Medicaid is the nation’s largest health insurance program and was introduced specifically to serve low-income Americans, including pregnant women, families with young children, those who are blind or disabled and the elderly. Although jointly funded, Medicaid is regulated by the federal government and administered by each state.
In Tennessee, Medicaid is called TennCare and provides coverage for one in five state residents. Those who meet the eligibility requirements receive a range of medically necessary services, including physician and specialist care, inpatient and outpatient hospital care, preventive services, diagnostic tests and community-based and institutional long-term care.
To be eligible for long-term care coverage, Johnson City residents must be U.S. citizens or qualified aliens and aged 65 or older, blind or disabled. Each applicant must also meet TennCare’s financial and functional requirements:
- Have a maximum income of 300% of the federal benefit rate, which is $2,313 per person per month
- Have no more than $2,000 per person in countable resources
- Be assessed as needing a nursing facility level of care
TennCare considers income from every source but excludes some resources, such as a principal residence, personal and household effects, one car and irrevocable burial trusts.
Those who are over the income limit may reach the necessary threshold by establishing an irrevocable
Qualified Income Trust. Excess income must be deposited into the QIT each month and can only be used for medical and long-term care expenses.
Married applicants with excess income and assets may still qualify for TennCare if their spouse doesn’t need coverage. A non-applicant spouse can keep to up to $3,160.50 of the applicant’s monthly income and $126,540 of the couple’s joint assets as
living and resource allowances.
Johnson City seniors can
apply for Medicaid coverage online through TennCare Connect or by calling (855) 259-0701.
CHOICES in Long-Term Services and Supports Waiver TennCare offers the
CHOICES waiver program to limit nursing home admissions and allow seniors and disabled adults to remain in the community. To qualify applicants must:
- Meet Medicaid’s residency and financial requirements
- Be assessed as needing a nursing home level of care
- Be at risk of nursing home placement if assistance isn’t provided
Depending on a participant’s assessed needs and preferences, they may receive services and supports at home, in an adult care home or an assisted living facility. The waiver doesn’t cover room-and-board fees, but it does cover a number of benefits such as:
- Adult day health services
- Personal or attendant care to complete activities of daily living
- Medication management
- Personal emergency response systems
- Respite care
- Transportation
- Assistive technologies
- Benefits counseling
Due to statewide waiver enrollment caps, applicants may be placed on a waiting list before receiving services. Once enrolled in the CHOICE program, seniors also receive primary care, acute care and behavioral health services through a TennCare
Managed Care Organization.
To learn more or apply for the CHOICES waiver, seniors in Johnson City can call the
First Tennessee Area Agency on Aging and Disability at (866) 836-6678.