Medicare and Medicaid Dual Eligibility in Tennessee 2026: Income Limits, Benefits & How to Apply

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Dual Eligibility in Tennessee: Key Facts

Dual Eligible Population Approximately 14% of Tennessee Medicare beneficiaries
QMB Income Limit (Individual) $1,255/month (100% FPL)
SLMB Income Limit (Individual) $1,694/month (120% FPL)
Tennessee Medicaid Agency Tennessee Division of TennCare
Phone 615-507-6100

What Is Dual Eligibility?

Dual eligible beneficiaries are individuals who qualify for both Medicare and Medicaid. In Tennessee, approximately 14% of Medicare beneficiaries are also enrolled in Medicaid. Dual eligible beneficiaries receive comprehensive coverage: Medicare covers hospital and medical services, while Medicaid covers additional services including long-term care, dental, vision, and hearing — services that Medicare does not cover. Medicaid also pays some or all of the Medicare premiums, deductibles, and copayments for dual eligible beneficiaries.

Medicare Savings Programs in Tennessee

Even if you do not qualify for full Medicaid, you may qualify for a Medicare Savings Program (MSP) in Tennessee that helps pay your Medicare costs. There are four MSP levels:

Program Individual Income Limit What It Pays
Qualified Medicare Beneficiary (QMB) $1,255/month Part A and B premiums, deductibles, and copayments
Specified Low-Income Medicare Beneficiary (SLMB) $1,694/month Part B premium only
Qualifying Individual (QI) ~$1,800/month Part B premium only (limited slots)
Qualified Disabled Working Individual (QDWI) ~$4,615/month Part A premium only

Benefits of Full Dual Eligibility in Tennessee

Full dual eligible beneficiaries in Tennessee receive:

  • $0 Medicare premiums — Medicaid pays your Part A and Part B premiums
  • $0 Medicare deductibles and copayments — Medicaid covers your Medicare cost-sharing
  • Extra Help for Part D — Automatic enrollment in the Low Income Subsidy, capping drug costs at $4.50-$11.20 per prescription
  • Long-term care coverage — Medicaid covers nursing home care and home and community-based services that Medicare does not cover
  • Additional services — Dental, vision, hearing, and transportation (varies by Tennessee Medicaid program)

How to Apply for Dual Eligibility in Tennessee

To apply for Medicaid in Tennessee and potentially qualify for dual eligibility, contact the Tennessee Division of TennCare at 615-507-6100. You can also apply online through Tennessee’s Medicaid portal or through your local Department of Social Services office. If you already have Medicare, applying for Medicaid will not affect your Medicare coverage — it will only add benefits.

D-SNPs: Dual Eligible Special Needs Plans in Tennessee

Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage plans specifically designed for dual eligible beneficiaries. In Tennessee, D-SNPs coordinate your Medicare and Medicaid benefits through a single plan, often with additional benefits like transportation, over-the-counter allowances, and care coordination. To find D-SNPs available in your county, use Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE.

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