TennCare CHOICES in Nashville: What It Covers (and What It Doesn't)

TennCare CHOICES is Tennessee's Medicaid long-term care program — but it doesn't work the way most Nashville families expect. Here's the real picture.

When Nashville families hear 'Medicaid covers senior care,' the mental image is usually a nursing home bill being paid in full. The reality of Tennessee's TennCare CHOICES program is more nuanced — and understanding the difference between Group 1 and Group 2 coverage can change your entire planning strategy.

The two CHOICES groups

CHOICES Group 1 covers nursing-facility placement. If your parent qualifies clinically (nursing-facility level of care) and financially (income ≤ $2,982/month, assets ≤ $2,000 in 2026), TennCare pays the nursing home at the Medicaid rate. Your parent contributes their income minus a personal-needs allowance (~$50/month). Room and board, skilled nursing, meals, and personal care are all covered. There is no waitlist for Group 1 — qualifying applicants are enrolled promptly.

CHOICES Group 2 covers home- and community-based services (HCBS) — personal care hours at home, adult day services, home-delivered meals, and respite for family caregivers. This allows qualifying seniors to remain in the community rather than a nursing facility. Group 2 operates on a Medicaid waiver with limited slots, so there can be a waitlist. Apply early if your parent may need these services.

The biggest misunderstanding: assisted living

TennCare CHOICES does NOT cover assisted-living (ACLF) room and board. This surprises most Nashville families. TennCare may fund personal-care hours inside an ACLF through Group 2, but the community's room and board must be paid privately. In Nashville, that's $4,300–$5,200/month on average — not covered by TennCare. Nursing home room and board IS covered under Group 1 at the Medicaid rate. This distinction drives many families to nursing-home placement earlier than they might prefer.

Applying in Nashville

Apply through TennCare Connect at tenncare.gov or call 855-259-0701. The Greater Nashville Regional Council (GNRC) Area Agency on Aging & Disability (615-255-1010) offers application assistance. Processing takes 45–90 days when documentation is complete — apply before a crisis, not during one. An elder-law attorney can help if assets exceed limits and a spend-down is needed.

Not sure which CHOICES group fits your parent's situation? A free Nashville advisor can help you map the options.