Healthcare Assistance for Single Mothers in Tennessee

Where to start

If you are pregnant: Ask a county health department to check for pregnancy coverage, then complete the full application. Ask what care can begin now and how long coverage lasts after the pregnancy.

If your child is uninsured: Apply for TennCare. Ask about CoverKids if your child does not meet TennCare rules.

If you got a denial: Read the notice and check whether it concerns eligibility or a medical service. These use different appeal steps.

If you cannot get coverage: Call a community clinic, check the Marketplace, and ask about drug-cost help. Do not put off urgent care just because an application is pending.

2026 TennCare income limits

Tennessee uses different income rules for different groups. These examples come from the state’s eligibility income guide. FPL means federal poverty level. A child, pregnant person, and parent can have different limits in the same home.

CoverKids example: For children and eligible pregnant women, the state lists up to 250% FPL. This is $54,100 a year for two people and $82,500 for four people under its posted 2026 chart. These figures are not a promise of approval.

Do not decide from income alone. TennCare checks who belongs in your household, your coverage group, residency, other insurance, and other rules. Some disability or long-term care groups also have resource tests. If your pay changed, report your current facts and let the state decide.

TennCare Medicaid: who it helps

TennCare is Tennessee’s Medicaid program. The state’s coverage group list includes children, pregnant people, low-income parents or caretakers, some people who have disabilities, people who receive SSI, and certain other groups.

There are also special paths for a child with complex medical needs (Katie Beckett), some former foster youth, people who need long-term services, and eligible people in treatment for breast or cervical cancer. A parent who does not meet the usual limit should ask whether another group could fit.

TennCare may pay for covered doctor visits, hospital care, pregnancy care, medicine, mental health care, dental services, and rides to covered appointments. Your care and plan rules may vary. Check your member card and plan before you book care.

Key point: Apply for everyone who needs insurance. The state may approve a child even when an adult is not approved. Do not skip the child’s application because of your own denial.

CoverKids for children and pregnant women

CoverKids eligibility explains Tennessee’s Children’s Health Insurance Program. It can cover eligible children younger than 19 and some pregnant women who do not qualify for TennCare.

For children, the state checks Tennessee residence, income at or below 250% FPL, citizenship or a qualifying immigration status, and other insurance. A child cannot use CoverKids as a second health plan. For pregnant women, the state says immigration papers are not required for CoverKids Pregnant Woman. A pregnant applicant with insurance that lacks maternity benefits, or with Marketplace coverage under a state exception, may also qualify. Ask the state to check your case.

The rules are different for children and pregnant women. If you were told you do not qualify, ask the agency exactly which program and person the decision covers. You can use the same application system to get screened.

TennCare Kids checkups and care

TennCare Kids covers recommended checkups and health services from birth through age 20 for children and young adults with TennCare. It includes well-child visits, vaccines, vision and hearing checks, dental care, behavioral health support, and other medically needed services.

Ask the child’s health plan who the primary care doctor is. If you need help with screening for developmental delays, complex care, or school services, ASMOM’s Tennessee disability support guide can help you find a starting point.

If the doctor recommends care that your plan will not cover, ask for the reason in writing and about the medical appeal process. An appeal does not replace emergency care.

Extra help: rides, dental care, and diapers

Rides to health care

TennCare’s ride benefit may help a member get to a covered appointment when there is no other ride. Schedule at least two business days ahead when you can. Some trips need extra review. For an urgent ride, ask whether the provider must confirm the need. Tell the ride service about a wheelchair or escort.

For Verida, the state lists “Where’s My Ride” as option 3 and Spanish as option 9. For Tennessee Carriers, it lists option 1 for ride status and option 2 for Spanish. For trips not covered by TennCare, check ASMOM’s Tennessee transportation help.

Dental services

TennCare dental services says Renaissance manages dental benefits. Covered, medically needed care is offered to TennCare adults at no cost. TennCare children have broad dental benefits through age 20, and eligible CoverKids children also have dental care.

Call Renaissance at 866-864-2526 to check your dentist, coverage, and any prior approval needed. Services must fit the plan rules. ASMOM’s Tennessee dental care guide also lists clinic options if you lack insurance.

Diapers for children under two

The state’s diaper benefit offers up to 100 diapers per month for TennCare and CoverKids members under age two at participating pharmacies. No prescription is needed. Ask the pharmacy which brands and sizes it stocks. For benefit questions, call OptumRx at 888-816-1680.

If you do not qualify: clinics and Marketplace plans

A TennCare denial may mean the program does not fit your adult coverage group. It does not mean you must stop looking for care. These paths may be worth checking:

• Health centers: Use the HRSA clinic locator and ask about fees based on family income, new patients, and urgent visits.
• Local health centers: The Tennessee Primary Care Association can help you find community health centers.
• Charity care: The charitable clinic finder lists Tennessee clinics. Services and openings vary.
• Marketplace coverage: Check HealthCare.gov dates. Open Enrollment for 2027 starts November 1, 2026. Enroll by December 15, 2026 for coverage starting January 1, 2027. The posted general deadline is January 15, 2027, for February 1 coverage.
• Coverage outside those dates: Check Special Enrollment Period rules after losing insurance, moving, having a baby, or another eligible life event. TennCare and CoverKids applications can be filed all year.

Marketplace plans and discounts are not automatic. Compare total monthly costs, deductibles, your doctor’s network, and prescriptions. A clinic may help you apply while you wait for a coverage decision.

CoverRx: prescription help, not insurance

CoverRx rules say this drug-cost program is for eligible Tennessee residents ages 18 to 64 who have lived in the state for six months, meet citizenship or qualified status rules, and have no other pharmacy coverage or Medicare. The income limit is up to 138% FPL. You can check the 2026 CoverRx income table for your household size.

The state’s CoverRx application page says new and repeat enrollment is open. Review the CoverRx drug list before you rely on it. The program charges copays for many prescriptions and has drug and monthly fill limits.

CoverRx does not pay for doctor visits or hospital stays. If your medicine is not covered, ask the pharmacist or clinic about other drug discounts or manufacturer help. Never stop or switch medicine without asking your prescriber.

How to apply for TennCare or CoverKids

The state’s application instructions allow you to apply online, by phone, or on paper. Pick the method you can complete and keep proof that you submitted it.

1. Online: Apply through TennCare Connect. Save the confirmation, check the case status, upload proof, and read letters.
2. Phone: Call 855-259-0701 for TennCare Connect. Ask about free language help. People who use TTY or TDD can call 800-848-0298.
3. Paper: Get the current state paper form. Mail it to TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240, or fax to 1-855-315-0669. Keep the mailing or fax proof.
4. In person: Ask a local DHS office about help or an online application kiosk. Health departments may help with pregnancy screening.

Plan time to finish the form. If TennCare needs more records, send them by the date in the notice. Tell TennCare if your address, income, insurance, or family size changes.

Documents and information to gather

Not everyone needs every item. You can still ask how to apply if something is missing. Bring what you have and ask which other forms of proof the office accepts.

If asked, have Social Security numbers for applicants who have them. Ask the agency what to do when an applicant has none or a document is hard to get. Write down each upload or fax date. Keep copies of notices and the application ID.

What to do if denied, delayed, or renewed

Start with the letter. Find the reason, date, person affected, and appeal instructions. An eligibility problem is different from a service or medical decision.

Eligibility appeal or late decision

Use the state’s eligibility appeal instructions if coverage was wrongly denied or ended, household income or size was counted wrong, or a premium or copay was based on wrong income. You can appeal through TennCare Connect, by phone at 855-259-0701, or with the state form.

If a normal application has had no decision for more than 45 days, ask about a delay hearing. For long-term care applications, the state lists 90 days. Read your notice for any appeal deadline. Act promptly; do not assume a delay pauses other deadlines.

Medical service appeal

If TennCare, CoverKids, or a plan refuses, stops, changes, or delays a medical service, check the medical appeal rules. TennCare says you have 60 days after learning of the problem to appeal. Call 800-878-3192 for medical appeal help. Ask about an urgent appeal if delay may cause serious harm.

Renewals and closed coverage

TennCare reviews eligibility from time to time. The renewal instructions say to keep contact details current and open every notice. Some people renew from state records, while others must return forms. If a renewal packet arrives, follow its due date. If coverage closed for missing renewal proof, ask about the reconsideration process right away.

Keep letters, screenshots, fax pages, case numbers, call notes, and the names of workers. For legal help with an appeal, contact an eligible local legal aid office; ASMOM’s Tennessee legal help guide lists places to start. This is general information, not legal advice.

Phone scripts you can use