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Last updated: 13 September 2026
Paying for assisted living in Tennessee often means combining several resources. TennCare CHOICES can pay approved care services in some participating assisted care living facilities, but not the resident’s room and board. Veterans benefits, Social Security, insurance, family help, and home-care alternatives may also matter.
Tennessee often calls licensed assisted living an Assisted Care Living Facility (ACLF).
Bottom Line
If money is tight, call your Area Agency on Aging and Disability (AAAD) at 1-866-836-6678 and ask for a TennCare CHOICES screening. CHOICES can pay approved ACLF care services, but the resident still owes room and board. In 2026, the room-and-board ceiling is generally the lesser of $2,385.60 per month or the lower comparable non-CHOICES rate. This is a billing limit, not cash paid to the resident.
Need Help Right Now?
Call 911 for immediate danger or a medical emergency. To report suspected abuse, neglect, or financial exploitation of a vulnerable adult, contact Tennessee Adult Protective Services at 1-888-277-8366, available 24 hours a day. If the problem involves rights, care, charges, discharge, or conditions inside a long-term care facility, call the long-term care ombudsman at 1-877-236-0013.
If the crisis is about losing housing, utilities, food, or another immediate need while you arrange care, use our Tennessee emergency help guide.
Start Here
- Call the AAAD. Use the Tennessee AAAD directory or 1-866-836-6678. Ask for CHOICES screening and home-care alternatives.
- Get an itemized quote. Separate room and board, care charges, extras, and private-room costs. Ask whether the facility contracts with the applicant’s TennCare plan.
- Check other payers. Screen veterans or surviving spouses for VA pension help. Also check long-term care insurance, Social Security, and family resources.
For a broader benefits check, keep the Tennessee senior benefits guide open while you make calls.
Quick Payment Routes
| Route | What it may help pay | Main limit | First step |
|---|---|---|---|
| TennCare CHOICES | Approved personal care, homemaker help, medication oversight, and other covered ACLF services | Does not cover room and board; medical and financial rules apply | AAAD or your TennCare health plan |
| VA pension with Aid and Attendance | Monthly pension income that can help with care costs if VA rules are met | Service, care-need, income, net-worth, and expense rules apply | County Veterans Service Office |
| Social Security or SSI | Resident’s share of room, board, and personal expenses | Tennessee does not add a state SSI supplement | Review current SSA benefit |
| Long-term care insurance | Policy benefits that may include assisted living | Waiting periods, benefit caps, and covered settings vary | Request the policy’s benefits schedule |
| PACE or home services | Community care that may avoid or delay assisted living | PACE is limited to Hamilton County; other services depend on need and availability | AAAD or PACE intake |
What Assisted Living Costs in Tennessee
Prices vary by care level, room, location, and fees. The CareScout 2025 survey, published in 2026, reported a Tennessee median of $5,845 per month ($70,140 per year) for a private one-bedroom assisted-living arrangement. It is a planning median, not a facility quote.
Do not compare that private-pay median directly with the CHOICES room-and-board ceiling. CHOICES separates approved care services from room and board. Our low-income assisted living guide explains common payment combinations; Tennessee rules still control the local case.
TennCare CHOICES: The Main Public Care Route
TennCare CHOICES is Tennessee’s Medicaid long-term services and supports program for eligible adults age 65 or older and adults age 21 or older with physical disabilities. Medical need and financial eligibility both matter.
What CHOICES can cover
CHOICES can pay approved long-term services and supports. When a member’s approved plan includes ACLF services, the state’s 2026 room-board memo lists covered care such as personal care, homemaker services, and medication oversight.
Room and board is separate. CHOICES cannot cover it as part of the HCBS benefit. The resident uses personal income or other outside resources for that part of the bill.
Who may qualify in 2026
For the Medicaid long-term services and supports category, 2026 TennCare limits show $2,982 per month in income and $2,000 in countable resources for a household of one. TennCare says some applicants over the income limit may be able to use a Qualifying Income Trust. Ask TennCare or the AAAD how that rule applies before creating a trust.
CHOICES also reviews property given away or sold below fair value during the prior five years. Do not transfer assets just to try to qualify. If the applicant is married, ask TennCare to calculate the case instead of self-screening from the single-person figures.
The 2026 room-and-board protection
When TennCare pays approved ACLF services, the 2026 room-and-board maximum is the lesser of $2,385.60 per month or a lower comparable non-CHOICES rate.
A resident may voluntarily pay the allowed difference for a private room, but Tennessee says this cannot be a condition of admission. A CHOICES-contracted ACLF must also accept the CHOICES payment as payment in full for covered ACLF services and cannot shift covered care costs into room and board.
If a CHOICES member has income above the $2,982 personal-needs amount, the 2026 memo says the excess can be collected as patient liability for covered ACLF services in addition to room and board. Ask the health plan for the exact patient-liability calculation before moving. The memo also says room-and-board delinquency can lead to discharge with proper notice, including at least 30 days’ advance notice.
| Item | 2026 figure | What it means |
|---|---|---|
| LTSS income limit | $2,982/month | Financial screening figure for a one-person Medicaid LTSS case; a Qualifying Income Trust may be possible if income is higher |
| LTSS resource limit | $2,000 | Countable-resource limit shown by TennCare for a one-person institutional/HCBS case |
| CHOICES ACLF room-board maximum | $2,385.60/month | Maximum subject to the lower non-CHOICES rate; applies when TennCare is paying approved ACLF services |
| Federal SSI maximum | $994/month | Maximum federal SSI amount for an eligible individual before reductions; Tennessee adds no state SSI supplement |
| Private assisted-living median | $5,845/month | CareScout 2025 survey median published in 2026; not a TennCare rate or facility quote |
These figures answer different questions. Do not subtract one from another as if every applicant receives the maximum benefit.
Do not assume a CHOICES slot is open
TennCare’s March 2026 LTSS guide says a Group 3 applicant who is not receiving SSI must meet the financial rules and have a slot available; the number of Group 3 slots depends on funding. The guide does not give a live statewide slot count. Ask the AAAD or health plan about availability now.
Estate recovery matters
Tennessee’s TennCare estate recovery page says recovery can apply after death when a member age 55 or older received CHOICES Groups 1, 2, or 3. Waivers and undue-hardship rules exist, including protections for a surviving spouse and certain children. Relatives are not personally responsible merely because they are family.
Veterans and Surviving Spouses
Qualified veterans and survivors receiving VA Pension may be eligible for extra VA Aid and Attendance payments when care needs meet VA rules.
Rates effective December 1, 2025, list a current VA pension rate (MAPR) of $29,093 for a veteran with no dependents who qualifies for Aid and Attendance and $34,488 with one dependent. MAPR is not an automatic payment; VA considers countable income, net worth, and deductible expenses.
VA’s medical expense guidance includes a residential-care worksheet. Use Tennessee’s county veterans offices finder for claim help, and see our Tennessee veteran benefits guide.
SSI, Social Security, and Medicare
The 2026 SSI amounts list a maximum federal payment of $994 per month for an eligible individual and $1,491 for an eligible individual with an eligible spouse. Actual payments can be lower. SSA’s SSI state supplements list shows Tennessee does not add a state SSI payment.
Medicare is not a general assisted-living payer. Medicare long-term care guidance says most non-medical long-term custodial care is not covered, though separate medically necessary services may be.
If Medicare premiums are straining the budget, ask about Medicare Savings Programs. Our Tennessee benefits portals guide explains the state entry points.
Long-Term Care Insurance and Private-Pay Planning
If the person has long-term care insurance, call before moving. Ask whether assisted living is covered, what triggers benefits, whether an elimination period applies, the daily or monthly benefit, the lifetime maximum, and whether the facility meets the policy definition.
For private pay, compare the total bill with dependable income, insurance, and family contributions. Budget for rate increases and costs outside the base price. Our long-term care insurance guide gives a policy checklist.
PACE and Home-Care Alternatives
If the person can remain safely in the community with enough support, home-based care may delay or avoid assisted living.
PACE in Hamilton County
The Tennessee PACE page requires age 55 or older, nursing-facility level of care, Hamilton County residence, and ability to live safely in the community. The state lists Alexian PACE at 423-698-0802. PACE coordinates medical and social services; it is not a statewide assisted-living rent benefit.
OPTIONS and other home services
The state-funded OPTIONS program page lists Tennessee residency, age 18 or older, and daily-living limitations. It has no income eligibility rule, but a sliding fee may apply. Services depend on need and availability.
If a relative is doing much of the care, our family caregiver pay guide explains Tennessee routes worth checking. If the person needs disability-specific help, see Tennessee disability help.
Check the Facility Before You Sign
Tennessee’s Health Facilities Commission (HFC) licenses Assisted Care Living Facilities. Use the HFC facility search before paying a deposit. Ask for the exact license type; a marketing name such as “senior living” does not prove the setting is an ACLF. A state bed report shows licensed capacity, not today’s vacancies or CHOICES participation.
| Ask | Why it matters | Get in writing |
|---|---|---|
| Do you currently take CHOICES? | A licensed ACLF is not automatically a CHOICES provider for every TennCare plan | Health plan contracts and who verifies eligibility |
| What is room and board? | CHOICES care payments and resident room-board charges are different | Base room, meals, utilities, and private-room amount |
| What care costs extra? | Medication help, escorts, supplies, or higher care levels can change a private bill | Current fee schedule and rate-change policy |
| What happens if needs rise? | A resident may later need more care than the facility can safely provide | Transfer, discharge, and notice policy |
| Is a deposit refundable? | Move-in plans can change while eligibility is pending | Refund conditions and deadlines |
For care, rights, or billing problems, ask the ombudsman for help. Regulatory complaints can also use the HFC complaints page.
How to Start Without Wasting Time
- List care needs. Note help with bathing, dressing, eating, walking, transfers, toileting, medications, supervision, and safety.
- Call the AAAD. If not enrolled in TennCare, ask for CHOICES screening. Current TennCare members should contact the health plan on their card.
- Verify the facility. Confirm CHOICES participation with the applicant’s health plan before moving when possible.
- Get the full price. Separate room and board, care charges, deposits, and optional fees.
- Check other payers. Review VA benefits and long-term care insurance.
- Keep a call log. Record names, dates, missing proof, and deadlines.
If assisted living remains unaffordable, compare income-based senior apartments plus home services. A lower-cost setting with approved support may be safer for the budget than spending down savings quickly.
Document Checklist
- Photo ID, Social Security number, and proof of Tennessee residency.
- Medicare, TennCare, and other insurance cards.
- Social Security, pension, annuity, wages, and other income statements.
- Recent bank and investment statements and information about other assets.
- Records of property sold, transferred, or given away during the prior five years for a TennCare LTSS application.
- Medication list, diagnoses, hospital or rehabilitation discharge papers, and physician information.
- A written list of help needed with activities of daily living and supervision.
- Facility rate sheet, admission agreement, deposit terms, and itemized room-and-board quote.
- Veteran discharge papers and marriage or survivor documents if VA pension may apply.
- Long-term care insurance policy, elimination-period information, and recent claim correspondence if applicable.
Reality Checks
- CHOICES is not “free assisted living.” Approved care services and room-and-board charges are treated separately.
- The $2,385.60 figure is not a payment to you. It is the 2026 maximum room-and-board charge under the specific CHOICES ACLF rule, subject to the lower comparable rate.
- A license is not a Medicaid contract. Confirm the facility’s current CHOICES participation with the applicant’s managed care plan.
- Availability changes. Facility vacancies, provider capacity, OPTIONS services, and some CHOICES enrollment can change. Get current confirmation instead of relying on an old directory.
- Over the income limit does not always end the inquiry. TennCare says a Qualifying Income Trust may be possible for some people above the LTSS income limit.
- Asset transfers can hurt. TennCare looks back five years for below-market transfers. VA pension has separate transfer rules. Get qualified advice before moving assets.
Common Mistakes to Avoid
- Assuming Medicare will pay the monthly assisted-living bill.
- Choosing a facility before checking whether it participates with the person’s TennCare health plan.
- Calling the 2026 CHOICES room-and-board ceiling a “Medicaid benefit” or cash grant.
- Comparing only the advertised base rent instead of the total written monthly charges.
- Giving away money or property before a Medicaid or VA eligibility review.
- Ignoring letters while an application is pending. A request for proof can have a short response deadline.
- Waiting until discharge day from a hospital or rehabilitation center to start long-term care planning.
Denied, Delayed, or Overwhelmed
Ask for the decision in writing. Identify whether the problem is eligibility, a medical/service decision, or a facility issue; the appeal path differs.
TennCare’s beneficiary support system helps CHOICES applicants and members with rights, complaints, appeals, and fair hearings. Disability Rights Tennessee lists 1-888-723-8193.
For a medical/service decision, TennCare medical appeals guidance gives a general 60-day appeal period after learning of the problem and lists 1-800-878-3192. Eligibility appeals use TennCare Connect instead, so read the notice.
If the facility itself is the problem, call the Long-Term Care Ombudsman. If you need a different housing plan while an application or appeal moves forward, use our Tennessee housing help guide.
Backup Options When the First Plan Fails
- Try another participating ACLF. Facility contracts with TennCare plans differ.
- Use home services longer. OPTIONS, CHOICES home care, PACE in Hamilton County, and family caregiving may delay a move.
- Reduce other costs. Medicare, food, utility, and housing help can preserve income for care.
- Recheck VA eligibility. Pension rules and medical expenses can change the result.
- Ask about payment plans. Facility policies vary; do not assume discounts are available.
Tennessee Official Resources
- AAAD statewide line: 1-866-836-6678 for aging services and CHOICES application help.
- TennCare LTSS Help Desk: 1-877-224-0219 for long-term services and supports questions.
- Long-Term Care Ombudsman: 1-877-236-0013 for facility rights and resident problems.
- Adult Protective Services: 1-888-277-8366 for suspected abuse, neglect, or exploitation; call 911 for immediate danger.
- Disability Rights Tennessee: 1-888-723-8193 for CHOICES applicant/member support through the Beneficiary Support System.
- Alexian PACE: 423-698-0802 for eligible Hamilton County residents.
For a plain-language map of the aging network before you call, use our Tennessee AAAD guide.
Phone Scripts You Can Use
AAAD / CHOICES screening
“I am helping a Tennessee resident who may need assisted living. I want to check TennCare CHOICES and any home-care alternatives before we sign a facility contract. Can you screen us and tell me what documents you need?”
Assisted living facility
“Do you currently provide CHOICES ACLF services for this person’s TennCare health plan? Please give me a written breakdown of room and board, covered care services, optional charges, private-room costs, deposits, and your rate-change policy.”
Veterans service office
“I am helping a veteran or surviving spouse who needs daily care. Can you screen for VA Pension with Aid and Attendance and tell us which assisted-living expenses and forms may count in this case?”
Appeal or problem
“We received a CHOICES denial or service decision. Please tell me whether this is an eligibility appeal or a medical/service appeal, the filing deadline, and how to get help submitting it correctly.”
Resumen en Español
En Tennessee, TennCare CHOICES puede pagar servicios de cuidado aprobados en un centro participante, pero no alojamiento y comida. En 2026, el límite general de alojamiento y comida para un miembro de CHOICES con servicios ACLF es el menor entre $2,385.60 al mes y una tarifa comparable menor.
Llame al 1-866-836-6678 para pedir una evaluación de CHOICES. Prepare comprobantes de ingresos, recursos, seguro y necesidades de cuidado. Veteranos y cónyuges sobrevivientes también deben preguntar por la pensión de VA y Aid and Attendance.
Si hay una denegación, pida la decisión por escrito. Disability Rights Tennessee ayuda con CHOICES al 1-888-723-8193. Para problemas dentro de un centro, llame al Ombudsman al 1-877-236-0013.
Frequently Asked Questions
Does TennCare pay for assisted living in Tennessee?
TennCare CHOICES can pay approved care services in a participating Assisted Care Living Facility when those services are part of the member’s approved plan. It does not pay room and board. The resident uses income or other resources for room and board.
What are the 2026 CHOICES financial limits?
For a one-person Medicaid long-term services and supports case, TennCare lists a 2026 monthly income limit of $2,982 and a $2,000 countable resource limit. TennCare says a Qualifying Income Trust may be possible when income is over the limit. Other rules, including medical eligibility and transfer rules, also apply.
What is the 2026 CHOICES room-and-board limit?
When TennCare is paying approved ACLF services, the 2026 room-and-board charge generally cannot exceed the lesser of $2,385.60 per month or a lower amount charged to a comparable non-CHOICES resident. A resident may voluntarily pay the permitted difference for a private room.
Does Medicare pay for assisted living?
Medicare does not pay most non-medical long-term custodial care, including the general assisted-living room-and-board bill. Medicare may still cover separate medically necessary services that meet Medicare coverage rules.
Does Tennessee add money to SSI?
No. The Social Security Administration currently lists Tennessee as a state that does not pay a state SSI supplement. The 2026 maximum federal SSI amount is $994 per month for an eligible individual before any reductions based on income or living arrangements.
Is PACE available across Tennessee?
No. Tennessee’s current PACE page says the program is for qualifying people age 55 or older who live in Hamilton County, meet nursing-facility level of care, and can live safely in the community. The state lists Alexian PACE at 423-698-0802.
What if CHOICES is denied or delayed?
Ask for the decision in writing and identify whether the issue is eligibility or a medical/service decision. Disability Rights Tennessee’s Beneficiary Support System can help CHOICES applicants and members with complaints and appeals at 1-888-723-8193. A TennCare medical appeal generally has a 60-day filing period after you learn of the problem.
About This Guide
Sources
This guide uses official federal, Tennessee state, local, and other high-trust nonprofit and community sources linked in the article.
Editorial note
This guide is produced under the GFS Editorial Standards using official and other high-trust sources. GFS is not affiliated with a government agency and is not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Corrections
Despite careful verification, errors may occur. Readers may email info@grantsforseniors.org with corrections.
Disclaimer
This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, funding, and availability can change. Readers should confirm current details directly with the responsible official program before acting.
Last updated: 13 September 2026 · Next review: 13 December 2026
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