Assisted Living in Tennessee

TennCare is Tennessee's Medicaid program. It pays for doctor visits, hospital care, prescriptions, and other medical services. It does not pay assisted living rent, but you need it to get TennCare CHOICES, which can pay for your care in an assisted care living facility.

For people 65 or older, blind, or disabled, there are two main ways to qualify. If you get SSI, you qualify for TennCare, and Social Security decides who gets SSI. If you need nursing home care or home and community care such as CHOICES, TennCare uses a higher income limit, shown in the last row of the table below.

Tennessee's "medically needy" spend-down, where you pay some medical bills yourself to qualify, is only for children and pregnant women. It is not open to older adults.

TennCare's long-term care program for adults 65 or older and adults 21 or older with a physical disability. It can pay for care in an assisted care living facility, including help with personal care, housekeeping, and taking your medicine. It can also pay for care in your own home, adult day care, respite for family caregivers, or a nursing home.

CHOICES does not pay room and board. You pay the facility for your rent and meals yourself.

Members are placed in one of three groups. Group 1 is for people in a nursing home. Group 2 is for people who need nursing home level care but choose care at home or in the community. Group 3 is for people who do not need nursing home care yet but are at risk of needing it. Assisted living is covered in Groups 2 and 3.

Groups 2 and 3 both have limits on how many people can enroll. TennCare rules set a cap on Group 2. When the cap is reached, new applicants go on a waiting list, with some slots held for people leaving a nursing home or hospital. For Group 3, TennCare has set a target of 1,750 people who do not get SSI, as of October 1, 2022.

A state-funded program that helps older adults and adults with disabilities stay in their own homes. It can pay for homemaker services, personal care, and home-delivered meals. Services depend on funding and on how much help you need.

There is no income limit. You may pay part of the cost on a sliding fee scale based on your income.

A program that gives frail older adults all of their medical and social care through one team, so they can keep living in the community instead of a nursing home. It covers doctor care, an adult day center, prescriptions, therapy, medical equipment, transportation, and personal care at home. Most members have both Medicare and TennCare.

In Tennessee, PACE is only offered in Hamilton County, through Alexian PACE.

The federal health insurance program for people 65 and older. Part A covers hospital stays and a short period of skilled nursing care after a hospital stay. Part B covers doctor visits, outpatient care, and medical equipment. Medicare does not pay for assisted living rent or for help with daily tasks like bathing and dressing. In 2026, Part B costs $202.90 a month with a $283 yearly deductible, and the Part A hospital deductible is $1,736.

Plans sold by private insurers that replace Original Medicare. They must cover everything Original Medicare covers, and many add drug, dental, vision, or hearing coverage. Plans, costs, and doctor networks vary by county.

Drug plans that add prescription coverage to Original Medicare. Each plan has its own list of covered drugs and its own premium. Most Medicare Advantage plans already include drug coverage.

A federal program, also called the Part D Low-Income Subsidy, that pays most Part D premiums, deductibles, and drug copays. People who get Medicaid, SSI, or a Medicare Savings Program qualify automatically.

TennCare programs that pay Medicare costs for people with limited income. They do not give full TennCare benefits. Anyone in QMB, SLMB, or QI-1 also qualifies for Extra Help.

Qualified Medicare Beneficiary (QMB) pays Part A and Part B premiums, deductibles, and coinsurance. Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI-1) pay the Part B premium. QI-1 is only for people who do not have other TennCare coverage, and it is paid only while federal funds last. Qualified Disabled and Working Individual (QDWI) pays the Part A premium for people who lost premium-free Part A after going back to work.

Monthly income for retired workers, based on what you earned during your working years. You can spend it on anything, including assisted living. You need at least 40 work credits, which is about 10 years of work. Benefits can start at 62, and the monthly check is larger if you wait until full retirement age or later.

A monthly federal payment for people who are 65 or older, blind, or disabled and have very little income and savings. Getting SSI usually qualifies you for Medicaid as well.