Medicaid is a program that helps low-income individuals pay for healthcare. In Tennessee, it’s called TennCare.
It covers doctor visits, hospital stays, prescriptions, and other medical expenses. For families in 2025, it’s a big help as health care costs keep going up.
Understanding income limits is key because they decide who gets covered. These limits change each year based on federal poverty levels. If your income is too high, you might not qualify.
How Medicaid Works in Tennessee
Tennessee’s Medicaid program is TennCare. It’s managed by the Tennessee Department of Finance & Administration.
TennCare covers children, pregnant women, parents and caregivers, seniors, people with disabilities, and medically needy individuals. It helps with everyday health needs and long-term care.
For 2025, federal poverty levels (FPL) set the base. The FPL is $15,650 a year for one person, with $5,500 added for each extra family member.
Tennessee has not expanded Medicaid for all low-income adults, so coverage is limited to specific groups. Income limits update yearly to match living costs and federal rules.
Tennessee Medicaid Income Limits 2025
Tennessee uses modified adjusted gross income (MAGI) for most groups. This is your tax income minus some deductions like child care. Gross income is your total before any subtractions.
Household size counts you, your spouse, and dependents. For pregnant women, add the unborn child. Countable income includes wages and interest.
For seniors and disabled, rules differ and tie to SSI levels. Limits are strict for parents but higher for kids and pregnant women.
Tennessee Medicaid Income Limits 2025 (Monthly Income)
| Group | Income Limit (% FPL) | Notes |
| Children (0–18) | Up to 195% | Higher for CHIP up to 250% if over Medicaid. |
| Pregnant Women | Up to 195% | Covers prenatal and postpartum care. |
| Parents/Caretaker Relatives | Up to 101% | For families with kids under 19. |
| Adults (No Expansion) | Not Available | No coverage for childless adults unless disabled. |
| Seniors & Disabled (ABD) | $967 (SSI level) | Spend-down if over; assets count. |
Income Limits by Household Size
Tennessee bases limits on household size. Add $458 monthly for each extra person beyond eight. These use 2025 FPL: $1,304 monthly for one.
2025 Income Limits for Tennessee Medicaid by Household Size
| Household Size | Monthly Limit (101% FPL for Parents) | Annual Limit (101% FPL for Parents) |
| 1 | $1,317 | $15,804 |
| 2 | $1,780 | $21,360 |
| 3 | $2,243 | $26,916 |
| 4 | $2,706 | $32,472 |
| 5 | $3,169 | $38,028 |
| 6 | $3,632 | $43,584 |
| 7 | $4,095 | $49,140 |
| 8 | $4,558 | $54,696 |
| +1 | +$458 | +$5,496 |
TennCare Eligibility Requirements 2025
You must live in Tennessee and plan to stay. U.S. citizens, nationals, or qualified immigrants qualify. Qualified immigrants include green card holders after five years or refugees.
Income must be below your group’s limit. Age rules: Kids 0-18, adults 19-64 (limited), seniors 65+. Pregnancy needs doctor proof for higher limits.
Disability means you can’t work due to a condition, shown by Social Security or doctor. Medical need applies to waivers for home care.
- CHIP for kids over Medicaid income up to 250% FPL.
- Assets ignored for most; for ABD, $2,000 single, $3,000 couple.
Special Medicaid Programs in Tennessee
TennCare Standard
For children with disabilities or high needs. Income up to 195% FPL. Covers extra services like therapy.
CoverKids (CHIP Program)
For kids up to 250% FPL in 2025. Benefits include dental and vision. No copays for preventive care.
Pregnant Women Medicaid
Up to 195% FPL. Coverage lasts through pregnancy and 12 months after birth. Includes prenatal visits and delivery.
Long-Term Services & Supports (LTSS)
For nursing homes: Income $2,901 single monthly, assets $2,000.
CHOICES program: Home care for elderly/disabled. Same income, assets.
Home & Community-Based Services (HCBS Waivers): For specific needs like intellectual disabilities. Income $2,901, assets $2,000.
Medicaid for People With Disabilities
SSI-related: $967 monthly single. Spend-down subtracts medical bills to qualify if over limit.
How to Apply for TennCare
- Apply online at TennCare Connect portal.
- Call 855-259-0701 for phone help.
- Mail forms or visit local DSS office in person.
- Bring ID, Social Security number, pay stubs, tax returns, address proof, medical docs if disabled or pregnant.
- Processing takes 45 days in 2025; 90 for disability.
Renewal & Redetermination Rules in 2025
Renew TennCare every year. You get a notice 45 days before due date. Update income and family with proof. Bring pay stubs or tax forms. Delays come from missing info. Report changes fast to avoid cuts. Unwinding from pandemic rules ends, but some still get extra reviews in 2025. Auto-renew if data matches.
Frequently Asked Questions
What are the Tennessee Medicaid income limits for 2025?
Limits vary: Kids up to 195% FPL ($2,543 monthly for one), pregnant 195% ($2,543), parents 101% ($1,317), ABD $967.
How do I qualify for TennCare in 2025?
Meet residency, citizenship, and income rules for your group. Apply at TennCare Connect with proof.
Does Tennessee offer Medicaid for adults in 2025?
Limited: Parents up to 101% FPL; no expansion for childless adults unless disabled.
What documents do I need for TennCare 2025?
ID, Social Security, income proof, address bill, medical notes if needed.
Does TennCare cover dental in 2025?
Yes for kids fully; adults get emergencies and limited preventive.
Can seniors qualify for TennCare in 2025?
Yes, if income under $967 monthly single and assets low.
What is the income limit for pregnant women on TennCare in 2025?
Up to 195% FPL, like $2,543 monthly for one.
Does TennCare have spend-down in 2025?
Yes, for medically needy: Subtract bills to meet limit.
How long does renewal take for TennCare in 2025?
45 days; respond quick to avoid gaps.
What if income is over limit for TennCare in 2025?
Try spend-down or Marketplace plans.
Conclusion
Tennessee Medicaid income limits for 2025 help families get needed care. With costs rising, knowing them lets you see if TennCare fits. Limits update yearly, so check often. Encourage checking eligibility now. Visit TennCare Connect or call for help. Apply early to get covered fast. Stay updated, your health matters.
