Among the many reasons people are uncertain about applying for TennCare, one of the most prominent (and scary) is the prospect of losing the family home.  Lots of people hear that if they apply for TennCare to pay for long-term care, the State or the nursing home will “take the home.”  Some folks are told that they have to sell their home before they can apply.  While some of these statements may contain elements of truth, they do not capture the full range of possibilities and options that may result in different outcomes.  That is why we advise people who might need TennCare benefits (either now or in the future) to seek an expert’s advice before making any major decisions, particularly about high-value and meaningful assets like the home.

Here’s the basic rule:  when the person who received TennCare benefits passes away, the State has the right to reclaim funds from the estate up to the amount that the State spent on that person’s care during their lifetime.  But like most rules, there are exceptions!

For instance, if the TennCare applicant is married to a person who is not receiving benefits (also known as the “community spouse”), and that spouse is living in the home in question, that changes the equation.  TennCare cannot reclaim funds from the estate of a TennCare recipient if that person’s community spouse is still alive. That means that loss of the home is not inevitable for married couples – but it also doesn’t mean that a couple should proceed without complete information about their application process.  To obtain the best possible outcome, a couple in this situation (or who may later be in this situation) should talk to an attorney who is familiar with TennCare eligibility and estate recovery procedures.

Another exception involves caregiving children living with a parent who receives TennCare.  Under the Child Caretaker Exception, TennCare may waive estate recovery if a child has lived continuously in the TennCare applicant’s home for at least two years prior to the TennCare application and if the child has resided in the home continuously following their parent’s approval for TennCare benefits.  One of the stipulations is that the caregiving child “provided care that delayed the Enrollee receiving CHOICES [TennCare long-term care services] for at least two years.”  This can be a difficult exception to prove, especially after the TennCare recipient passes away, so it is best to establish proof with the help of a knowledgeable Elder Law Attorney with proven experience in processing successful applications.

These are just two examples of TennCare estate recovery exceptions that can prevent the loss of the family home.  There are many legal strategies that can help the family prepare wisely for TennCare enrollment, and several others which may reduce or eliminate the amount the State may reclaim after the TennCare recipient passes away.  But there is also a lot of misinformation about TennCare in the community.  Every situation is unique, and the best results are achieved by consulting an experienced professional who can evaluate your situation and advise you about which rules and exceptions may apply.  Before you make a decision or commit to any significant changes, talk to a qualified elder law attorney who knows the ins and outs of TennCare and can set you on the right path.

Photo © John Weinhofer.