Need Help?

Need Health Insurance or Medical Care?

Q:  What TennCare services can my child get?

A:  Kids on TennCare have a right to all the health care they need.  There’s a law that says so!  These services include mental health services, physical therapy, speech therapy, medical equipment, home health care, dental care, vision care, and much more! LEARN MORE ABOUT WHAT TENNCARE PROVIDES FOR CHILDREN.

Q:  How do I apply for TennCare?

A:  You need to fill out some papers!  You can do this online or in person at your county Department of Human Services (DHS) Office. You can also call and ask for an application to be mailed to you.  If you have any questions about applying, you can call the Family Assistance Service Center at 1-866-311-4287.

Q: What groups does TennCare currently cover?

A: TennCare has multiple different eligibility categories for families, children, and individual adults.  Almost all of them have strict requirements on income and resources.  If you’re not sure whether you’re eligible, you can always apply.  For an overview of which groups TennCare covers, DOWNLOAD THIS FLYER (PDF).

Q: What is Spend Down?

A: Spend Down is a category of eligibility for TennCare.  Most categories have very strict requirements on how much income a family can have.  Spend Down lets a family use medical bills and expenses to offset that income.  Spend Down is currently open to all children and is called Medically Needy Spend Down. There are occasional windows when adults can apply for themselves, too. This is called Standard Spend Down.

The rules about counting bills and income are very complicated, CLICK HERE TO DOWNLOAD OUR MEDICALLY NEEDY SPEND DOWN FLYER AND WORKSHEET. The worksheet can also be used for counting bills for Standard Spend Down.

For more information about Standard Spend Down for adults, DOWNLOAD OUR STANDARD SPEND DOWN FLYER. We have one in Spanish/Español as well.

Q:  My child can’t get TennCare. Can CoverKids help?

A:  CoverKids can help some children who do not qualify for TennCare.  The child cannot have other insurance, either.  CoverKids is a public health insurance program. LEARN MORE ABOUT COVERKIDS.

Q: What if it’s a medical emergency, and I can’t pay?

A:  You still have a legal right to get hospital care for an emergency or childbirth.  They can’t turn you away until a doctor has examined you.  An emergency room card can help you get care.  FIND OUT MORE ABOUT HOW TO GET EMERGENCY ROOM CARE.

Q:  Will TennCare pay for nursing home care?  What about nurses I need at home?

A: TennCare provides important financial protections for nursing home eligible patients and their families.  If you are nursing home eligible, TennCare will either pay for you to get care in a nursing home, or they will pay for nurses and aides to come to your house if it is cheaper. FIND OUT MORE ABOUT HOW TO APPLY FOR NURSING HOME COVERAGE AND IN-HOME COVERAGE.

Q: Can I get help paying my MediCARE premium?

A:  QMB helps people who are age 65 or older, or who are disabled, or who have kidney failure pay for MediCARE.  FIND OUT MORE ABOUT HOW TO APPLY FOR QMB.

Q: Can I get help paying for medicine?

A:  Whether you are insured or not, you might have trouble getting the medicine you need. HERE ARE SOME TIPS ON HOW TO GET LOW OR NO-COST MEDICINES.

Q: What is the Pickle Amendment?

A: The Pickle Amendment gives eligibility to some people who now get Social Security Disability payments (SSDI) but who used to get SSI.  If you were ever eligible for SSI and SSDI in the same month, you might be eligible for benefits.  LEARN MORE ABOUT PICKLE ELIGIBILITY.

Q: I am an immigrant. What are health care options for me and my family?

Many low-income, legal immigrants or their family members may be able to get TennCare. There are also other options. READ MORE ABOUT THE QUESTIONS THAT IMMIGRANTS AND THEIR FAMILIES OFTEN ASK ABOUT HEALTH CARE IN TENNESSEE.

For a list of local immigrant-friendly clinics and resources, READ HERE. For a list of others clinics and resources not listed in the above guide, CHECK HERE.

TennCare Won’t Pay for the Care I Need. How Do I Appeal?

Q:  What are my child’s TennCare service appeal rights?

A:  Kids on TennCare have a right to all the health care they need. LEARN WHAT TO DO IF TENNCARE WON’T GIVE YOUR CHILD THE CARE THEY NEED.

Q:  How do I appeal?

A:  Do you have a problem with TennCare, Families First or Food Stamps? An appeal might fix the problem. There are two kinds of appeals – eligibility and services.  There are different rules for these appeals.  FIND OUT MORE ABOUT APPEALING.

Q: I’m on TennCare, so why am I getting bills?

A:  Some of these bills might be mistakes!  TennCare may need to pay them. READ MORE ABOUT GETTING BILLS WHILE ON TENNCARE.

Foster Parents and Children

Q: Did you recently leave DCS custody?

A: You have a right to apply for TennCare.  You can apply online or by going to your local Department of Human Services office. FIND OUT MORE ABOUT WHAT TO DO IF YOU’RE AGING OUT OF FOSTER CARE.

Q: How can I get TennCare services for a child in foster care?

A:  A law called EPSDT promises all necessary medical and mental health services for children in, or at risk of entering, State Custody.  If a child in foster care isn’t getting the health care they need, you can tell the juvenile court and file an appeal. FIND OUT MORE ABOUT HOW TO GET SERVICES FOR CHILDREN IN CUSTODY.

Q: When can I appeal for a child in foster care?

A: If you know a child in state custody who is not getting the physical or mental health care they need, you can file an appeal.  Birth parents, foster parents, Guardians ad litem, CASA volunteers, doctors, and advocates can all file appeals. FIND OUT MORE ABOUT WHEN YOU CAN APPEAL FOR A CHILD IN FOSTER CARE.

En Español

Q: ¿Qué servicios para niños provee TennCare?

A: Su niño tiene derecho a recibir el cuidado médico que necesita. Puede recibir servicios como terapia física o del habla, equipo medico, y cuidado dental.  Aprenda más sobre TennCare.

Q: ¿Tengo derecho de apelar si TennCare niegue algo?

A: ¡Sí! Su niño tiene derecho a recibir el cuidado médico que necesita.  Si TennCare niegue algo, puede apelar.  Aprenda más sobre el proceso de apelar.

Q: Mi hijo no puede obtener TennCare.  ¿Puede recibir CoverKids?

A: CoverKids puede ayudar a unos niños que no califican para TennCare.  El niño no puede tener otro seguro médico.  CoverKids es un programa pública – entonces un niño debe tener papeles para recibirlo.  Aprenda más sobre CoverKids.

Other Links & Resources

Q: I didn’t see my question here.  Where else can I look for help?

A: If you didn’t find the answer to your question, try checking the flyers at Legal Aid’s website.  Legal Aid helps with lots of issues besides health care.  They have information on renters’ rights, filing your taxes, dealing with paycheck garnishment, and many other questions. If you have a specific question about TennCare, call the TJC to find out if we can help you.