Page Reviewed / Updated - January 27, 2021
This webpage will assist residents of Tennessee in understanding the costs associated with elder care, such as assisted living, home care, and adult day care. A variety of payment options and programs that provide financial assistance and care support, enabling seniors to age in residential care facilities or at home, are explored. Options for payment are also covered.
While the programs covered here are inclusive of what is available via the state of Tennessee, there are also programs available at a national level. When researching options for care, it is extremely important to explore every option to find the best program for the situation. To assist in finding programs nationwide, please use our Resource Locator Tool.
Cost of Care Calculator
In Tennessee, according to Genworth’s 2020 Cost of Care Survey, the 2021 statewide average cost of assisted living is $4,039 / month. However, the monthly average can fluctuate quite a bit throughout the state, depending on one’s geographic location. The least expensive areas of the state for assisted living are Nashville-Davidson, Morristown, Johnson City, and Jackson, where the monthly average ranges between $3,435 and $3,750. The most expensive areas are Kingsport, Cleveland, Memphis, and Chattanooga, where the average monthly cost is higher than the state average at $4,200 to $4,515 / month. For cost savings, one may consider moving to an area that offers assisted living at a lower rate.
Alzheimer’s care, also called Memory Care, often is even more costly, given the greater level of care and safety measures. On average, this type of care costs an additional $858 - $1,128 / month.
As of 2021, per the 2020 Genworth Cost of Care Survey, the average cost of home care per hour in Tennessee is $20.50. The most affordable areas for home care are Knoxville, Memphis, and Jackson, where the average hourly rate is $19.25 - $20.00. The areas of Kingsport, Johnson City, and Clarksville are on par with the statewide hourly average. The most expensive areas are Nashville-Davidson, Chattanooga, and Morristown, with an average rate of $22.00 / hour.
For those who need limited medical assistance in the home, home health care is also available at approximately $.50 more an hour statewide. One exception is the area of Cleveland, where the cost of home health care is approximately $2.75 more an hour than is home care.
According to Genworth’s 2020 Cost of Care Survey, the average daily rate in Tennessee for adult day care in 2021 is $78, which is just over the national average of $74. The rate for daily care does not vary significantly across the state, with the exception of Johnson City. Here, the most expensive rate is found at approximately $95 / day. The most affordable areas for adult day care are Morristown, Memphis, and Knoxville, where daily rates run between $71 and $78. In Chattanooga, Cleveland, and Nashville-Davidson, the average cost is just over the statewide average and is between $80 and $83 /day.
Medicaid is a health care program designed to assist low-income individuals and families in affording the cost of medical care. In Tennessee, Medicaid is known as TennCare, and will provide limited personal care, as well as cover the cost of living in a nursing home for seniors and disabled individuals.
Medicaid also offers long-term care in the home and community for the elderly and disabled through Medicaid Waivers, often called Home and Community Based Services Waivers (HCBS). These waivers are intended to prevent or delay nursing home placements. Many seniors and disabled individuals prefer to age at home, and doing so saves the state of Tennessee money.
As of 2021, Tennessee currently offers one Medicaid Waiver relative to the elderly, the TennCare CHOICES in Long-Term Care Program, often simply referred to as CHOICES. While this program does provide nursing home services, it also assists seniors and/or disabled individuals who would require nursing home care, if not for the services provided via this waiver. Assistance may include personal care, homemaker services, meal delivery, respite care, adult day care, and home modifications. Some services can be consumer directed, or said another way, participants are able to self direct their own care. This means friends and some family members can be hired as the care recipient’s personal care attendant. Eligible applicants may live in their home, the home of a relative, an adult foster care home, or in assisted living. To learn more about this waiver and the eligibility requirements, click here.
*Note: There was a former Tennessee Waiver called the Elderly and Disabled Home and Community Based Services Waiver (E & D HCBS). However, this waiver was replaced with CHOICES.
In order to be eligible for long-term care Medicaid in Tennessee, there are functional and financial requirements that must be met. As of 2021, a senior applicant must not have income in excess of 300% of the Federal Benefit Rate (FBR). This figure is equivalent to $2,382 / month, or put differently, $28,584 / year. If an applicant is over the income limit, it is still possible to meet the income restriction through the use of an irrevocable Qualified Income Trust (QIT). So not to cause confusion, QITs are the same thing as Miller Trusts
The asset limit for an individual applicant is $2,000 in 2021. However, several assets, also called resources, are exempt from this limit. These include one’s home, given the applicant lives in it and his / her equity interest is not greater than $603,000, or he / she is married and the non-applicant spouse lives in it. Other exemptions include household furnishings, an automobile, and personal items, such as clothing. As with income, one can still meet the asset restriction if over the limit. For instance, one can purchase an irrevocable funeral trust. However, it is extremely important that one does not give away assets in order to reach the limit. Doing so is in violation of Medicaid’s look-back rule (if done within 5 years of Medicaid application) and can cause a period of Medicaid disqualification
As mentioned above, individuals who are over the income and / or asset limit(s) may still qualify for Medicaid. Contacting a professional Medicaid planner for assistance is suggested. This will ensure the best chance of acceptance into Medicaid, as the restructuring of finances can be complicated. The application process is also a bit trickier for married couples. Therefore, it is recommended they also seek assistance from a Medicaid planner.
Tennessee currently offers two assistance programs for state elderly or disabled residents who are in need of long-term care and want to remain living in their home or community.
1) The Tennessee Adult Day Care Services program is offered through the Tennessee Department of Human Services. This program offers personal assistance during the day, which enables seniors to live in their home independently or provide assistance to family caregivers. Other services provided in adult day care include meals, medication reminders, and recreational activities. To learn more about the benefits and eligibility requirements, click here.
2) Tennessee OPTIONS for Community Living provides in-home services and supports, such as personal care, homemaker services, personal emergency response systems, and meal delivery. This program allows for consumer direction, meaning individuals can hire the personal caregiver of their choosing, including select family members. For more program information, click here.
Another program, LIHEAP (Low Income Home Energy Assistance Program), provides financial assistance with energy costs associated with heating and cooling homes. This program is for low-income residents, many being seniors, and offers both emergency and regular benefits. While this program doesn’t directly assist with the costs associated with long-term care, it does allow money that would otherwise be going towards energy costs to be freed up for long-term care costs.
While Tennessee offers state specific options to assist in paying for care, there are also federal and non-profit programs. When searching for assistance to lower the cost of care or to help pay for care, it is important to consider all of your options. Make sure to use our Resource Locator Tool to find the program that best meets your needs and circumstances. There are also eldercare loans, as well as programs that aid veterans with assisted living in Tennessee.
As one can see, the cost of care can vary quite a lot across the state of Tennessee. Even within the same geographic area, the cost of care can fluctuate a great deal. It’s important to find the care provider that most fits your needs and budget. To assist families in their search for the most affordable provider that meets their needs in the geographic area in which they reside, we have partnered with an organization that can assist in this search. This service is free to the consumer. Get assistance finding affordable care in your area.
For more information about the costs and resources available in Tennessee cities, click on the links below.