What if my TennCare application is denied?

Has your application been denied? Or do you have to pay co-pays and disagree with how much you have to pay? Or does TennCare have your income or family size wrong? You might want to file an eligibility appeal. If you have questions about the appeal process or need help filling out the required papers, call the TennCare Advocacy Program at 1-800-758-1638.

  • What are the reasons for an Eligibility Appeal?
    • DHS has your income or family size wrong.
    • DHS made a mistake in your co-pay amount.
    • You think you qualify for one of the groups that can have TennCare.
    • DHS sent your RFI papers to the wrong address, but you gave them the correct address.
    • You asked for more time to turn in the RFI but DHS said no.
  • When An Eligibility Appeal Won't Help
    • You don't have any other way to pay for healthcare or medicine
    • You can't get or afford insurance
    • You think there should be an exception made to the rules in your case
  • How long do I have to file an appeal?
    • New Applicant
      • A new applicant has up to 40 days from the date of your denial letter to file an appeal
    • Reverifying Member
      • If you're reverifying your TennCare and DHS says you don't qualify, you have up to 40 days from the date of your termination letter to file an appeal
      • If you appeal before your TennCare ends, you can keep TennCare during the appeal process

After you file an appeal, it can take up to 90 days for a decision.

  • How do I file and Eligibility Appeal?
  1. You can appeal by phone
    • Call the Family Assistance Service Center at 1-866-311-4287
    • It's a free call
    • Write down and keep the date and time you called and the name of the person you talked to
  2. Or, you can appeal by mail
    • Fill out an eligibility appeal page from DHS.
    • Or, you can write your appeal on plain paper. Be sure to include:
      • Your Full Name
      • Your Social Security Number
      • The names of anyone in the household with the same problem
      • Daytime phone number and best time to call
      • The mistake you think DHS made
      • Proof that shows why you think DHS made a mistake
Make a copy of your appeal to keep for your records.
Mail your Eligibility Appeal to:
Tennessee Department of Human Services
Division of Appeals and Hearings
PO Box 198996
Nashville, TN 37219-8996

Or, you can fax your Eligibility Appeal to the Division of Appeals and Hearings at 1-866-355-6136.