TennCare Announces The Opening of Standard Spend Down

Thursday, September 23, 2010 | 08:15 am

Phone Line Opens for First 2,500 Applicants October 4

NASHVILLE – The TennCare Standard Spend Down program is opening enrollment for the first time to new applicants beginning Monday, October 4, 2010.  Standard Spend Down is available through a waiver to the Medicaid program for a limited number of low income individuals, or those with high, unpaid medical bills who are aged, blind, disabled, or the caretaker relative of a Medicaid eligible child. Eligible individuals must have enough unpaid medical bills to meet the “spend down” threshold to qualify for and keep their coverage.

“Through the collaborative efforts of TennCare, the Department of Human Services, the Tennessee Hospital Association, advocacy groups and the federal government, I am pleased that we are now able to offer this additional assistance to qualified low income individuals or those with very high medical bills,” said TennCare Director Darin Gordon.

A special call-in phone line through the Tennessee Department of Human Services has been set up for interested applicants.  The only way to request an application is by calling the toll-free number.  The number is 1-866-358-3230 and will be open between 6:00 p.m. - 8:30 p.m. CST on October 4th.  The phone lines will be open from 6:00 p.m. – 8:30 p.m. on subsequent weekdays until 2,500 interested applicants call in.  Prospective applicants are encouraged to check eligibility qualifications before calling in. Eligibility criteria and other helpful information is available here.  People wishing to apply for other TennCare categories should call the Family Assistance Service Center at 1-866-311-4287 during normal business hours. 

"The toll-free number system is the best way to ensure equal access to Tennessee citizens interested in this program,” said DHS Commissioner Gina Lodge. “We want to be very clear--the ONLY way to request an application for this program is through the toll free number.”

After the first 2,500 calls are taken, the phone lines will be closed.  The Tennessee Department of Human Services will send applications to the first 2,500 individuals and will review their eligibility for any open Medicaid categories and the newly opened Standard Spend Down.  Once those applications are reviewed for eligibility, the phone lines will open again.  Advanced notifications will be made to the public and other stakeholders prior to those lines opening.

Recent legislation called for the "expansion of the Standard Spend Down category for TennCare enrollment up to a maximum of seven thousand (7,000) individuals in FY 2010-2011." The program will continue to open and close on a rolling basis until the 7,000 slots are filled. 

Standard Spend Down Eligibility:

In addition to being aged (65 or older), blind*, disabled,* or a caretaker relative, a person must meet certain income restrictions, or be able to “spend down” qualifying unpaid medical bills to that limit.   The following chart shows the income limits:

Household Size
Monthly Income

Applicants also must not have resources that exceed $2,000 for a family of one and $3,000 for a family of two with an additional $100 added per additional individual in the family.

A person’s unpaid medical bill must have been accrued within the past 90 days.  Medical bills paid by the applicant within the past 30 days may count towards meeting an applicant’s spend down requirement.

Pregnant women and children still are eligible for the Medically Needy Spend Down program which has never closed and does not have an enrollment cap.

*To be considered blind or disabled, an individual must meet standards set by the Social Security Administration.

For more information on Standard Spend Down program and more detailed eligibility information please click here.