TennCare CHOICES Eligibility (2026): Who Qualifies and How to Apply

ElderHearth offers general information, not financial, legal, or medical advice. Medicaid dollar limits change every year, so confirm the current figures with TennCare or your parent's managed care organization before you apply.

For a Tennessee family trying to keep a parent at home, TennCare CHOICES is often the program that makes it possible, and TennCare CHOICES eligibility is what decides whether that door opens. It is the state's Medicaid long-term care program, and it can pay for in-home help instead of a nursing home (see what that care costs in Tennessee), including paying a family member to provide that care. But it has real gates: your parent has to fit one of three groups, meet income and asset limits, and be assessed as needing a certain level of care. This guide explains TennCare CHOICES eligibility in 2026 and how to apply.

What is TennCare CHOICES?

TennCare CHOICES is the part of Tennessee's Medicaid program that covers long-term services and supports, whether in a nursing facility or at home through home and community based services (HCBS). It is organized into three groups:

In short, the TennCare CHOICES Group 2 vs Group 3 difference is whether your parent already needs a nursing-home level of care (Group 2) or is only at risk of needing it (Group 3). For a family that wants to keep a parent at home, Group 2 is usually the target: it covers the same people who would qualify for a nursing home, but delivers the care at home instead. One thing to know early: unlike Group 1, Groups 2 and 3 are not an entitlement, so slots are limited and there can be a waitlist.

TennCare CHOICES income limit and asset limits (2026)

Eligibility is financial as well as medical. For 2026, a single applicant's limits are:

• Income: up to $2,982 a month, which is set at 300% of the federal SSI benefit rate and rises each January. The Social Security Administration published that rate: "The maximum Federal Supplemental Security Income (SSI) monthly payment amounts for 2026 under title XVI of the Act will be $994 for an eligible individual".
• Countable assets: $2,000 for a single applicant. Your parent's home and one vehicle are generally not counted.
• Home equity: the home is normally exempt while your parent lives there or intends to return, up to a home equity limit of $752,000 in 2026.

If your parent is married and only one spouse applies, the rules protect the spouse who stays home. Under Medicaid's spousal rules, the at-home spouse can keep the house, a share of the couple's assets (up to $162,660 in 2026), and enough of the couple's income to live on (up to $4,066.50 a month). Because these figures change every year, treat the numbers here as a 2026 guide and confirm the current ones when you apply. This is the part of TennCare CHOICES eligibility where families most often benefit from talking to a Medicaid planner or the local Area Agency on Aging.

The nursing-home level-of-care requirement

Money is only half of it. CHOICES also has a functional test. For Groups 1 and 2, your parent must be assessed as needing a nursing-home level of care, meaning they need enough daily help that they would otherwise qualify for a nursing facility. Group 3 is for people who do not yet meet that bar but are at risk of it without support, so the help is meant to keep them from getting there. That nursing home level of care in Tennessee is measured by an assessment of your parent's needs, done through their managed care organization, not by a diagnosis alone.

Can a family member be paid through CHOICES?

Yes, and for many families this is the point. CHOICES includes an option called Consumer Direction, where your parent becomes the employer and hires their own caregiver rather than using an agency. An adult child can be the paid caregiver. A spouse, legal guardian, or power of attorney cannot be hired. The caregiver has to be 18 or older, pass a background check, complete training, and be set up through CDTN, the program's fiscal employer agent. If getting paid to provide the care is your main question, our guide to getting paid to care for a parent in Tennessee walks through how the pay works in detail. So yes, TennCare does pay for a caregiver, including a family member, through this route.

However the care is arranged, the work is physical before it is anything else: most of a nursing-home level of care delivered at home is getting a parent in and out of a chair, a bed or a car. Our guide to transfer aids for the elderly at home covers the belt, the board and the lift that fit each stage, and what keeps a caregiver's back intact.

How to apply for TennCare CHOICES

The process runs through TennCare and a managed care organization (MCO):

1. Apply for TennCare for your parent if they are not already enrolled, since CHOICES sits inside TennCare.
2. Request a CHOICES assessment through your parent's MCO, which determines the level of care and the services your parent qualifies for.
3. Ask for Consumer Direction if you want your parent to hire a family caregiver, or Agency with Choice if you would rather an agency employ the caregiver.
4. Complete enrollment with CDTN so the authorized hours can be paid.

If your parent is close to the income limit or has a spouse still at home, get advice before you spend down assets, because the spousal rules and a five-year look-back on asset transfers can change the math.

Frequently Asked Questions

How do you qualify for TennCare CHOICES? Your parent has to meet three things: fit one of the three CHOICES groups, meet the financial limits (in 2026, up to $2,982 a month in income and $2,000 in countable assets for a single applicant), and be assessed by their managed care organization as needing the right level of care. Groups 2 and 3 also have limited slots, so a waitlist is possible.

What is the income limit for TennCare CHOICES in 2026? For 2026, the income limit is $2,982 a month for a single applicant, set at 300% of the federal SSI benefit rate. It changes each January, and married couples with one applicant are treated differently, so confirm the current figure when you apply.

Does TennCare pay for a caregiver? Yes. Through the CHOICES Consumer Direction option, TennCare pays a family caregiver, such as an adult child, to provide in-home care. A spouse, legal guardian, or power of attorney cannot be the paid caregiver. The caregiver must pass a background check and enroll through CDTN.

What is the difference between TennCare CHOICES Group 2 and Group 3? Group 2 is for people who qualify for a nursing-home level of care but choose to receive it at home. Group 3 is for people who do not yet meet that level of care but need support to avoid needing it. Both have limited enrollment, unlike Group 1, which is an entitlement.

How do I apply for TennCare CHOICES? Enroll your parent in TennCare, then request a CHOICES assessment through their managed care organization, and ask for Consumer Direction if you want to hire a family caregiver. The MCO assessment determines the level of care and the services covered.

Where to start

The first step is to make sure your parent is enrolled in TennCare, then call their managed care organization and request a CHOICES assessment, asking specifically about Group 2 and Consumer Direction if you want to keep the care at home with a family caregiver. Because the money rules are where families lose time, it is worth a call to your Area Agency on Aging before you move assets around. Meeting TennCare CHOICES eligibility takes some paperwork, but it is the program that most often lets a Tennessee parent stay home, and it pairs with the state's other help, from getting paid to care for a parent in Tennessee to home modification grants and property tax relief for seniors in Tennessee. If you are weighing home care against a facility, our comparison of aging in place versus assisted living can help.

This guide is part of our Tennessee senior care resources, which cover every program that helps a parent age in place in the state.

If you would rather not think it through alone, you are welcome to write to us; we read every message.

Sources

• TennCare, TennCare CHOICES program.
• American Council on Aging, TennCare CHOICES program eligibility and Tennessee Medicaid eligibility limits (2026).