Tennessee CoverKids Income Limits for Kinship Caregivers

Your Income Probably Doesn't Matter

The most common mistake grandparents and relatives make when applying for a child's health coverage in Tennessee: assuming their own income disqualifies the child. It usually doesn't.

Under federal MAGI (Modified Adjusted Gross Income) household construction rules, when a relative caregiver raises a child and doesn't claim the child as a tax dependent, the child's Medicaid eligibility household consists of only the child and any biological siblings in the home. The caregiver's wages, pension, Social Security, and spousal income are completely excluded from the calculation.

This means a grandparent earning well above the adult TennCare limit can have a grandchild fully eligible for free health coverage.

TennCare vs CoverKids

Tennessee has two programs covering children's healthcare, and the income limits differ by the child's age:

TennCare (Medicaid):

• Infants under age 1: a higher income limit than the 142% FPL limit for children ages 1 through 5
• Children ages 1 through 5: up to 142% FPL
• Children ages 6 through 18: up to 133% FPL

CoverKids (Tennessee's CHIP program):

• Children from birth through age 18: up to 250% FPL

If the child's income exceeds the TennCare Medicaid limits but falls below 250% FPL, they qualify for CoverKids instead. In practice, most kinship children have little or no personal income, making them eligible for TennCare Medicaid at the lowest thresholds.

Children placed in legal guardianship through SPG or in DCS state custody receive automatic TennCare coverage regardless of income.

What Counts as the Child's Income

Child support and Social Security survivor benefits in the child's name are evaluated against TennCare caps. If the child receives SSI, confirm its treatment with TennCare Connect. In most kinship situations, the child has zero countable income.

How to Apply

Applications go through TennCare Connect at tenncareconnect.tn.gov or by calling 1-855-259-0701. This is a separate system from ONE DHS (which handles Families First and SNAP). Submitting an application on ONE DHS for cash or food assistance does not automatically trigger a TennCare determination — you need to apply through TennCare Connect specifically.

Processing takes up to 45 calendar days. Once approved, the child is enrolled in a TennCare Managed Care Organization — Amerigroup, BlueCare, or UnitedHealthcare Community Plan — based on your area. Dental coverage is through DentaQuest statewide.

12-Month Continuous Eligibility

Once enrolled, children stay covered for a full 12 months regardless of minor income changes. Annual renewals are conducted primarily through automated checks — the state compares electronic wage, tax, and benefit databases. If automated verification succeeds, coverage renews without any caregiver paperwork.

If the state can't verify electronically, TennCare Connect sends a pre-populated renewal packet with a 30-day response deadline.

The 90-Day Safety Net

If you miss the renewal deadline and the child's coverage is terminated procedurally, Tennessee gives you a 90-day reconsideration window. Submit the completed renewal packet within 90 days of the termination notice, and TennCare must process it without requiring a brand-new application — restoring coverage retroactively to close the gap.

This safety net doesn't apply to coverage denied for substantive reasons (income exceeding the limit), only to procedural closures from missing paperwork.

Appealing a Denial

TennCare eligibility denials must be appealed within 40 calendar days of the notice date through TennCare Connect. MCO-level service denials (a prescription or therapy rejection) follow a different path — the MCO's internal grievance process first, then a state medical fair hearing.

The Tennessee Kinship Financial Help Guide walks through TennCare and CoverKids applications alongside every other program available to kinship caregivers, with a clear chart showing which programs count your income and which evaluate only the child's.

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