Medicaid · A Pillar Guide from Preferred Care at Home
Tennessee families call TennCare, then the CHOICES program, then their local human services office — and get three different answers. TennCare Medicaid, CHOICES, and state-funded OPTIONS are three separate doors, and this guide maps which one fits yours before you spend a week on hold.
Medicaid home care in Tennessee runs through three separate programs, each with its own eligibility rules, coverage, and application path. Here is the map, before anything else.
Medicare home health is short-term skilled care after a hospital stay. Tennessee Medicaid home care is long-term care built around daily living — bathing, meals, medications. Families mix these up constantly; both may apply at different times.
The TennCare Institutionalized Individuals category covers nursing facility care and home and community based services — using a $2,982 monthly income limit and $2,000 resource limit for one person. Long-term services use different limits than acute health services.
The TennCare CHOICES program is Tennessee Medicaid’s long-term services and supports pathway. It is not separate from TennCare — but it carries its own benefits rules, and it is managed through a managed care organization rather than an individual agency.
OPTIONS for Community Living is state funded, not federal Medicaid, and uses a sliding fee scale instead of strict income limits. It may help families who need in-home support but do not qualify financially for the Medicaid program.
01
Your parent is slower on the stairs, missing medications, or forgetting appointments. Their primary care provider mentioned Medicaid, and you have no idea whether that means TennCare, the CHOICES program, or something else. This guide lays out the map before you spend a week on hold.
02
Tennessee funds both nursing home care and home and community based services — and the benefits of staying home often outweigh a facility move once families see the full picture, especially for adult children juggling a full-time job alongside a parent’s care.
03
You’re already providing daily supervision and wondering whether Medicaid offers relief. CHOICES includes consumer direction for eligible services, and OPTIONS may cover respite and attendant care — neither guarantees payment, but community based services can include companion and homemaker help for families who qualify.
You stop wasting weeks on the wrong door: TennCare Connect for financial Medicaid eligibility, the Area Agency on Aging and Disability for state-funded help, or a private-pay path if neither applies. Calling the right number first is worth more than any brochure.
CHOICES benefits are real but capped: adult day care at 2,080 hours a year, companion and homemaker services in assisted living exclude room and board. PERS units, home-delivered meals, minor home modifications, and even pest control may be available through ECF CHOICES — coverage varies by county and plan.
Once you understand the difference between eligibility approval and provider acceptance, you stop asking providers “do you take Medicaid?” — and start asking whether your parent’s TennCare category authorizes the specific personal care assistance needed.
Once you know which Medicaid door fits, here is how Hendersonville families actually move forward — call us at (615) 970-3737 with questions along the way.
Name what your parent needs help with day to day: bathing, meals, medications, transfers, or supervision. A physical disability may qualify someone for different services than age alone.
Compare the Institutionalized Individuals income and resource rules against your parent’s finances. Over the limit? OPTIONS or private pay may fit better — and waiting too long carries its own risk.
Online via TennCare Connect, by phone at 1-855-259-0701, or on paper at your local human services office. The AAAD (1-866-836-6678) can send someone to help at home if your parent has a disability.
Once TennCare approves and CHOICES is authorized, a managed care organization builds the plan of care, sets hours, and may open consumer direction for eligible services.
Approval opens the door. Choosing caregivers who fit your parent’s personality, schedule, and clinical needs is a separate conversation — and that is where we come in.
Quin Christensen and Richard Patterson own this location and live in the Hendersonville area. Quin came into this work after watching his own parents navigate cancer, stroke, and heart disease; Richard started at 14 in an assisted living facility. Both take calls.
Melissa Maxfield is a Licensed Practical Nurse on our team, and Lisa Barry serves as our Transition Liaison, coordinating hospital-to-home moves. Preferred Care at Home was founded by a registered nurse and her family, and that clinical foundation still shapes local offices across Middle Tennessee.
Certified Preferred Provider status was earned through additional training in home care operations and client support — combined with multiple years of Home Care Pulse recognition as Employer of Choice, Provider of Choice, and Leader in Experience.
The Institutionalized Individuals category: income at or below $2,982/month and resources at or below $2,000 for one person, covering nursing facility care and home and community based services alike.
TennCare’s long-term services and supports program for seniors 65+ and adults 21+ with a physical disability — managed through your assigned MCO, with structured benefits and consumer direction for eligible services.
OPTIONS for Community Living: state funded, adults 18+, sliding fee scale instead of strict income limits, and no estate recovery — for families who need in-home support but don’t qualify financially for Medicaid.
When none of the three doors fits or while applications process, private pay covers any care immediately — including live-in home care, which sits outside every plan of care.
Families assume the choice is “Medicaid or private pay.” In Tennessee there is a third door: OPTIONS has no strict income requirement, while CHOICES uses federal Medicaid rules with strict thresholds. Which fits depends on finances, level of need, and disability status.
Yes, but not through one program. TennCare’s long-term services pathway (the CHOICES program) covers home and community based services for eligible seniors and adults with a physical disability.
State-funded OPTIONS covers a separate set of in-home supports for people who may not qualify for the Medicaid program financially.
There is no premium, but CHOICES benefits have structured limits, not unlimited coverage. Some services are capped by hours or dollars per year, and certain settings require the family to pay room and board out of pocket.
Consumer direction is available for some services, but that is not guaranteed family-caregiver pay — ask the MCO for a written plan of care with all limits spelled out.
Qualification depends on financial rules, level of care need, and disability or age. For the Institutionalized Individuals category, income must sit at or below the federal benefit rate, with resources at or below the asset limit.
Level of care is assessed against daily living activities like bathing, dressing, meals, and medications — and adults with a qualifying physical disability may be eligible earlier than 65.
Tennessee accepts applications three ways: online through TennCare Connect, by phone at 1-855-259-0701, or on paper. Local human services offices also have kiosks.
If the applicant has a disability, the Area Agency on Aging and Disability can send someone to the home to help — reachable at 1-866-836-6678.
In some cases, yes. CHOICES includes consumer direction for eligible home and community based services, allowing a member to hire and direct their own attendant care — and certain family members may qualify as paid caregivers.
A non-applicant spouse or legal guardian generally cannot be paid, and eligibility is decided case by case — don’t assume pay is guaranteed by enrolling.
CHOICES covers structured home and community based services, not everything a family might need. Room and board in assisted living is not covered, assistive technology is limited to $900 a year, and adult day care is capped annually. Non-medical private-pay services outside the plan of care — including live-in home care — are the family’s responsibility.
The application itself takes most people 30 to 60 minutes through TennCare Connect. Approval takes longer: federal rules allow up to 45 days for standard applications and up to 90 days when a disability determination is required.
Call (615) 970-3737 if you have questions along the way — we help families sort the sequence before they apply.
Estate recovery applies to TennCare members who received long-term care benefits under CHOICES Groups 1, 2, or 3 at age 55 or older. Recovery is waived when the member is survived by a non-applicant spouse, a child under 21, or a blind or disabled child of any age.
Hardship waivers also exist. Ask an estate-planning attorney before enrolling if this is a concern — we are not attorneys, but we can point you to local resources.
Every week of waiting is a week your parent is figuring it out alone.
We’ll walk through the TennCare, CHOICES, and OPTIONS questions before you spend hours on hold. Call or text (615) 970-3737.
