Check Your Coverage Options in Tennessee
Enter your household size and income before taxes to see where you land in Tennessee.
Estimate using 2026 federal poverty guidelines and Tennessee's income limits as of January 2026. If you are pregnant, count the baby you are expecting in your household size. People 65 and older or with disabilities follow different rules. This is not an official determination — only Tennessee's Medicaid agency or the marketplace can confirm eligibility.
Coverage gap: Tennessee has not expanded Medicaid. Adults earning below $15,960/year (100% FPL) who don't fit traditional categories may have no affordable coverage option. Those above 100% FPL qualify for marketplace subsidies.
Tennessee Medicaid Income Limits 2026
The following table shows the key income thresholds for Tennessee in 2026:
| Household Size | 100% FPL | 138% FPL | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,960 | N/A | $63,840 |
| 2 | $21,640 | N/A | $86,560 |
| 3 | $27,320 | N/A | $109,280 |
| 4 | $33,000 | N/A | $132,000 |
| 5 | $38,680 | N/A | $154,720 |
| 6 | $44,360 | N/A | $177,440 |
Because Tennessee has not expanded Medicaid, the 138% FPL threshold does not apply for adult eligibility. Adults earning between 0-100% FPL may fall into the coverage gap. Those earning between 100-400% FPL can access marketplace subsidies.
About TennCare
Who Qualifies in Tennessee
If you're a resident of Tennessee trying to understand your healthcare options, here's what you need to know about TennCare (Tennessee's Medicaid program) and marketplace subsidies. Tennessee has not expanded its Medicaid program, meaning that most adults without dependent children will not qualify, regardless of how low their income is. You may qualify for TennCare if you are a child (up to age 21, with income limits varying by age, for example, children ages 6-18 with household income up to 138% of poverty), a pregnant woman (up to 250% of the federal poverty level, or FPL), or a parent/caretaker of minor children (with household income not exceeding 105% of poverty). Seniors and individuals with disabilities may also qualify, though they face income and asset limits, such as a $2,000 asset limit for individuals and a monthly income limit of $2,982 for individual applicants in 2026 for long-term care programs. If you are a childless adult with an income below 100% of the FPL, you will unfortunately fall into Tennessee's "coverage gap" and won't be eligible for either TennCare or marketplace subsidies.
If You're Near the Income Line
If your income is too high for TennCare but still modest, you might qualify for subsidies on the federal HealthCare.gov marketplace. For example, if you are an adult with dependent children and your income is just above the 105% FPL TennCare cutoff, you could transition to marketplace coverage. The benchmark Silver plan in Tennessee is around $711 per month. With marketplace subsidies, your actual payment could be significantly reduced based on your income. It's important to remember that changes in your household income can shift your eligibility between TennCare and marketplace subsidies, so it's wise to recheck your options if your financial situation changes. During the recent unwinding of pandemic-era continuous coverage, nearly 556,000 people were disenrolled from TennCare, but many can reapply if their circumstances change and they believe they now qualify.
What TennCare Covers
TennCare provides comprehensive benefits to those who qualify, covering a range of healthcare services. The program operates under an "1115 waiver," which allows Tennessee to customize its Medicaid program, and all TennCare beneficiaries are enrolled in plans administered by private health insurance companies. This managed care model aims to provide high-quality, cost-effective care. For those who are elderly or have physical disabilities, the TennCare CHOICES program offers home and community-based services as an alternative to nursing facility care. Additionally, Tennessee has specific programs for individuals with breast or cervical cancer. While some cost-sharing may apply to certain enrollees for covered services, copayments are generally not required for emergency services for Medicaid enrollees.
Options in the Coverage Gap
If you find yourself in the coverage gap, meaning your income is too high for TennCare but too low for marketplace subsidies, there are still practical alternatives in Tennessee. Community health centers, also known as Federally Qualified Health Centers (FQHCs), provide comprehensive primary and preventative care, including dental and mental health services, regardless of your ability to pay. They offer services on a sliding fee scale based on your income. Many hospitals in Tennessee also have financial assistance or "charity care" policies that can reduce or eliminate medical bills for eligible low-income, uninsured patients. Programs like Project Access in Southeast Tennessee coordinate donated specialty medical care for uninsured residents who don't qualify for other programs but earn below 150% of the FPL. Additionally, organizations like the Tennessee Justice Center can help with TennCare enrollment appeals and offer guidance on hospital financial assistance. If your income increases above 100% of the FPL, remember to revisit HealthCare.gov, as you may then become eligible for significant marketplace subsidies.
Tennessee Medicaid and CHIP Income Limits for Children and Pregnancy
Children and pregnant women qualify for coverage in Tennessee at higher incomes than other adults. Children under 19 are covered up to 255% of the federal poverty level, through Medicaid at lower incomes and Tennessee's separate CHIP program above that (CHIP may charge a small premium). Pregnancy coverage runs up to 255% FPL. Parents and caretakers of minor children qualify only up to about 105% FPL.
| Household | Children 255% FPL |
Pregnant 255% FPL |
Parents 105% FPL |
|---|---|---|---|
| 1 | $40,698 | — | $16,758 |
| 2 | $55,182 | $55,182 | $22,722 |
| 3 | $69,666 | $69,666 | $28,686 |
| 4 | $84,150 | $84,150 | $34,650 |
| 5 | $98,634 | $98,634 | $40,614 |
| 6 | $113,118 | $113,118 | $46,578 |
Annual income limits for 2026, including the standard 5-point income disregard. A pregnant woman counts as at least two people, so the one-person row does not apply. Tennessee sets its parent limit for a family of three, so figures for other household sizes are approximate. Limits as of January 2026, from KFF's annual survey of state Medicaid and CHIP eligibility rules.
Marketplace Insurance in Tennessee
Tennessee residents who do not qualify for Medicaid can purchase private health insurance through the federal marketplace at HealthCare.gov. The average benchmark (second-lowest cost Silver) plan in Tennessee costs approximately $711/month for a 40-year-old (2026 average; 2027 rates are published shortly before open enrollment begins November 1).
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Tennessee might pay for a Silver plan after subsidies under the 2027 premium tax credit rules, based on the $711/month benchmark:
| Income Level | Annual Income | Your Cost | Monthly Subsidy |
|---|---|---|---|
| 150% FPL | $23,940 | ~$86/mo | $625/mo |
| 200% FPL | $31,920 | ~$180/mo | $531/mo |
| 250% FPL | $39,900 | ~$288/mo | $423/mo |
| 300% FPL | $47,880 | ~$408/mo | $303/mo |
| 400% FPL | $63,840 | ~$544/mo | $167/mo |
These estimates are for a 40-year-old individual on a benchmark Silver plan in Tennessee. Actual premiums depend on your age, household size, tobacco use, and plan choice. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays. Tennessee uses the federal marketplace at HealthCare.gov.
How to Get Coverage in Tennessee
Your path depends on your income:
- Income above $15,960/year (100% FPL): You qualify for marketplace subsidies. Apply through HealthCare.gov during open enrollment (Nov 1 – Jan 15) or after a qualifying life event.
- Income below $15,960/year: Check if you qualify for traditional Medicaid (children, pregnant women, disabled). Apply through TennCare.
- Children: Tennessee covers children under 19 in families up to 255% FPL ($84,150 for a family of 4), regardless of expansion status.
Calculate Your Subsidy in Tennessee
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Tennessee.
Frequently Asked Questions
What are Tennessee's Medicaid eligibility requirements?
Tennessee has not expanded Medicaid, so there is no standard income limit for adults. Traditional Medicaid covers specific groups (children, pregnant women, disabled, very low-income parents). Income limits for these groups vary. Children are generally covered up to 200-300% FPL through CHIP.
Is Medicaid expanded in Tennessee?
No, Tennessee has not expanded Medicaid. This creates a coverage gap for adults earning below 100% FPL who do not qualify for traditional Medicaid categories.
How do I get help paying for health insurance in Tennessee?
Tennessee residents with household income between 100% and 400% FPL ($15,960 to $63,840 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through HealthCare.gov.
What is the name of Tennessee's Medicaid program?
Tennessee's Medicaid program is known as TennCare. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and certain other qualifying groups.
What should I do if my TennCare coverage is ending?
If your TennCare coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through HealthCare.gov. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
What are my options if I'm in Tennessee's Medicaid coverage gap?
If you're in the coverage gap (earning below $15,960/year but not qualifying for traditional Medicaid), look into community health centers in Tennessee that offer sliding-scale fees based on income. Many hospitals have charity care programs for uninsured patients. Free clinics and the 211 helpline can connect you with local resources. If your income changes, reapply — even small income increases could qualify you for marketplace subsidies.
What's stopping Medicaid expansion in Tennessee?
Medicaid expansion has been a politically contentious issue in Tennessee. The state legislature has not passed expansion legislation, leaving an estimated coverage gap for adults earning below 100% FPL. Advocacy groups continue to push for expansion, and several neighboring states have recently adopted it. Check with Tennessee's legislative updates for the latest status.