Medicaid & Assisted Living in Tennessee: Yes

Updated September 4, 2026. Quick answer: yes, through TennCare CHOICES in Long-Term Services and Supports: Assisted Care Living Facility (HCBS-ACLF) service, Groups 2/3. Medicaid does not pay the facility’s room and board either way; only the care and service component.

What Tennessee covers

Waiver / state plan option	TennCare CHOICES in Long-Term Services and Supports: Assisted Care Living Facility (HCBS-ACLF) service, Groups 2/3
Covers an assisted living setting?	Yes: “Community-based residential alternative to nursing home care in a licensed Assisted Care Living Facility that provides and/or arranges for daily meals, personal, homemaker and other supportive services or health care including medication oversight (to the extent permitted under State law), in a home-like environment to persons who need assistance with activities of daily living.”
Room and board	Never covered by Medicaid, in Tennessee or any state; see below.

The room-and-board split

Federal law is the floor every state builds on: “The Secretary may by waiver provide that a State plan approved under this subchapter may include as “medical assistance” under such plan payment for part or all of the cost of home or community-based services (other than room and board) approved by the Secretary” (42 U.S.C. §1396n(c)(1), Social Security Act §1915(c)). The words in parentheses do the work: whatever a state’s waiver pays for inside an assisted living community, it is not the rent, the meals, or the room itself. That portion stays the resident’s own to fund, out of income, savings, or a family contribution; the waiver only ever reaches the care and service layer on top of it. Tennessee’s own materials say the same thing directly: “Coverage shall not include the costs of room and board.” (TennCare CHOICES Attachment 4: Service Definitions (Provider Credentialing Reference), tn.gov).

The waitlist

Slot-limited for non-SSI Group 3 enrollees (enrollment target of 1,750) : “As of October 1, 2022, based on current appropriations, there is an enrollment target of 1,750 for non-SSI recipients” (as of October 1, 2022)

What you get to keep: the personal needs allowance

300% of the SSI Federal Benefit Rate for HCBS enrollees (not stated as a flat dollar figure in this source) a month: “300% of the Supplemental Security Income-Federal Benefit Rate (SSI-FBR) for HCBS enrollees, PACE, and Self-Determination Waiver” This is the amount of a waiver participant’s own income the state lets them keep for personal spending after the rest goes toward the cost of their care; it varies by state because each state sets its own figure inside the federal floor.

Paying for care is the harder half

What a waiver covers is only part of the problem, because room and board still has to come from somewhere, and an adviser can look at income, savings and the likely timeline together before a placement decision is made.

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What this doesn’t answer

Coverage and the room-and-board exclusion are directly confirmed in TennCare’s own CHOICES service-definitions document, and the personal needs allowance is stated only as a percentage of the SSI federal benefit rate rather than a fixed dollar figure, so we report it that way instead of guessing a number. The waitlist figure (1,750 non-SSI slots) is dated October 1, 2022 on TennCare’s current CHOICES webpage; we could not confirm a more recent update was issued, so treat it as the most recent state-published figure rather than today’s exact count. Group 2 (SSI recipients) enrollment status specifically was not separately addressed in the sources reviewed.

Sources

Read September 4, 2026.

Same question, other states: Texas · Utah.

General information drawn from each state’s own Medicaid agency and federal statute, not legal, tax or financial advice. Medicaid is administered state by state; waiver names, coverage decisions, waitlists and allowance amounts change by state budget and legislative action. This page cannot see your own state’s current caseload. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.

Related: Tennessee’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.

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