Age & Income Requirements for Medicaid in Tennessee

Medicaid is a federal-state program providing health coverage to low-income individuals and families who lack access to affordable health-care insurance. Tennessee’s Medicaid program is called TennCare. Tennessee sets standards for eligibility, which is determined for individuals and families by the state Department of Human Services and its local offices.

Adults

• Individuals age 18 to 65 qualify for Medicaid if their monthly household income meets the limits set by the state and their resources (i.e., money in savings) are below a certain threshold amount. As of 2010, the limits are: individuals with monthly income of $1,288 or less; $1,658 or less for a two-person household; or $1,972 or less for a three-person household; and $2,240 or less for a four-person household. The resource limit is $2,000, regardless of the household size.

Pregnant Women

• Pregnant women who do not qualify for other Medicaid income and resource-limit categories but lack access to private health-care coverage may qualify for Medicaid if they meet income and resource limits, regardless of age. Monthly household income and resource limits for pregnant women are the same as those for Medicaid-eligible adults.

Children

• The state classifies as medically needy certain children up to age 21, pregnant women and children 18 and younger. Income requirements for this group must be no more than $241 a month for a family of one or $325 a month for a family of four. Resource limits are not to exceed $1,000 for an individual or $2,000 for two people in a household.

Newborns

• Babies born to Medicaid-eligible women automatically become eligible for Medicaid benefits at birth. Eligibility for babies has no income or resource requirements.

Senior Citizens and the Disabled

• Senior citizens and the disabled (and blind) with income limits of $674 per month for a household of one or $1,011 per month for a household of two meet the income requirement for Medicaid. The state requires these individuals maintain resources less than $2,000 for a single-person household and $3,000 for a two-person household.

Women with Breast and Cervical Cancer

• Women under 65 diagnosed with breast or cervical cancer who do not have health-care insurance or have insurance that does not cover treatment for these diseases qualify for Medicaid. To meet the income guidelines, household income must not exceed 250 percent of the federal poverty level. As of 2009-2010, monthly income cannot exceed $2,429 for a family of two or $3,675 for a family of four. The state does not impose resource limits for this population.