TennCare CHOICES: Tennessee's Long-Term Care Medicaid Program
TennCare CHOICES is the long-term services and supports (LTSS) component of TennCare — Tennessee's Medicaid program — administered by the Division of TennCare. It covers nursing facility care and home- and community-based services (HCBS) for eligible older adults and adults with physical disabilities.
Who qualifies (2026)
- Residency: Tennessee resident
- Clinical: Nursing-facility level of care (LOC) — requires assessment
- Income: ≤ $2,982/month (300% of SSI federal benefit rate)
- Assets: ≤ $2,000 (individual); home, one car, and personal items may be exempt
- Look-back: 60 months for asset transfers; improper transfers create a penalty period
Two coverage groups
CHOICES Group 1 covers nursing-facility placement. CHOICES Group 2 covers HCBS — personal care, adult day services, and support coordination — for eligible people who can safely remain at home or in the community. Group 2 operates on a waiver with limited slots, so there can be a waitlist.
How to apply
Apply through TennCare Connect at tenncare.gov or call 855-259-0701. A DHS field office can also help. The CHOICES assessment is conducted by a registered nurse or social worker and determines LOC and the appropriate group.
Managed care
TennCare CHOICES is managed through contracted Managed Care Organizations (MCOs) — currently BlueCare Tennessee and UnitedHealthcare Community Plan (UHCCP). Once enrolled, your MCO coordinates care and authorizes services. You can request a specific nursing facility or HCBS provider as long as they are in the MCO's network.
What it covers
- Nursing facility care (Group 1 and 2)
- Personal care at home (Group 2)
- Adult day health care (Group 2)
- Respite care for family caregivers (Group 2)
- Home-delivered meals, minor home modifications (Group 2)
- Support coordination
What it does not cover
TennCare CHOICES does not cover most assisted living (ACLF) room-and-board costs. Some ACLFs accept CHOICES-funded personal care hours, but the room-and-board portion must be paid privately. Room and board in a nursing facility IS covered for CHOICES Group 1 enrollees at the Medicaid rate.
Spend-down and planning
If income or assets exceed limits, a spend-down or Medicaid planning strategy may apply — an elder-law attorney can help. The 60-month look-back means asset transfers within five years of application are scrutinized. Tennessee does seek estate recovery on assets after a beneficiary's death.
Free help from a local Nashville advisor
Nashville Senior Advisor connects families across Davidson, Williamson, Rutherford, Wilson, Sumner, Maury, Robertson, and Dickson counties with a free local advisor — no fees, ever. We help you understand your options, compare licensed providers, verify TDH and CMS credentials, and coordinate the move. Tell us your situation →
Common questions
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Getting senior-care help in the Nashville metro
If you're starting a senior-care search in the Nashville metro, the process is simpler than it looks. It begins with an honest assessment of what your parent actually needs day to day, followed by a realistic budget and a look at how to fund it — savings, long-term-care insurance, VA Aid & Attendance, or Tennessee's TennCare CHOICES for those who qualify. Only then does it make sense to tour communities, because the care level determines which licensed options can legally serve your parent.
Nashville metro families also have free public resources. The GNRC Area Agency on Aging & Disability (615-255-1010 / 866-836-6678) screens seniors for meals, in-home support, caregiver respite, and benefits counseling. Much of it is free or sliding-scale and doesn't require Medicaid. A single call can unlock several programs at once.
Tennessee programs worth knowing about
In Tennessee, senior-care facilities are licensed and inspected by TDH through the Board for Licensing Health Care Facilities — verify any license and inspection history free at tn.gov/health. Service funding flows through the local Area Agency on Aging; Nashville metro's is the GNRC Area Agency on Aging & Disability. Long-term-care help runs through TennCare CHOICES, and the Long-Term Care Ombudsman plus TDH Adult Protective Services protect residents. Our advisors help families use all of these at no cost.
Why families choose a local Nashville metro advisor
National senior-living websites are essentially lead brokers: enter your information and a dozen communities call you within minutes, whether they fit or not. A local advisor works differently. We focus only on the Nashville metro — Davidson, Williamson, Rutherford, Wilson, Sumner, Maury, Robertson, and Dickson counties — so we know the buildings, the directors, and which providers are genuinely strong for memory care versus assisted living versus Residential Homes for the Aged. We shortlist two or three real fits instead of selling your contact details to the highest bidder.
Both models are free to families, because communities pay a referral fee only when someone moves in. The difference is depth and trust: we verify every option against the TDH license database and CMS Nursing Home Compare, we tell you about good providers that don't pay us, and we stay reachable after the move. That local, lighter-touch approach is why families across the Nashville metro start with us rather than a national 800 number.
Free help from a local Nashville advisor
Nashville Senior Advisor connects families across Davidson, Williamson, Rutherford, Wilson, Sumner, Maury, Robertson, and Dickson counties with a free local advisor — no fees, ever. We help you understand your options, compare licensed providers, verify TDH and CMS credentials, and coordinate the move. Tell us your situation →
What to do next in the Nashville metro
Senior-care decisions rarely improve by waiting, but they don't have to be made in a panic either. The most useful first step is a short, no-pressure conversation that turns a vague worry into a concrete plan: what level of care fits, what it will realistically cost in the Nashville metro, and which licensed communities or services are genuine candidates right now. From there, touring two or three real fits beats wading through dozens of listings.
- Free assessment. A 15-minute call to pin down care needs, budget, and timeline.
- A real shortlist. Two or three TDH-licensed options that actually fit — not a dozen sales calls.
- Hands-on help. We help you tour, compare itemized pricing, and coordinate the move.
- Always free to families. We're paid by the community only if you choose to move in.
Whether you need help this week or are planning months ahead, a free the Nashville metro advisor can save you days of research and a costly mismatch. Tell us what's going on — there's no obligation.