There are many different branches of TennCare, Tennessee’s Medicaid program. It is not one overarching program that covers all your needs once you are enrolled; rather, different TennCare programs meet different needs or serve different populations. The programs vary from insurance for low income families and children, to hospice services, to hospitalization coverage in emergencies, to help with Medicare premiums, to coverage for long-term care.
The TennCare coverage that pays for long-term care is called CHOICES. Long-term care means that a person needs ongoing help doing a variety of everyday activities because of aging, an injury, or a disability. These activities can include dressing, bathing, eating, and transferring, to name a few. The need for long-term care may also be related to dementia, which reduces cognitive abilities and can result in risks to the person’s safety.
Long-term care offered through TennCare CHOICES may be delivered in nursing homes, assisted living facilities, and private residences, depending on which CHOICES group the person enrolls in. The specifics of each CHOICES group are slightly different, but eligibility for all is the same: there must be evidence to show that the person needs a nursing home level of care, and they must qualify financially.
TennCare applications can be complicated, and assessing medical and financial eligibility isn’t always straightforward. There is also lots of misinformation you may hear by word-of-mouth. If you or a loved one might seek TennCare benefits in the future, contact a qualified elder law attorney to help maximize benefits, preserve assets like the home, and avoid missteps along the way.