CHOICES Home Care Guide for Tennessee

What Is CHOICES?

• CHOICES stands for Community Health Options, Innovative Community-based Enabling Services & Supports.
• It is TennCare's managed long-term care program for seniors and adults with physical disabilities.
• CHOICES lets you receive care at home or in the community instead of a nursing home.
• The program is run through TennCare's managed care organizations (MCOs): BlueCare, Amerigroup, and UnitedHealthcare Community Plan.
• CHOICES covers the same people who would qualify for nursing home Medicaid — but delivers care where you live.

CHOICES Groups — Which One Fits?

• CHOICES Group 1: Nursing home care (traditional nursing facility placement).
• CHOICES Group 2: Home and community-based services for seniors and adults with physical disabilities who need help but do NOT yet meet nursing home level of care.
• CHOICES Group 3: Home and community-based services for people who DO meet nursing home level of care but choose to stay home. This is the main group for people who would otherwise be in a nursing home.
• Most people looking for in-home aides and support fall into Group 2 or Group 3, depending on the severity of their needs.
• Your MCO care coordinator will help determine which group fits your situation after a PAE assessment.

Services Covered

• Personal care assistance — help with bathing, dressing, grooming, toileting, and mobility.
• Home modifications — ramps, grab bars, widened doorways, and other changes to make your home safer and more accessible.
• Adult day care — supervised daytime programs with activities, meals, and health monitoring.
• Companion care — someone to be with you for safety and socialization.
• Assistive technology — devices and equipment to help you live more independently.
• Pest control — to maintain a healthy living environment.
• Respite care — temporary relief for family caregivers so they can take a break.
• Minor home repairs — fixes needed for health and safety.
• Meals — home-delivered meals or congregate meal programs.
• Personal emergency response systems (PERS) — a button you wear that calls for help if you fall or have an emergency.

Income and Asset Rules

• Same financial eligibility as nursing home Medicaid: income up to 300% of SSI (approximately $2,829 per month in 2025).
• Asset limit: $2,000 for an individual in countable assets.
• Exempt assets: your primary home, one vehicle, personal belongings, household furnishings, prepaid burial plans.
• If married, spousal protections apply — the community spouse can keep up to $154,140 in assets (2025).
• If your income is over the limit, a Qualified Income Trust (Miller Trust) may help you qualify.
• The 5-year look-back period on asset transfers applies, just like nursing home Medicaid.

How to Get a PAE (Pre-Admission Evaluation)

• A PAE is a medical assessment that determines whether you need a nursing home level of care.
• Even if you want to stay home, you must meet this standard to qualify for CHOICES Group 3.
• Your doctor, hospital social worker, or MCO care coordinator can request a PAE.
• The evaluation looks at your medical needs, ability to perform daily activities, and cognitive function.
• You can request a PAE by calling your MCO or TennCare Connect at 1-855-259-0701.

Choosing a Managed Care Organization (MCO)

• When you enroll in CHOICES, you must pick one of TennCare's three MCOs to manage your care.
• BlueCare Tennessee — part of BlueCross BlueShield of Tennessee. Call: 1-800-468-9698.
• Amerigroup Tennessee — Call: 1-800-600-4441.
• UnitedHealthcare Community Plan — Call: 1-800-690-1606.
• Each MCO assigns you a care coordinator who builds your care plan and connects you with services.
• You can switch MCOs once per year during open enrollment if you are not satisfied.

Can Family Members Be Paid as Caregivers?

• In some cases, yes — CHOICES allows certain family members to be paid as personal care aides.
• The family member must meet the MCO's requirements and go through their hiring process.
• Spouses are generally not eligible to be paid caregivers, but adult children, siblings, and other relatives may qualify.
• The MCO determines whether a family member can serve as a paid caregiver on a case-by-case basis.
• This can be a great option for families who are already providing care and need financial support.

How CHOICES Differs from Nursing Home Medicaid

• Same financial eligibility — income and asset rules are identical.
• The key difference is WHERE you receive care: at home instead of in a facility.
• You stay in your own home, maintain your independence, and receive services tailored to your needs.
• A care coordinator works with you to create a personalized plan of care.
• CHOICES can be more cost-effective for TennCare than nursing home placement.
• If your needs increase beyond what can be managed at home, you can transition to nursing home care under CHOICES Group 1.

Key Contacts

Documents You Will Need

Nursing home Medicaid requires extensive financial documentation. Gather these items before applying:

• Photo ID (driver's license, state ID, or passport)
• Social Security card or number for everyone on the application
• Proof of Tennessee residency (utility bill, lease, or mail with your address)
• Proof of U.S. citizenship or immigration status (birth certificate, passport, or immigration documents)
• Proof of income for everyone in the household (pay stubs, tax return, Social Security statement, employer letter)
• Bank statements (checking and savings) for the past 30 days
• 5 years of bank statements (checking, savings, CDs, money market)
• 5 years of financial records (all accounts)
• Property deeds and mortgage statements
• Vehicle titles and registrations
• Life insurance policies (face value and cash value)
• Retirement account statements (401k, IRA, pension)
• Records of any assets sold, transferred, or gifted in the past 5 years
• Burial/funeral pre-payment contracts
• Medicare card (if applicable)
• Social Security benefit statement (SSA-1099)
• Pension income documentation
• Marriage certificate (if married)
• Spouse's financial documents (income and assets)
• Medical records documenting need for assistance with daily activities
• List of current medications and treating physicians
• Pre-Admission Evaluation (PAE) or doctor's statement of care needs
• Power of Attorney documents (if someone is applying on behalf of the person)