TennCare is Tennessee's Medicaid program, administered by the Tennessee Division of TennCare. Whether an immigrant qualifies for TennCare in 2026 depends on two separate tests: immigration status and income. Passing the income test alone is not enough if you do not meet the immigration status requirement, and vice versa. Tennessee is also a non-expansion state, meaning the program does not automatically cover all low-income adults the way it would in expansion states.
This guide explains which immigration statuses qualify, what Tennessee's income limits are by household size in 2026, how CoverKids (Tennessee's CHIP program) fits in for children and pregnant women, and what options exist for those who cannot get full TennCare coverage. For national Medicaid immigrant rules, see Can Immigrants Get Medicaid. For Tennessee's general TennCare rules, see Tennessee Medicaid income limits.
Direct answer: which immigration statuses qualify for TennCare in 2026
It depends on immigration status. Tennessee's TennCare program uses the federal qualified non-citizen definition under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA, 1996). Since October 1, 2026, full Medicaid and CHIP are limited to citizens, green card holders, Cuban and Haitian entrants, and citizens of Micronesia, the Marshall Islands and Palau, who must also meet Tennessee's income and category requirements. Refugees, asylees and other immigrants without a green card generally no longer qualify, though Tennessee covers lawfully residing children and pregnant women under its CHIP state option. The table below summarizes the rules since the October 1, 2026 changes took effect.
TennCare income limits by household size and category (2026)
Tennessee sets TennCare income limits differently for each eligibility category. Qualifying on immigration grounds is necessary but not sufficient: you must also fall into one of Tennessee's covered categories and be below the income limit for that category. Tennessee uses MAGI (Modified Adjusted Gross Income) rules for children, pregnant women, and parents/caretakers, with no asset test for those groups.
Tennessee's five main TennCare/CoverKids income limits in 2026 are: (1) Parents and caretaker relatives: up to 105% of the federal poverty level (FPL), the highest of any non-expansion state. (2) Pregnant women: up to 250% FPL. (3) Infants (age 0-1): up to 195% FPL. (4) Children age 1-5: up to 142% FPL. (5) Children age 6-18 and CoverKids (CHIP): 138% FPL for Medicaid; up to 250% FPL for CoverKids. Healthy adults without dependent children do not qualify at any income level, which is the core effect of Tennessee not having expanded Medicaid.
How the 5-year bar works and who is exempt
Federal law under PRWORA (1996) generally requires qualified non-citizens to wait 5 years after obtaining qualified immigrant status before becoming eligible for federally funded benefits like Medicaid and CHIP. For Tennessee TennCare purposes, the 5-year clock starts on the date you obtained a qualifying immigration status, not the date you entered the country. So a lawful permanent resident who had temporary protected status or an H-4 visa for years before getting a green card does not get credit for that earlier time.
Tennessee has elected the CHIP state option that allows coverage of lawfully residing children and pregnant women before the 5-year bar is completed. This means a child who is a lawful permanent resident in the first year of their green card status can still qualify for TennCare children's coverage or CoverKids if income limits are met. Pregnant women who are lawfully present in Tennessee may also be covered before the 5-year bar is met. The Tennessee Division of TennCare makes this determination on a case-by-case basis; call 855-259-0701 to confirm.
- Exempt from the 5-year bar (qualify immediately for full TennCare if income and category rules are met): green card holders who came as refugees or asylees; Cuban and Haitian entrants; Amerasian immigrants admitted under the Immigration Act of 1990; Afghan and Iraqi special immigrants; COFA migrants (residents of the Marshall Islands, Micronesia, and Palau living in the U.S.). Since October 1, 2026, refugees, asylees, trafficking victims and other immigrants without a green card generally no longer qualify.
- Exempt for children and pregnant women only (under Tennessee's CHIP state option): lawfully residing children and lawfully residing pregnant women during the 5-year wait, subject to TennCare's case-by-case determination.
- Refugees, asylees, and other humanitarian statuses: before October 1, 2026, these groups were exempt from the 5-year bar and could receive TennCare for 7 years from the date their status was granted. Since October 1, 2026, refugees, asylees and other immigrants without a green card generally no longer qualify. Green card holders who came as refugees or asylees are exempt from the 5-year bar.
- Not exempt, subject to 5-year wait: lawful permanent residents (LPRs / green card holders) in their first 5 years of LPR status. Since October 1, 2026, parolees, VAWA applicants (Violence Against Women Act) and other immigrants without a green card generally no longer qualify, even after 5 years.
Is Tennessee a Medicaid expansion state?
Tennessee is one of 10 states that has not expanded Medicaid under the Affordable Care Act. The 10 non-expansion states as of 2026 are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. In expansion states (40 states plus Washington D.C.), adults age 19 to 64 with household income up to 138% of the FPL automatically qualify for Medicaid regardless of whether they have children or a disability. Tennessee has not adopted this expansion, so healthy adults without dependent children cannot get TennCare at any income level.
The ACA coverage gap affects immigrants in Tennessee particularly hard. In expansion states, a green card holder who completes the 5-year bar at age 35 with no children and an income of $18,000 per year would immediately qualify for Medicaid. In Tennessee, that same person falls into the coverage gap: too much income for TennCare (which only covers adults with children), and potentially too little income for ACA marketplace subsidies, which in 2026 require income of at least 100% FPL ($15,650 for one person). Beginning January 1, 2026, immigrants under the 5-year bar who are below 100% FPL also lost access to ACA premium tax credits under the 2025 reconciliation law, deepening the coverage gap for recently arrived immigrants.
Emergency Medicaid for immigrants who do not qualify for full TennCare
Tennessee is required by federal law to provide Emergency Medicaid to individuals who meet all TennCare eligibility requirements except for immigration status. Emergency Medicaid covers the treatment of an emergency medical condition: a condition that, without immediate attention, would place the patient's health in serious jeopardy, cause serious impairment of a bodily function, or cause serious dysfunction of a body organ or part. Emergency Medicaid in Tennessee covers true emergency room visits, emergency surgery, and other acute care. It does not cover routine preventive care, non-emergency specialist visits, dental cleanings, or ongoing management of chronic conditions.
For pregnant women, Emergency Medicaid in Tennessee covers labor and delivery and routine prenatal and postpartum care classified as part of the emergency delivery. This is a significant exception: an undocumented pregnant woman or a DACA recipient who is pregnant can receive TennCare coverage for the labor and delivery itself under Emergency Medicaid, even without regular TennCare enrollment. The baby, once born a U.S. citizen, is immediately eligible for full TennCare on the citizen track regardless of the parents' immigration status, provided the family meets income limits.
October 1, 2026 changes to TennCare immigrant eligibility
The 2025 federal reconciliation law includes a provision (Section 71109) that, beginning October 1, 2026, restricts Medicaid and CHIP immigrant eligibility to a narrower set of categories. Since October 1, 2026, only the following groups remain eligible for full Medicaid/TennCare: lawful permanent residents (LPRs) who have met or are exempt from the 5-year bar; Cuban and Haitian entrants; and COFA migrants (residents of the Marshall Islands, Micronesia, and Palau). Refugees, asylees, trafficking victims, Afghan/Iraqi special immigrants, VAWA applicants, and many other previously eligible groups no longer qualify for full TennCare since October 1, 2026, unless they have obtained LPR status.
Tennessee immigrants who were enrolled in TennCare through a humanitarian immigration status (refugee, asylee, trafficking victim, or similar) generally no longer qualify since October 1, 2026 unless they have a green card, and should check whether they can adjust their immigration status. GetCoveredTenn navigators (getcoveredtenn.org) can assist with reviewing coverage options. Legal aid organizations in Tennessee, including Tennessee Justice Center and Legal Aid Society of Middle Tennessee, can help with immigration status questions affecting benefit eligibility.
How to apply for TennCare in Tennessee: documents and steps
Tennessee immigrants apply for TennCare through TennCare Connect, the official state portal at tenncareconnect.tn.gov. Applications are accepted year-round with no enrollment window. After confirming your immigration status category is eligible (see the table in the first section), gather identity documents, your immigration status documents (green card, I-94, asylee approval notice, or equivalent), proof of Tennessee residency, and income documentation for all household members. Call 855-259-0701 if you need phone or in-person assistance, or visit a GetCoveredTenn navigator (getcoveredtenn.org) for free help in multiple languages.
Documents needed to apply for TennCare as an immigrant in Tennessee include: (1) immigration status document (I-551 green card, I-94, I-766 EAD, or USCIS approval notice for asylee/refugee status); (2) proof of identity (driver's license, state ID, or passport); (3) Social Security number for each person who has one; (4) proof of Tennessee residency (utility bill, lease, or bank statement); (5) income proof for all household members (pay stubs, employer letter, or no-income statement); (6) household composition proof (birth certificates or guardianship documents for children). Tennessee has up to 45 days to make a determination on a standard Medicaid application.
How to appeal a TennCare denial
Tennessee residents who are denied TennCare have the right to appeal. The denial notice from TennCare will specify the reason for denial and the deadline to appeal. Tennessee TennCare appeals follow these steps: First, you have 90 days from the date of the denial notice to request a state fair hearing. Second, you can file the appeal online through your TennCare Connect account at tenncareconnect.tn.gov, by phone at 855-259-0701, or by mailing a written request to TennCare. Third, if you file the appeal within 10 days of the denial notice (or before the denial takes effect), you can request that your TennCare benefits continue during the appeal process. Fourth, a hearing officer will review your case. Fifth, if the fair hearing decision is also unfavorable, you can appeal to the Davidson County Chancery Court.
Tennessee immigrants who believe a TennCare denial was incorrect based on their immigration status should seek help from a navigator or legal aid organization. The Tennessee Justice Center (tnjustice.org, 615-255-0331) provides free legal assistance with TennCare denials and appeals. GetCoveredTenn (getcoveredtenn.org) offers free navigator assistance in multiple languages for both TennCare applications and appeals.
What TennCare covers and who administers it
TennCare is the name of Tennessee's Medicaid and CHIP program, established in 1994 as one of the first statewide managed care Medicaid programs in the U.S. The Tennessee Division of TennCare administers the program, which serves approximately 1.5 million Tennesseans. All TennCare enrollees receive coverage through one of three managed care organizations (MCOs): BlueCare Tennessee, UnitedHealthcare Community Plan of Tennessee, or Wellpoint (formerly Amerigroup Tennessee). TennCare covers doctor visits, hospital stays, mental health and substance use treatment, prescription drugs, preventive care, dental for children, and many other services.
CoverKids is Tennessee's CHIP (Children's Health Insurance Program), covering children under age 19 whose family income is too high for TennCare Medicaid but at or below 250% FPL ($82,500 for a family of four in 2026). CoverKids has the same immigration eligibility rules as TennCare for children, with the additional protection that lawfully residing children can apply even before the 5-year bar is met. The premium for CoverKids is $25 to $35 per child per month depending on income. Applications for both TennCare and CoverKids are submitted through the same TennCare Connect portal at tenncareconnect.tn.gov.
Frequently Asked Questions
Can a green card holder get TennCare in Tennessee?
It depends on how long you have had your green card. Lawful permanent residents (green card holders) must generally complete a 5-year waiting period after receiving their green card before qualifying for full TennCare. An exception exists for lawfully residing children and pregnant women, who may qualify before the 5-year bar is met under Tennessee's CHIP state option. After the 5-year bar is complete, a green card holder with children and income below 105% FPL ($34,650 for a family of four in 2026) would qualify for TennCare as a parent/caretaker.
Can a refugee or asylee get TennCare in Tennessee?
Only in some cases. Since October 1, 2026, full Medicaid and CHIP are limited to citizens, green card holders, Cuban and Haitian entrants, and citizens of Micronesia, the Marshall Islands and Palau. Refugees and asylees without a green card generally no longer qualify for full TennCare, though Tennessee covers lawfully residing children and pregnant women under its CHIP state option. If you have adjusted to a green card, you qualify like any green card holder and do not have to wait 5 years, provided you meet income and category requirements. Emergency Medicaid still pays for emergency care for people who would otherwise qualify. Contact TennCare Connect at 855-259-0701 for help with your case.
Can DACA recipients get TennCare in Tennessee?
No, not for full TennCare. DACA (Deferred Action for Childhood Arrivals) recipients are not considered qualified non-citizens under PRWORA, so they are not eligible for full TennCare Medicaid or CoverKids in Tennessee. DACA recipients are eligible for Emergency Medicaid only, which covers true medical emergencies and labor/delivery for pregnant women. Since August 25, 2025, DACA recipients cannot buy a plan through the ACA marketplace (HealthCare.gov) or get premium tax credits, at any income; they can buy a plan directly from an insurance company at full price.
Can undocumented immigrants get any healthcare coverage in Tennessee?
Undocumented immigrants in Tennessee can access Emergency Medicaid for true medical emergencies, including labor and delivery for pregnant women. Babies born in Tennessee to undocumented parents are U.S. citizens and are immediately eligible for full TennCare if income limits are met. Beyond Emergency Medicaid, options include Federally Qualified Health Centers (FQHCs), which serve all patients on a sliding-fee scale regardless of immigration status. Find an FQHC near you at findahealthcenter.hrsa.gov. Undocumented immigrants cannot purchase ACA marketplace plans.
Does Tennessee cover immigrant children in TennCare or CoverKids?
Yes. Tennessee has elected the CHIP state option to cover lawfully residing children before the 5-year bar is met. A lawfully residing child (including a child who is a new lawful permanent resident or a child in an H-4 dependent status) can apply for TennCare children's coverage or CoverKids in Tennessee as long as income limits are met. Children who are qualified non-citizens and whose parents have completed the 5-year bar qualify on the same terms as citizen children. Undocumented children are eligible for Emergency Medicaid only.
What happens to my TennCare if I change immigration status?
TennCare is required to be notified of changes to immigration status. If your status changes in a way that makes you eligible (for example, you became a lawful permanent resident after being a DACA recipient), you should contact TennCare Connect to update your case. If your status changes in a way that removes eligibility, TennCare will send a notice and you have the right to appeal. Report immigration status changes by calling 855-259-0701 or through your TennCare Connect account at tenncareconnect.tn.gov.
Is Tennessee a Medicaid expansion state?
No. Tennessee is one of 10 states that has not expanded Medicaid under the ACA as of 2026. The other non-expansion states are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Texas, Wisconsin, and Wyoming. Because Tennessee has not expanded, healthy adults without dependent children cannot get TennCare at any income level, creating a coverage gap for low-income adults. This affects qualified immigrants the same way it affects citizens: a qualified immigrant adult who has cleared the 5-year bar but has no children cannot get TennCare unless they have a disability or are elderly and SSI-eligible.
What are the income limits to qualify for TennCare in Tennessee 2026?
TennCare income limits vary by category in 2026. Parents and caretaker relatives must earn at or below 105% FPL ($34,650 for a family of four). Pregnant women qualify up to 250% FPL ($82,500 for a family of four). Infants (age 0-1) qualify up to 195% FPL; children age 1-5 up to 142% FPL; children age 6-18 up to 138% FPL. CoverKids (CHIP) covers children under 19 up to 250% FPL ($82,500 for a family of four). Tennessee uses 2026 Federal Poverty Level guidelines from ASPE/HHS for all MAGI-based calculations. Healthy adults without dependent children cannot qualify for TennCare at any income level.
