What is CHOICES and do I qualify for it?

TennCare CHOICES in Long-Term Services and Supports (CHOICES for short) is for individuals requiring, or at risk of requiring, a nursing home level of care and who qualify for Medicaid long-term services.

CHOICES offers services, called Home and Community Based Services or HCBS, to help adults aged 21 or older with physical disabilities, and seniors aged 65 or older, live in their own home or in their community for as long as possible. CHOICES also provides care in a nursing home if this is needed.

The Greater Nashville Regional Council (GNRC) has been designated by the Tennessee Commission on Aging and Disability (TCAD) as the Area Agency on Aging and Disability (AAAD) for thirteen counties in Middle Tennessee. GNRC assists TennCare by helping identify and screen candidates for the program. Call our Information and Assistance Hotline to begin the screening process for CHOICES at 615-255-1010 or 866-836-6678

How do I qualify for CHOICES?

To qualify for CHOICES, you must need the level of care provided in a nursing home and qualify for Medicaid long-term care. Individuals who qualify for CHOICES can fall into one of three categories:

Individuals who fall into CHOICES Group 1 are those receiving nursing home care, regardless of age.

CHOICES Group 2 individuals qualify for nursing home level of care but choose to receive home care services instead. Group 2 individuals must be 65 years of age or older, or 21 years of age or older with a physical disability.

CHOICES Group 3 is for adults 21 years of age or older with a physical disability, and seniors aged 65 or older, who need home-based services to prevent them from entering a nursing home care. Individuals in Group 3 must also be receiving Supplemental Security Income (SSI) from the Social Security Administration.

Income qualifications for Medicaid long-term services and supports is established each calendar year by TennCare and are subject to change. These income requirements apply to all individuals benefiting from CHOICES, regardless of which group they qualify under.

Learn more about CHOICES qualification, including income requirements, by visiting the CHOICES Qualifications tab on the TCAD website, or by calling the Information and Assistance Helpline managed by GNRC at 615-255-1010 or 866-836-6678

What kind of services can I receive through CHOICES?

Below are some of the home and community-based services covered within the CHOICES program. Please note some of these services have limitations.

• Short personal care visits to assist with daily tasks such as taking a bath, getting dressed or eating meals.
• Attendant care, which includes the same kind of help offered by personal care visits but for longer periods of time.
• Homemaker services
• Home-delivered meals
• Personal emergency response systems such as an emergency button
• Adult day care
• In-home or in-patient respite care so your caregivers can rest.
• Assistive technology such as grabbers to reach things.
• Minor home modifications such as grab bars or a wheelchair ramp.
• Pest control
• Community-based residential alternatives such as assisted living facilities
• Nursing homes

Read more about what is covered under CHOICES here.

What is the screening process?

If you are a resident of Cheatham, Davidson, Dickson, Houston, Humphreys, Montgomery, Robertson, Rutherford, Stewart, Sumner, Trousdale, Williamson, or Wilson County, your TennCare CHOICES screening begins with calling the Information and Assistance Helpline managed by GNRC at 615-255-1010 or 866-836-6678. Our trained counselors can determine initial eligibility through a phone interview and will ask about age and disability status, as well as income and assets.

Once eligibility has been determined, a registered nurse or licensed social worker will conduct an in-person assessment. This step is necessary to determine what types of services an individual will require and their level of need. Only after the assessment is a service plan developed and providers selected. All service providers are vetted and monitored by GNRC and TennCare.

Recurring assessments and monitoring are executed on a regular basis and are necessary to ensure that individuals are having their needs met in an effective manner.

What should I have prepared to do for a screening?

When preparing for a CHOICES screening, or helping a loved one prepare for their CHOICES screening it is helpful to have the following information on-hand:

• Personal information, such as full name, date of birth, Social Security number, and contact details
• Income and assets. Income requirements are set by TennCare each calendar year and are subject to change.
• Medical history, including any conditions or recent hospitalizations.
• Willingness to discuss any physical or cognitive limitations related to activities of daily living (ADL) and instrumental activities of daily living (IADL)
• Information about current living arrangements, such as whether the elderly or disabled person lives alone or with family.
• Insurance coverage information, such as Medicare or private insurance.
• Any legal documents, such as power of attorney documents.

ADL refers to the fundamental and routine daily activities of everyday life, such as the ability to feed, groom, and dress oneself, as well as the ability to control one’s bladder and bowel movements. The ability to move from one place to another, such as the toilet, is also part of the ADL category. IADL refers to complex, cognitive tasks that allow for the organizing of an individual’s day, such as managing one’s own transportation, shopping, meal preparation, housecleaning, and home maintenance, managing medications and communicating with others. Both ADLs and IADLs are used when evaluating what level of care an individual will need to maintain good health and quality of life.

During your call with a trained counselor at the GNRC, you can ask any questions regarding the screening process.

What if I don’t qualify for CHOICES?

OPTIONS for Community Living is the state-funded program created to provide elderly and disabled adults home and community-based services. OPTIONS and CHOICES provide similar HCBS, however OPTONS does not have income eligibility requirements. Instead, participants in OPTIONS over a certain income receive services at a sliding-scale fee. This program is considered a last resort to TennCare CHOICES and is facilitated by local Areas on Aging and Disability (AAAD). Learn more about OPTIONS by visiting What is OPTIONS and do I qualify for it?

Of course, for those that do not qualify for state and federally funded support, home and community-based services are available through private pay. Private, long-term care insurance is also an option for those who have purchased plans.

Have more questions? Call Our Helpline

Call our Information and Assistance Hotline to learn more about any of GNRC's programs and services. 615-255-1010 or 866-836-6678