Transfers require dates, values, and records
TennCare applies a 60-month review to relevant transfers and, for 2026, calculates a penalty with an average daily private-pay nursing-facility rate of $295.87. The policy says the penalty is calculated in days, rounded down, and can apply to both nursing-facility and HCBS applicants. TennCare transfer policy
That daily divisor is a Tennessee-specific practical nuance. A family should retain closing records, appraisals, bank statements, gift documents, and proof of actual value received because an unsupported “sale” or home arrangement can create a transfer issue. TennCare transfer policy
Community spouses need both resource and income analysis
TennCare’s resource assessment takes a snapshot of both spouses’ countable resources at the first continuous confinement and subtracts the community spouse’s share before testing the institutionalized spouse’s $2,000 resource limit. The 2026 federal community-spouse resource range is $32,532 to $162,660, but the actual protected amount depends on the snapshot and applicable adjustments. TennCare Resource Assessment policy CMS 2026 spousal-impoverishment bulletin
TennCare’s July 2026 income policy also provides a Community Spouse Income Maintenance Allowance when its rules are met and funds are actually transferred. Its listed standard maintenance amount is $2,705 per month effective July 1, 2026, with the final allowance affected by income and shelter calculations. TennCare post-eligibility income policy
Do not confuse probate planning with Medicaid protection
Tennessee’s TOD-deed statute may help property pass at death, but the beneficiary takes subject to TennCare claims and other interests affecting the property. The deed should not be presented as a way to erase a Medicaid transfer review or estate-recovery issue. Tennessee Uniform Real Property Transfer on Death Act TennCare Estate Recovery
Good advance planning is documented, individualized, and completed before a crisis. A Tennessee elder-law attorney should evaluate trusts, home title, spouse protections, taxes, creditor issues, and projected care setting before any deed or gift is signed. TennCare QIT policy TennCare transfer policy
Not mutually exclusive. Most families combine two or three funding pillars — this one rarely stands alone.
The
Journey Assessment ranks all ten pillars against your specific situation and
recommends the top three.
