TennCare Application Document Checklist

From caidee.org · Tennessee TennCare resource

Identity & Personal Records

Driver's license or state ID (current)
Social Security card (or SSN verification letter)
Birth certificate
Marriage certificate (if applicable)
Divorce decree (if applicable)
Citizenship/immigration documents (if not US-born citizen)

Income (last 3 months)

Pay stubs OR employer letter (every job in the household)
Social Security benefit award letter
SSI/SSDI letters
Pension statements
VA benefits documentation
Self-employment 1099s + business income/expense records
Unemployment / workers comp / other public benefits
Child support orders + payment records

Assets (most recent 60 months for nursing home)

Bank statements — all checking, savings, money market
Brokerage / investment account statements
IRA, 401(k), retirement account statements
CD certificates
Life insurance policies (face value + cash value)
Vehicle titles and registration
Real estate deeds and recent property tax bills
Burial plot deeds / funeral pre-payment contracts
Annuities
Trust documents (any trust the applicant created or benefits from)

Medical Records (Katie Beckett & nursing home applications)

Treating physician letter explicitly addressing level of care
Hospital discharge summaries (last 2 years)
Specialist reports from each treating specialist
Therapy notes (PT, OT, speech, behavioral, ABA)
Diagnosis list with ICD-10 codes
Current medication list (name, dose, frequency, prescriber)
Medical equipment / DME documentation
Most recent IEP, IFSP, or 504 plan (if applicable)
Recent SSI determination (if filed)

Look-Back / Transfer Records (for nursing home only)

Records of gifts >$1,000 in last 5 years
Real estate transfer documents in last 5 years
Large bank withdrawals + explanations
Trust funding records

caidee.org/downloads/document-checklist · Updated for 2026 TennCare rules · Not legal advice — for navigation guidance only