Ignoring a renewal packet can make families lose TennCare, Tennessee's Medicaid coverage, even when they still qualify. Federal law (42 CFR 435.916) requires the state to try an automatic renewal from data it already holds before it asks you for a single document, but when a packet does reach you, it has to come back on time.

Renew online at TennCare Connect · Call TennCare Connect: 1-855-259-0701

In This Guide

Renewal is the most consequential moment in a Medicaid beneficiary's year. Eligibility is set once at initial application, then redetermined every 12 months under the standard Medicaid renewal cycle. Most procedural closures hit people who remained eligible and simply did not return the packet in time, the exact case the 90-day reconsideration window below is built to fix.

TennCare covers roughly 1.4 million Tennesseans and runs as a division of the Tennessee Department of Finance and Administration under the TennCare III Section 1115 demonstration, approved through December 31, 2030.

The Tennessee Medicaid renewal and recertification cycle

TennCare redetermines eligibility for most members once every 12 months, the standard renewal cycle. Your renewal month is fixed at approval and recurs in that same calendar month every year, so an October approval renews every October. TennCare calls this yearly step "re-enrollment," and you complete it through the same TennCare Connect portal you used to apply.

Renewals split into two paths by eligibility category:

  • MAGI populations (children, pregnant women, and parent/caretaker relatives): renewed using Modified Adjusted Gross Income methodology. Tennessee has not adopted ACA Medicaid expansion, so there is no expansion-adult group; adult TennCare runs through the traditional categories (parents and caretaker relatives, pregnant women, and Aged, Blind and Disabled), including the CHOICES and Katie Beckett long-term-care pathways.
  • Non-MAGI populations (Aged, Blind, and Disabled adults on SSI rules, CHOICES long-term services and supports, and Medicare Savings Programs): renewed under a framework with an asset test. Federal law requires every state to verify assets at renewal through an Asset Verification System (Section 1940 of the Social Security Act), so non-MAGI renewals clear automatically less often than MAGI renewals and usually require bank statements, retirement-account statements, life-insurance documentation, and a signed AVS authorization.

Ex parte Tennessee Medicaid renewal: the federal mandate

The single most important rule in modern Medicaid renewal is the ex parte default at 42 CFR 435.916(b)(1). Before TennCare asks you for any information at renewal, it must make a redetermination without requiring information from you whenever it can do so from reliable information already in your account or otherwise available to the agency, including electronic data sources. Only when it cannot renew on that basis may it request information from you.

In Tennessee, ex parte renewal pulls from Social Security Administration earnings, retirement, disability, and Supplemental Security Income records, IRS tax data, state wage and unemployment records, SNAP and other benefit records, Medicare entitlement data, and documentation from your prior renewal cycle. If those sources confirm you remain within your category's income threshold and your household has not changed, the renewal is automatic: TennCare sends you a notice of the determination and its basis, and you need not return it unless something on it is wrong.

When ex parte fails, TennCare must send a renewal form and give you at least 30 days from the date of the form (42 CFR 435.916(a)(3)) to respond, supply any missing information, and sign. That duty, and the 90-day reconsideration window below, cover eligibility based on modified adjusted gross income (MAGI). If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, Tennessee may follow the same procedures but is not required to, so ask TennCare what deadlines apply to you. It most often fails for income that does not appear in wage databases (self-employment, gig, cash, or seasonal work), the asset-verification gap on ABD and CHOICES cases, and household changes such as a new baby, a move, marriage, or divorce. Because Tennessee is a Section 1634 state, one group skips the packet entirely: SSI recipients are enrolled automatically, so SSA's own SSI redetermination drives their Medicaid renewal. And if SSI payments stop, TennCare must review you for every other eligibility category before it can end your coverage.

How to renew TennCare, your Tennessee Medicaid coverage

Under 42 CFR 435.916, a renewal may go in through any mode of application the agency offers, and no in-person interview may be required. In Tennessee that means online, phone, mail, fax, or assisted help, with TennCare Connect online the fastest.

Channel Where it goes Notes
Online tenncareconnect.tn.gov Fastest, document upload, status tracking, yearly re-enrollment, recommended
Phone TennCare Connect 1-855-259-0701 (TN Relay 800-848-0298) Telephonic signature accepted
Mail TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240 Allow processing time after receipt
Fax 1-855-315-0669 Keep the confirmation page
In person / assisted Local Tennessee Department of Health offices; AAAD network (1-866-836-6678) for long-term care DDA at 1-800-535-9725 for I/DD services

TennCare Connect is the state's self-service portal and the primary renewal channel. If you already have an account from your initial application, use it; if not, create one using any TennCare notice.

The 90-day TennCare reconsideration window

If your coverage closed because you missed the renewal paperwork, you usually do not have to start over.

Under 42 CFR 435.916, if you lose Medicaid for failure to return the renewal form (a procedural termination, not an eligibility-based one), the agency must reconsider your eligibility and treat the late-returned form as the renewal if you submit it within 90 days of the termination, without requiring a new application (required for MAGI-based coverage; a state option otherwise). If you are found still eligible, your coverage is restored.

The 90-day clock starts on the termination date, not the notice date, so read your closure notice carefully.

To activate the window, submit the renewal form through any channel above. If you no longer have it, log in to TennCare Connect or call 1-855-259-0701 to request a new one, and note the closure date so your case is routed correctly.

Children's 12-month continuous eligibility

Section 5112 of the Consolidated Appropriations Act, 2023 requires every state to give children under age 19 enrolled in Medicaid or CHIP (CoverKids in Tennessee) 12 months of continuous eligibility from the date of enrollment, effective January 1, 2024.

Once a child is enrolled, coverage is locked in for 12 months regardless of changes in family income. If a parent loses TennCare mid-year because household income rose, the children stay covered until the next annual renewal. Limited exceptions allow mid-year termination: the child turns 19, moves out of Tennessee, or reaches the end of the 12-month continuous-eligibility period. Report an income increase anyway.

Pregnant women and 12-month postpartum coverage

Tennessee covers pregnant members and extends coverage for at least 12 months postpartum, using the permanent state option created by the American Rescue Plan Act and made permanent by the Consolidated Appropriations Act, 2023. Presumptive (prenatal) eligibility runs through county health departments, where self-attestation is accepted for immediate interim coverage up to 250% of the Federal Poverty Level; the mandatory pregnancy category reaches 195% FPL, with the band above it covered under TennCare III flexibilities. Postpartum coverage continues regardless of income, and the annual renewal cycle resumes afterward.

Long-term care and CHOICES renewals: two reviews at once

If you receive TennCare long-term services and supports through CHOICES (nursing facility or home and community based services), your renewal has two independent components, both of which must stay current.

Financial redetermination

Conducted on the annual 12-month cycle, this review includes the asset test federal law requires the state to run through the Asset Verification System. In 2026, TennCare CHOICES checks income and assets against a resource limit of $2,000 for an individual or $3,000 for a couple where both spouses apply, and requires a signed AVS authorization. Three Tennessee-specific figures drive the rest of the budget:

  • Income cap. Tennessee is an income-cap state: an applicant whose gross monthly income exceeds the Medicaid Income Cap of $2,982 (300% of the 2026 SSI federal benefit rate of $994) must route the excess through a Qualified Income Trust (Miller Trust), and that trust must keep functioning at renewal.
  • Patient liability. The post-eligibility budget subtracts a Personal Needs Allowance before the rest of your income goes to the cost of care, and the size of that allowance depends on where you live. The $70 per month figure is the allowance for a resident of a nursing facility or an ICF/IID. A CHOICES member receiving HCBS at home keeps far more: the allowance for HCBS enrollees is 300% of the SSI federal benefit rate, or $2,982 in 2026, the same figure as the income cap.
  • Spousal impoverishment. If you are married, the community spouse keeps half the couple's combined countable resources, floored at $32,532 and capped at $162,660 in 2026. It is half, not the maximum automatically. The community spouse also has an income floor of $2,705 per month.

Level of care reassessment

Separately, a Pre-Admission Evaluation (PAE) confirms you still meet nursing-facility level of care; your MCO Care Coordinator manages it for CHOICES members. CHOICES has three groups. Group 1 (nursing-facility care) is not subject to an enrollment target, so no waiting list applies to it. Group 2 (HCBS for people who meet nursing-facility level of care) runs under a statewide enrollment target of 12,500; once that target is reached, qualified applicants go on a waiting list unless they meet the rule's reserve-capacity or exception criteria. Group 3 (people at risk for institutionalization who do not meet that level of care) carries a target of 1,750 for non-SSI recipients and an annual HCBS expenditure cap of $18,000. You can pass one review and fail the other. If level of care is not approved, CHOICES ends, but you may continue on standard TennCare for non-LTSS coverage if otherwise eligible.

Returned mail and your MCO

The federal rule that required an agency to search for a new address before acting on returned mail, 42 CFR 435.919, was removed effective July 31, 2026. Federal law now says only that the agency may act without advance notice when your whereabouts are unknown (42 CFR 431.213(d)), and that coverage must be reinstated if your whereabouts become known while you are still eligible (42 CFR 431.231(d)). Tennessee may still have its own procedures, so if your packet came back as undeliverable, call TennCare at 1-855-259-0701 and ask where your case stands.

Your MCO matters at renewal too. In TennCare's Managed Care Program Annual Report for calendar year 2024 (submitted June 2025), BlueCare held 37.7% of statewide Medicaid enrollment, with Wellpoint and UnitedHealthcare Community Plan each at 29.9%; a fourth plan, TennCare Select, held 2.5% and serves special populations. Wellpoint is the plan formerly known as Amerigroup, so older mail naming "Amerigroup" means Wellpoint.

To avoid a returned-mail closure, update your address in TennCare Connect (or by calling 1-855-259-0701) after a move, update it with your MCO as well, and file a USPS change-of-address form.

What goes wrong: two renewal scenarios

The cases below are illustrative composites, not real individuals.

Renewal scenarios worked end to end

Ex parte success: a MAGI parent household?

A parent with two children and steady W-2 wages has an October renewal. TennCare runs ex parte in August; SSA and wage data confirm the household and income, and all three stay MAGI-eligible. A September notice renews coverage for 12 months with no action required.

90-day reconsideration: a member who moved?

A member moves in August; the packet goes to the old address and is returned, and coverage closes at the end of October. When a pharmacy rejects the card in mid-November, she calls TennCare Connect and submits the form in December, within 90 days of the closure. TennCare reinstates coverage without a new application.

Procedural vs eligibility-based termination

This distinction determines whether you have a 90-day reconsideration window under 42 CFR 435.916 or whether you must file a new application.

Termination type Definition Reconsideration available?
Procedural Failure to return the renewal form, missing signature, no documentation, or no response to a request for information Yes, 90 days from the termination date
Eligibility-based TennCare determined you no longer meet income, residency, citizenship, age, disability, or other categorical criteria No, you must file a new application

Read the stated reason on your termination notice: "failure to provide requested information" signals a procedural closure; a reference to income, an asset limit, or a categorical change means your remedy is a new application or an appeal.

Appeal rights when TennCare ends your coverage

If your renewal is denied or coverage terminated, you have a federal right to a fair hearing under Section 1902(a)(3) of the Social Security Act and 42 CFR 431.220. The 90 days in 42 CFR 431.221(d) is a ceiling on the window a state may allow, not a floor you are owed. A renewal denial or termination puts you on TennCare's eligibility track. An appeal filed within 40 days of a termination or denial notice is timely, a medical (service) appeal runs 60 days from when you find out there is a problem, and continuation of benefits is a separate, earlier clock at 20 days. Work to the date printed on your own notice, and call TennCare Connect at 1-855-259-0701 if it is unclear. Tennessee's published numbers are far shorter than 90 days, so do not plan around the federal one.

Tennessee adjudicates its own fair hearings internally, with an Administrative Judge rendering the final decision, and runs two tracks:

  • Eligibility appeal (a denial, a coverage ending, an income or family-size error, or a delayed decision): filed with TennCare Connect at 1-855-259-0701, online, or by mail to the Eligibility Appeals Unit, P.O. Box 23650, Nashville, TN 37202-3650, by the date printed on your notice. A member who has waited more than 45 days for a standard decision, or 90 days on a long-term-care application, can request a delayed hearing.
  • Medical (service) appeal (a denied, reduced, or terminated covered service, including a CHOICES service): filed with TennCare Member Medical Appeals at 1-800-878-3192, by mail, fax, or online. You have 60 days to appeal after learning of the problem, and it is usually decided within 90 days.

Continuation of benefits (aid paid pending). Federal law continues your Medicaid during an appeal only if you request the hearing before the action takes effect; if TennCare's action is later upheld, the agency may recoup the cost of services furnished solely by reason of that continuation. In Tennessee, benefits continue if you file within 20 days of the notice (or before the coverage end date, if later), pending the Administrative Judge's decision.

Special populations and renewal nuances

Medicare Savings Programs

Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualifying Individual (QI), and Qualified Disabled and Working Individual (QDWI) eligibility is redetermined on the same 12-month non-MAGI cycle, with an ex parte attempt first, which works well because Social Security and SSDI income sits in the federal data hub. See Tennessee Medicare Savings Programs for specifics.

Refugees and qualified immigrants

When the agency cannot promptly verify a declared citizenship or immigration status, federal law (42 CFR 435.956) requires a reasonable opportunity period, generally ending the earlier of verification or 90 days, during which it may not delay, deny, reduce, or terminate benefits for someone it otherwise finds eligible.

What changes after 2026: the move toward 6-month renewals

The COVID-19 continuous-enrollment requirement ended in 2023, and the unwinding redeterminations ran through 2024.

Section 71107 of the 2025 budget-reconciliation law (H.R.1, Public Law 119-21) requires states to redetermine eligibility once every 6 months, rather than every 12 months, for the ACA expansion-adult population, for renewals scheduled on or after January 1, 2027. Because TennCare III covers no expansion-adult group, the 6-month cadence currently reaches essentially none of TennCare's roughly 1.4 million members.

The same law also shortens retroactive eligibility for applications filed on or after January 1, 2027, to two months before the application month for most enrollees, down from the three-month federal default.

In Tennessee there is almost nothing left to shorten. TennCare III waives Section 1902(a)(34) and 42 CFR 435.915 outright, except for pregnant women (plus 60 days postpartum), infants under one, and individuals under 21. Aged, blind and disabled applicants and every CHOICES and ECF CHOICES group get nothing before the filing date. So the filing date is what your family is protecting: file the day a nursing-home stay begins, not after the first bill arrives.

Common Tennessee Medicaid renewal mistakes

  1. Ignoring the renewal packet because the envelope looks like junk mail. Ex parte succeeds for only a portion of renewals; the rest require the manual packet, returned by the deadline printed on it.
  2. Updating your address with Social Security or one MCO but not with TennCare. Do not assume an address change filed with SSA or your MCO reaches TennCare; update it directly through TennCare Connect and your MCO.
  3. Not knowing the 90-day reconsideration window exists. A procedural closure gives you 90 days to return the renewal form without reapplying (required for MAGI-based coverage; a state option otherwise).
  4. Missing the AVS signature for an ABD or CHOICES renewal. Without your signed authorization, TennCare cannot run the required asset check and the renewal stalls.
  5. Letting the Qualified Income Trust lapse. If your income exceeds the income cap, the QIT must keep functioning at every renewal, not just at initial approval.
  6. Waiting too long to protect benefits during an appeal. Continuation of benefits must be requested within 20 days of the notice, earlier than the 40 days that keep an appeal timely.

Frequently Asked Questions

How often do I have to renew TennCare?

Once every 12 months for most members. Your renewal month is the same each year and is tied to your initial approval date. The 6-month cadence in the 2025 federal law applies only to ACA expansion adults, a group Tennessee does not cover.

What happens if I miss my TennCare renewal deadline?

Your coverage closes at the end of your renewal month. If the closure was procedural, you have a 90-day reconsideration window to submit the renewal form and have your eligibility reconsidered without filing a new application (required for MAGI-based coverage; a state option otherwise). If you miss the 90-day window, you must file a new application through TennCare Connect.

Where do I submit my TennCare renewal?

The fastest method is online at tenncareconnect.tn.gov. You can also call 1-855-259-0701, mail the form to TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240, or fax it to 1-855-315-0669. Online submission gives you document upload and status tracking.

My child is on TennCare. If my income goes up mid-year, does my child lose coverage?

No. Under federal continuous-eligibility rules effective January 1, 2024, children under 19 have 12 months of continuous eligibility from the date of enrollment. Your child keeps TennCare until the next annual renewal even if your income rises. Exceptions: turning 19, moving out of Tennessee, or reaching the end of the 12-month period.

Why does my ABD or CHOICES renewal need bank statements?

ABD and long-term-care Medicaid have an asset limit, and federal law (Section 1940 of the Social Security Act) requires the state to verify your assets at renewal through an Asset Verification System, which automated income data cannot do on its own. TennCare reviews recent bank statements, retirement accounts, and life-insurance documentation, and the AVS needs your signed authorization.

Can I appeal if my TennCare renewal is denied?

Yes, and faster than the federal 90-day ceiling suggests, which is the most a state may allow rather than time you are owed. A renewal denial puts you on Tennessee's eligibility track: an appeal filed within 40 days of the notice is timely, and continuation of benefits must be requested within 20 days. File with TennCare Connect at 1-855-259-0701 or by mail to the Eligibility Appeals Unit, P.O. Box 23650, Nashville, TN 37202-3650, by the date on your notice. A denied service is instead a medical (service) appeal, 60 days from when you find out, through Member Medical Appeals at 1-800-878-3192.

Tennessee Medicaid renewal: contacts and resources

These offices handle renewals, reinstatements, and appeals.

TennCare Connect Renew online, upload documents, update your address, check case status, and file an eligibility appeal. 1-855-259-0701 tenncareconnect.tn.gov
TennCare Member Medical Appeals Appeals of a denied, reduced, or terminated covered service. 1-800-878-3192
Area Agencies on Aging and Disability (AAAD) Local intake and help for older adults and long-term-care applicants. 1-866-836-6678
Department of Disability and Aging (DDA) Intake for ECF CHOICES, Katie Beckett, and I/DD services. 1-800-535-9725
MCO member services Update your address with your plan: BlueCare 1-800-468-9698, UnitedHealthcare Community Plan 1-800-690-1606, Wellpoint 833-731-2153.

If you are unsure whether your renewal has been processed, log in to TennCare Connect and check your case status, or call 1-855-259-0701., To confirm you remain eligible, see Tennessee Medicaid eligibility and income limits, how to apply for TennCare, the Tennessee Medicaid hub, and the national Medicaid hub.

Learn More

MedicaidHow to apply for TennCareHow to apply for TennCare in 2026: TennCare Connect, paper applications, documents to gather, processing timelines, the CHOICES PAE, and appeals. MedicaidTennessee Medicaid eligibility and income limitsThere is no single TennCare income limit. Tennessee Medicaid uses five separate tests (ABD, CHOICES, ECF CHOICES, Katie Beckett, MSPs). 2026 numbers inside. MedicaidTennessee Medicaid appeals and fair hearingsHow to appeal a Tennessee Medicaid (TennCare) denial: the two TennCare appeal tracks, the 20-day clock that keeps your benefits on, and where to file. MedicaidTennCare CHOICESTennCare CHOICES is Tennessee's Medicaid program for adults needing nursing-home-level care. Three groups, a Group 2 waitlist, 2026 eligibility inside. MedicaidTennessee Medicaid managed care plansA 2026 plain-language comparison of Tennessee's three TennCare MCOs, BlueCare, UnitedHealthcare Community Plan, and Wellpoint, plus how to switch plans. MedicaidTennessee Medicare Savings ProgramsTennessee Medicare Savings Programs in 2026: QMB, SLMB, and QI income limits, the Part B premium savings, Part D Extra Help, and how to apply through TennCare.

Find personalized help navigating your Tennessee Medicaid renewal 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.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.