How Can I Fill out an Application for PHP TennCare?

The state of Tennessee offers a program to low-income residents in need of medical assistance. Known as TennCare, the program provides Medicaid services to qualifying citizens based on income, lack of insurance through employer, or cases of families considered uninsurable due to a child's pre-existing condition. Applying for PHP TennCare can be accomplished by submitting an application online or by completing a form provided by your local Tennessee Department of Human Services (DHS) office.

Instructions

• 1

  Determine if you are eligible. Complete a TennCare eligibility application online, accessible through the Tn.gov website (see Resources). You can also be screened for eligibility at your local DHS office. A directory of DHS offices is available online (see Resources). You will be required to provide information on any disabilities, whether or not you are pregnant, and your monthly medical expenses. You must report if you are receiving SSI, employment income, or Medicare and if you have any health insurance. You will have the option to add other household members to your eligibility screening.

• 2

  Obtain an application. Once you have been determined eligible, obtain a PHP TennCare application. You may request an application over the phone or receive one from your local Tennessee DHS office. You can also print a pdf version of the application from the Tn.gov DHS website or access the application online (see Resources). Register before completing the online application by supplying a user name and password.

• 3

  Complete the application. Supply contact information including name, address and all phone numbers. Respond to detailed financial questions including all income, a list of household expenses and who pays each one, any health insurance coverage, and the names of everyone in the household.

• 4

  Submit the application. If you are completing the PHP TennCare application online, you will be directed to submit it once all information in the required fields has been completed. If you chose to complete a written application, hand deliver or mail it to your local Tennessee DHS office.