How to File an Eligibility Appeal

Open and read all mail from TennCare. Follow the directions and make sure to return requested information.

Do you think TennCare made a mistake? TennCare can help. Here are some reasons you can file an appeal:

  • You were denied, and we made a mistake.
  • Your health care ended or is ending.
  • We have your income or family size wrong.
  • Your co-pays or premiums are too high, and we have your income wrong.

You have waited for a decision for more than 45 days (or more than 90 days if you applied for long-term care, you can ask for a delayed hearing).

There are 3 ways to file a TennCare Eligibility Appeal:

  1. By Phone. Call us at 855-259-0701.
  2. Online by using your TennCare Connect at tenncareconnect.tn.gov.
  3. In writing. You can download the TennCare Eligibility Appeal Form in English or Spanish. Or, you can write your appeal on plain paper. If you write your appeal on plain paper, be sure you include:
  • Your full name (first name, middle initial, last name)
  • Your Social Security Number
  • The names of anyone else in your household with the same problem
  • Your daytime phone number and the best time to call
  • The specific mistake you think we made
  • Any proof that shows why you think we made that mistake

Mail your appeal to this address:

TennCare Connect
P.O. Box 305240
Nashville, TN 37230-5240.

Or fax it to 1-855-315-0669. It is a free fax line.

Keep a copy of your appeal. Write down the date that you mailed or faxed it to us. If you fax it, keep the page showing that your fax went through.

Is it because you have a health, mental health, or learning problem or a disability? OR, do you need help in another language? If so, you have a right to get help. Call TennCare Connect for free at 855-259-0701.

Someone who has the legal right to act for you can also file an appeal for you.

Do you have a mental illness and need help with your TennCare? The TennCare Advocacy Program can help you. Call them for free at 1-800-758-1638.

Finally, Legal Services or Legal Aid may give you free help with your appeal. To find out more, click on the link below for the organization that serves your area.

You may be able to enroll your baby right now. TennCare and CoverKids have made it easy to enroll newborns over the phone:

  • Do you already have TennCare and CoverKids? Call TennCare Connect for free at 855-259-0701 when your baby is born.
  • If you do not have TennCare or CoverKids, you can apply for your baby over the phone. Call TennCare Connect for free at 855-259-0701.

After you file your appeal, we will look at the federal and state records to see if you applied.

If we can find proof you applied, we will work your application. We may need more facts from you. If we do, we will send you a letter that says what facts we need to finish your application. You will have 10 days to send us the proof we ask for. After we get the facts we need, we will finish working your application and send you a letter about our decision.

What if we do not get the facts we need within 10 days? You will get another letter that says your application is denied.

If we cannot find proof you applied, we will send you a letter and ask you to give us the proof. You will have 10 days to send us proof that you applied. After we get the proof from you, we will finish working on your application. What if we do not get proof that you applied within 10 days? You will get another letter that says your request for a delayed hearing is denied.

When we have proof of your application date, we will give you a decision on your application. Or, we will give you a hearing within 45 days (or 90 days for CHOICES applications). If we give you a hearing, we start counting on the day we find the proof you applied or on the day that you send your proof to us (whichever day is earlier).