAs hadn't happened?" If yes, you keep TennCare.
2. Section 1619(b). If you're a working SSI recipient whose earnings push you over the SSI break-even point, you can keep TennCare under Section 1619(b) up to a federally calculated state-specific earnings threshold. This is meant to keep people from losing health coverage when they go to work.

What Standard ABD covers: Hospital, physician, prescription, behavioral health, transportation, and comprehensive adult dental, available since January 1, 2023 and now administered by Renaissance Dental Benefits Manager (effective November 1, 2025). Routine adult vision (glasses, eye exams) is not covered under Standard ABD; vision is covered only when medically necessary or as part of LTSS member benefits.

Pathway 2: CHOICES (Tennessee's Long-Term-Care Medicaid Pathway)

CHOICES is the program that pays for nursing-facility care or in-home long-term-care services for Tennessee seniors and adults with physical disabilities. Its rules are completely different from Standard ABD.2,5

CHOICES has three Groups, separated by functional eligibility. The financial test in this section is TennCare's published standard for Groups 1 and 2 only:

• Group 1: Nursing facility care (residence in a Medicaid-certified facility). No enrollment target, so no waitlist.5
• Group 2: Home and community-based services (HCBS) at the nursing-facility level of care, in lieu of placement. The enrollment target is 12,500, and applicants who can't be enrolled at target go on a Group 2 waiting list. That target is not absolute, though: Reserve Capacity and the rule's specified exceptions can allow enrollment even when it has been reached. Group 2 also requires that the plan of care cost no more than the member's Individual Cost Neutrality Cap.5
• Group 3: "At Risk for Institutionalization", HCBS for people who don't yet meet nursing-facility level of care but who would soon without help. Enrollment is capped (a target of 1,750 for non-SSI recipients as of October 1, 2022) and annual HCBS spending is capped at $18,000, excluding minor home modifications.5 Because Group 3 applicants do not meet nursing-facility level of care, the $2,982 special income standard below, which is tied to institutional level of care, is not the Group 3 test. Ask TennCare Connect which category a Group 3 determination would run under.

CHOICES financial eligibility, 2026

What "the spouse keeps" really means

The CSRA and MMNA together are the most misunderstood parts of CHOICES eligibility. Here's the plain-English version:

CSRA (assets). When the institutionalized spouse is determined to need CHOICES, TennCare takes a snapshot of the couple's countable assets on the first day of the most recent continuous period of institutionalization. The community spouse is allowed to keep half of those assets, up to $162,660. If half of the assets is less than $32,532, the community spouse keeps a $32,532 minimum.2 Anything above the CSRA max must be spent down (or, more typically, restructured through legitimate planning) before the institutionalized spouse can qualify.

MMNA (income). When CHOICES starts paying, the institutionalized spouse's income is mostly redirected to their cost of care. But TennCare lets them divert some of that income to the community spouse if the community spouse's own income is below the MMNA. For 2026, the most a community spouse can keep this way is $4,066.50/month; the income the institutionalized spouse diverts brings the community spouse up toward that cap before any of it goes to the nursing facility.2

These protections exist because Congress recognized in the 1988 spousal-impoverishment law (Medicare Catastrophic Coverage Act, P.L. 100-360, codified at 42 USC § 1396r-5) that nursing-facility care should not bankrupt the spouse who stays at home. The numbers re-index every July 1 based on CMS's Spousal Impoverishment Standards. For the full Tennessee playbook, including the snapshot date, the Income-First rule, TennCare's Single Fixed Annuity model under ABD Manual § 125.015, Hughes v. McCarthy 6th Circuit precedent, fair hearings under Tenn. Comp. R. & Regs. 1200-13-19, and four worked examples, read Tennessee Spousal Impoverishment Rules: 2026 CSRA, MMMNA, and the Community Spouse Toolkit.

The QIT (Qualified Income Trust)

Tennessee is an "income-cap state" for CHOICES, meaning if your income is even one dollar over $2,982/month, you fail the income test.2 You do not qualify by spending down, Tennessee does not have a medically-needy program for adults.

The fix is the Qualified Income Trust (QIT), sometimes called a Miller Trust in other states. (Authority: 42 USC § 1396p(d)(4)(B) federally; Tenn. Comp. R. & Regs. 1240-03-03-.03(8) and the TennCare ABD Eligibility Manual "Trusts" chapter at the state level, Tennessee has no stand-alone QIT statute.) Here is how a QIT works month to month:

The QIT does not "protect" the income, it just makes it not count for the eligibility test. The money still flows to the facility. But without the QIT, an applicant whose income is over the $2,982/month cap would be denied entirely.2 With it, they qualify and Medicaid pays the gap.

The 60-month look-back

Any uncompensated transfer in the 5 years preceding application, gifting a grandchild $20,000 for college, signing a house over to an adult child for $1, paying a daughter "under the table" for caregiving, is presumed to be a disqualifying gift. The federal authority is 42 USC § 1396p(c) as amended by DRA-2005 (P.L. 109-171); TN's binding rule is at Tenn. Comp. R. & Regs. 1240-03-03-.03 with operational guidance at TennCare ABD Manual § 125.010.7

The 2026 penalty divisor is $295.87/day (TennCare ABD Eligibility Policy Manual 125.010, dated January 5, 2026).7 So if a parent gifted $50,000 to a child four years before applying for CHOICES, the penalty is roughly $50,000 ÷ $295.87 = 169 days of ineligibility. Critical: under DRA-2005 the penalty does NOT start on the gift date, it starts on the LATER of the gift date or the date the parent is otherwise eligible AND in a nursing facility AND would be receiving Medicaid but for the penalty.

There are legitimate exceptions (transfers between spouses, transfers to a blind or disabled child, certain caregiver-child residence transfers, and sole-benefit trusts) and legitimate planning structures (compliant annuities, promissory notes, personal services contracts at fair market value, and undue-hardship waivers). But anything you do inside the 60-month window without an attorney's review is risky. If CHOICES is on the horizon for a family member, do not gift assets without consulting an elder-law attorney first. For the complete TN-specific framework, exempt-transfer mechanics, and worked penalty calculations, see Tennessee's 5-Year Lookback and Penalty Divisor complete guide.

Pathway 3: ECF CHOICES (the I/DD Long-Term-Care Pathway)

ECF CHOICES is Tennessee's HCBS program for people with intellectual or developmental disabilities. It is administered through the Department of Disability and Aging (DDA), not the standard CHOICES intake, so the application path is different even though TennCare still pays.3

Disability requirement: I/DD diagnosis as defined by Tenn. Comp. R. & Regs. 1200-13-01-.02, intellectual disability beginning before age 18 or developmental disability beginning before age 22.

Five Groups, with different financial standards:3,1

• Group 4 (children under 21, NF LOC or At Risk): SSI ($994/month) for SSI-eligible applicants; or the ECF "217-Like" Group at $2,982/month for institutional-LOC-equivalent applicants.3
• Group 5 (adults 21+, At Risk for Institutionalization): an interim "At Risk" Group with its own income standard and a $2,000 resource limit.3
• Group 6 (adults 21+, NF LOC): 217-Like Group at $2,982/month, $2,000 resources.3
• Group 7 / Group 8 (children/adults with severe behavior-support needs at the institutional level): 217-Like Group at $2,982/month.3
• A Working Disabled track also exists across categories so that people with disabilities can work without losing Medicaid; its exact 2026 income threshold is set by TennCare and should be confirmed with the DDA at application.

For 217-Like Group applicants, the income standard is 300% of the SSI Federal Benefit Rate, or $2,982/month in 2026.3 The 60-month look-back applies, and the QIT mechanism is available for applicants over the 217-Like income limit.

The age question. ECF CHOICES is for people whose qualifying I/DD condition began before age 18 (intellectual disability) or 22 (developmental). It is not the right pathway for someone who develops a cognitive condition late in life, that person belongs in regular CHOICES.

Pathway 4: Katie Beckett (the Children's Pathway)

Katie Beckett is Tennessee's small but important pathway for children under 18 whose medical needs are likely to last at least 12 months (or result in death) and produce severe functional limitations, and who are not Medicaid-eligible because of their parents' income or assets.3

The whole point of Katie Beckett Part A is the "deeming exception": for a child who meets an institutional level of care but is cared for at home, Part A provides full Medicaid eligibility by waiving the deeming of the parents' income and assets to the child, so only the child's own income and resources are looked at.3 That waiver is a Part A feature. Part B children are not enrolled in Medicaid, so it does not apply to them.8

Application path: Self-referral through TennCare Connect at tenncareconnect.tn.gov. There is a medical part and a financial part, and both are started at the same time, but the financial process cannot be completed until the medical eligibility determination is finished. TennCare handles financial eligibility; the Department of Disability and Aging (DDA) handles medical eligibility, making the Part B level-of-care determination itself and referring the child on to Ascend, which makes the Part A level-of-care determination.3

Important sequencing rule: Applicants must apply for and be determined eligible for Part B before being considered for Part A. This trips up families who assume Part A is the "first-line" option.3

Pathway 5: Medicare Savings Programs (the Most Underutilized Door)

If a Tennessee senior is on Medicare, has income too high for Standard ABD ($994/month) or CHOICES ($2,982/month), and doesn't need long-term care, the Medicare Savings Programs are usually the right place to look. These are TennCare-administered programs that pay for Medicare premiums (Part B = $202.90/month in 2026, an annual savings of $2,434.80) and, in QMB's case, all Medicare cost-sharing including the Part A inpatient hospital deductible ($1,736), Part B annual deductible ($283), Part A coinsurance days 61–90 ($434/day), and SNF coinsurance days 21–100 ($217/day). For the federal and TennCare authority, the income disregards, and worked examples, see the Tennessee Medicare Savings Programs deep guide.4,1,2

The income brackets are tied to the Federal Poverty Level, and the resource limit ($9,950 for an individual in 2026) is roughly five times higher than the asset limit for Standard ABD or CHOICES.4 Many Tennessee seniors who think they're "too rich" for Medicaid actually qualify for one of these.

Note: a standard monthly unearned-income disregard applies to all three brackets, so the practical income test runs slightly higher than the raw FPL number.

Three underused features of the MSPs:

1. Automatic Part D Extra Help. QMB, SLMB, and QI enrollees are automatically enrolled in the Part D Low-Income Subsidy (LIS), also called Extra Help, under 42 USC § 1395w-114(a)(3)(B), which sharply lowers Part D drug-plan premiums, deductibles, and copays. You do not have to file a separate application for it.
2. QMB billing protection. Under 42 USC § 1396a(n)(3)(B), Medicare providers may not bill QMB-enrolled patients for any Medicare deductible, coinsurance, or copayment, whether Original Medicare or a Medicare Advantage plan, whether Medicaid-enrolled or not. If you're on QMB and a provider sends you a bill, the bill is illegal. Call 1-800-MEDICARE and the Tennessee State Health Insurance Assistance Program (SHIP), free statewide counseling run by the Department of Disability and Aging, at 1-877-801-0044 or dda.ship@tn.gov.10
3. Part B Special Enrollment Period. Per the Consolidated Appropriations Act of 2021 and 87 Fed. Reg. 66454, an individual newly determined eligible for an MSP who never previously enrolled in Part B is granted a Part B SEP, they can enroll without late-enrollment penalty. The MSP determination itself opens the door.

Application path. Same as any TennCare application, TennCare Connect online (tenncareconnect.tn.gov), by phone (1-855-259-0701), or through Social Security on Form SSA-1020 (which forwards MSP applications to TennCare under 42 USC § 1320b-14). The standard TennCare application captures MSP eligibility automatically; there is no separate paper MSP application in Tennessee. The full intake walkthrough, including paper application address P.O. Box 305240 Nashville, fax 1-855-315-0669, electronic asset checks under the 2024 CMS streamlining final rule, the 45-day determination clock, and the no-retroactive QMB rule under 42 USC § 1396a(e)(8), is in the Tennessee Medicare Savings Programs deep guide.4

What About a Working-Age Adult Under 65? Tennessee's Coverage Gap

Every pathway above assumes you are 65 or older, disabled, a child, or already on Medicare. But many people who search "Tennessee Medicaid income limit" are none of those, a 61-year-old who retired early, lost a job, or left work to care for a spouse, still several years short of Medicare. For that reader, the honest answer is the hardest one on this page.

In the 41 states (including Washington, D.C.) that adopted the Affordable Care Act's Medicaid expansion, a non-disabled adult under 65 can get full Medicaid up to 138% of the federal poverty level, about $1,835 a month or roughly $22,000 a year for one person in 2026, with no asset test and no income disregards.11,12 Tennessee is not one of them. Tennessee is one of ten states that did not adopt the expansion, so this "new adult group" pathway does not exist in TennCare at all.13

The result is what policy analysts call the coverage gap. A non-disabled, non-elderly adult without dependent children generally cannot get full TennCare on income alone here, no matter how low that income is, and in nine of the ten non-expansion states, Tennessee among them, an adult below the federal poverty line ($15,960 a year for one person in 2026) earns too much for Medicaid but too little to qualify for Marketplace premium subsidies.13,12

So where does that leave you? Three realities:

1. The Marketplace is the realistic fallback, and it works better above the poverty line. If your income is at or above 100% FPL, you almost certainly qualify for subsidized Marketplace coverage at HealthCare.gov, often for a very low or $0 premium. If your income is below the poverty line, you're in the gap: apply for TennCare anyway (only the agency can rule you out), then price a Marketplace plan.
2. A MAGI door still exists if you're a parent or caretaker relative, but it's narrow. The one adult TennCare pathway that survives in a non-expansion state is for parents and caretaker relatives of a dependent child, and its income cutoff is a frozen 1996 welfare standard far below the poverty line, not 138% FPL. If you do reach TennCare through a MAGI-based group, that test counts your Social Security benefit in full, including any non-taxable portion that never appears on your tax return, so a "$0 taxable income" reading does not mean $0 for Medicaid.14
3. Disability, or age 65, changes the question. If you are found disabled, you move onto the Standard ABD pathway (Pathway 1) at the $994/month SSI limit. And when you turn 65, or reach Medicare through disability earlier, the MAGI/new-adult-group route closes and you are assessed on the aged, blind, and disabled track instead, measured against the SSI benefit rate of $994 a month, with an asset test that the MAGI groups never face.15,16,11 Nothing about your income has to change for your answer to flip on your 65th birthday.

The takeaway: if you are a working-age Tennessean under 65 without a disability determination, TennCare is usually not your door, HealthCare.gov is. But apply for TennCare anyway before you assume you're out, and re-check the moment you qualify on the basis of disability or age.

How TennCare Counts "Income" and "Assets"

The dollar limits above are only useful if you understand what counts toward them. Two quick reference accordions:

Why TennCare Income Limits Don't Allow Adult Spend-Down

Online articles often say "you can spend down to qualify for Medicaid." That advice is wrong for Tennessee adults.

In states with a "medically needy" program (like Michigan, Illinois, or several northeast states), an applicant whose income is over the SSI limit can qualify for Medicaid each month by deducting medical bills from their countable income, a sort of monthly recalculation. Tennessee does not have that program for adults.

Tennessee's medically-needy category exists, but it is restricted to children under 21 and pregnant women only. For Aged/Blind/Disabled adults, the choices are:1,2,4

1. Standard ABD: Income at or below SSI ($994/month) → qualify.1
2. CHOICES: Need long-term care, income up to $2,982/month → qualify (use a QIT if over).2
3. Medicare Savings Programs: On Medicare, income up to $1,816/month and countable resources under $9,950 (individual) → premium assistance. Read the top bracket carefully: QI is paid from a capped annual federal allotment, states approve it first-come first-served with priority to last year's enrollees, you must reapply every year, and it is not open to anyone already enrolled in TennCare Medicaid or TennCare Standard.4
4. None of the above: Look to the Marketplace, employer coverage, or Medicare on its own.

There is no monthly-recalculation spend-down for adults in Tennessee. Don't let an out-of-state web article (or an out-of-state relative) tell you otherwise.

What to Do If You're Denied

A TennCare denial is not the end of the road. Most denials fall into one of three categories, each with a different fix:

1. Wrong category. Common scenario: a senior who needs nursing-facility care applies for Standard ABD, gets denied for being over the SSI income limit, and is told "you make too much for Medicaid." The fix is to apply for CHOICES, which has a $2,982/month limit, not $994.
2. Income over the CHOICES cap. Fix is to set up a Qualified Income Trust through an attorney, deposit the excess income into the trust each month, and re-apply.
3. Asset issue. Often a misclassified asset (e.g., the eligibility worker counted a vehicle that should have been exempt, or counted retirement-account principal that wasn't yet accessible). Fix is the appeal process. Eligibility-denial appeals are filed through TennCare Connect; medical/service-denial appeals go to TennCare Member Medical Appeals (TMMA) at 1-800-878-3192. The medical-appeal window is 60 days after you find out there is a problem.17

Always apply, even if you think you're over the limit. The application is free; TennCare Connect won't charge you, and a "no" only costs the time it took to fill out the application. Many families assume they're disqualified, never apply, and miss benefits they were entitled to.

Bottom Line

TennCare income limits are not a single number, and the answer for your family depends on which pathway fits your situation. Walk through the five pathways above with your actual numbers in hand:1,2,4

1. Below $994/month income, under $2,000 in assets, no long-term care needed? Apply for Standard ABD.1
2. Need nursing-facility-level care, income under $2,982/month? Apply for CHOICES.2
3. Need nursing-facility-level care, income over $2,982/month? Talk to an elder-law attorney about a QIT, then apply for CHOICES.
4. Have an I/DD diagnosis? Apply through DDA for ECF CHOICES.
5. Child under 18 with a significant disability and family income over the regular limits? Apply for Katie Beckett through TennCare Connect.
6. On Medicare with income under $1,816/month and countable resources under $9,950? Apply for QMB, SLMB, or QI.4

When in doubt, apply. The application is free. The worst outcome is a "no" that gives you a written reason, and that reason often points directly at the right pathway you should have applied for instead.

Learn More

Find personalized help walking through TennCare eligibility for your family at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.