TennCare Connect Application: How to Apply for Long-Term Care Medicaid in Tennessee

Your parent needs nursing home or home care coverage through TennCare CHOICES, and you're staring at the TennCare Connect portal wondering where to start. The application process involves two separate tracks filed simultaneously — a financial application through TennCare Connect and a clinical assessment submitted by a medical provider. Missing either track means the entire application stalls.

Here's the actual step-by-step process for getting a TennCare CHOICES application submitted correctly.

The Two-Track Filing System

TennCare long-term care applications are not a single form. They require parallel submissions:

Track 1 — Financial application: Filed through TennCare Connect (the state's online portal) or at your local Department of Human Services (DHS) office. This establishes that your parent meets the income cap ($2,982/month) and asset limit ($2,000 countable).

Track 2 — Clinical assessment: A Pre-Admission Evaluation (PAE) must be completed by a certified medical provider and uploaded to the PERLSS system. This proves your parent needs a nursing facility level of care (9+ points on the acuity scale). Additionally, a Level I PASRR screening must be completed before any nursing home admission to screen for serious mental illness or intellectual disabilities.

Both tracks must be active for the application to proceed. Filing the financial application without the PAE, or completing the PAE without the financial application, leaves the case incomplete.

Filing Through TennCare Connect

TennCare Connect is Tennessee's online benefits portal at the state website. To apply for CHOICES:

1. Create an account on TennCare Connect if you don't have one. You can apply on behalf of your parent if you have legal authority (Power of Attorney or guardianship).

2. Select the correct application type. You're applying for TennCare Medicaid with long-term services and supports — not standard TennCare health coverage.

3. Gather financial documentation before you start. The system will ask for:

   • 3 months of bank statements (all accounts, both spouses)
   • Social Security award letters showing current monthly amounts
   • Pension statements
   • IRA/401(k)/investment account statements
   • Property deed or mortgage statement
   • Vehicle titles
   • Life insurance policies (face value over $1,500 is countable)
   • Any asset transfers in the past 60 months

4. Submit and note your application date. This date matters — TennCare can provide up to three months of retroactive coverage from the application date if your parent met all eligibility criteria during that period.

The Clinical Side: Getting the PAE Filed

While your financial application processes through TennCare Connect, the clinical assessment happens separately:

Who files it: The PAE is completed by a physician, nurse practitioner, or certified assessor — not by the family. If your parent is in a hospital, the discharge planning team typically initiates this. If they're at home, their primary care provider or a home health agency can complete the evaluation.

What it measures: The PAE scores your parent across Activities of Daily Living (transferring, mobility, eating, toileting) plus orientation and behavioral factors. A minimum of 9 points out of 26 qualifies for CHOICES Groups 1 and 2.

Where it goes: The completed PAE is uploaded directly into PERLSS (Provider Entry and Registration for LTSS), which links to the financial application already in the TennCare system.

Timeline: What to Expect

The standard processing time for a TennCare CHOICES application is up to 90 days. During this period:

• Days 1-14: DHS reviews initial financial documentation. They may request additional records — respond immediately to avoid delays.
• Days 14-45: Asset verification, lookback review (checking 60 months of financial history for uncompensated transfers).
• Days 45-90: Final determination and MCO assignment (BlueCare, UnitedHealthcare, or Wellpoint).

Hospital Presumptive Eligibility (HPE): If your parent is being discharged from a hospital and needs immediate post-discharge care, ask the hospital social worker about HPE. Qualified hospitals can grant temporary TennCare eligibility on the spot — it won't cover long-term CHOICES services, but it bridges the gap for acute post-discharge care while the main application processes.

Common Application Mistakes

Filing without a QIT when income exceeds $2,982: Tennessee is an income cap state. If your parent's gross monthly income exceeds the limit, the application will be denied unless a Qualified Income Trust is already established and funded before the eligibility determination.

Incomplete financial disclosure: DHS reviews 60 months of records. Omitting accounts — even closed ones or accounts with small balances — triggers requests for information that delay the process by weeks.

No legal authority: If your parent cannot manage their own application due to cognitive decline and you don't have a valid Durable Financial Power of Attorney, banks will refuse to release statements and the application stalls. In severe cases, court-supervised conservatorship may be necessary.

Missing the PASRR requirement: A Level I PASRR must be completed before nursing home admission. Skipping this step can result in the facility refusing admission or the application being sent back for completion.

Alternative Filing Methods

If the online portal isn't working for your situation:

• In-person: Visit your county DHS office with all documentation. Some families find this faster for complex cases.
• Phone: Call TennCare Connect's helpline for assistance with the online application.
• Through your AAAD: Your regional Area Agency on Aging and Disability can assist with application intake and connect you with CHOICES counselors who help navigate the process.

Getting It Right the First Time

A denied application means restarting the 90-day clock. The Tennessee Medicaid Long-Term Care & Asset Protection Guide includes complete document checklists, QIT setup instructions, and the financial worksheet that mirrors exactly what DHS reviews — so you catch disqualifying issues before submitting rather than discovering them in a denial letter eight weeks later.

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