TennCare Applicants: Beware of Conditional Assistance

In recent months, TennCare caseworkers have been promoting a strategy called “conditional assistance” to help over-resourced applicants qualify for benefits.  Conditional assistance is available to any applicant who has a single excess non-liquid resource and therefore does not meet the financial requirements to qualify for benefits.  The TennCare policy manual defines non-liquid resources as real property, life estates, livestock, oil and mineral rights, farm or business equipment, vehicles, or “items of unusual value.”  A TennCare applicant who uses conditional assistance to qualify for benefits will start receiving benefits immediately, but he or she is required to sell the excess non-liquid assets within a period of 9 months for real property or 3 months for all other types of assets.

Of course, there’s a catch:  after the excess property is sold, TennCare will reclaim the amount that has been spent on the applicant’s care during the conditional assistance period, up to the total amount of the asset that was sold.  And if the applicant does not sell the property within the allotted time, he or she will be disqualified for benefits, but the State will still reclaim funds from the later sale of the asset.

TennCare applicants should beware of this strategy and explore all other options before accepting conditional assistance.  In most cases there are other legal ways to qualify for benefits without divesting of assets and repaying the State.  It is of course in the State’s interest to promote this strategy because it results in returned funds; however, it is not in the applicant’s interest to accept conditional assistance.  The applicant may lose thousands of dollars that could pay for supplemental care, improve quality of life for the applicant or a spouse, or be passed on to loved ones.

If you or someone you know is planning to apply for TennCare benefits, is already in the process, or has been denied, seek advice from a qualified professional.  An expert who knows all the TennCare ins and outs will help you steer clear of common missteps and may preserve assets and peace of mind for the whole family.

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