Medicaid appeals in Tennessee: hearing deadline and keeping benefits
TennCare (and CoverKids): you have 40 days to ask for a fair hearing.
Eligibility appeals: your TennCare continues if you appeal within 20 days of the notice, or before your coverage end date if that is later.
Checked against official sources: October 30, 2026.
Appeal deadlines are strict. If you are near a deadline or your care is urgent, call free help today.
Medicaid (TennCare (and CoverKids)) denials in Tennessee
- Medicaid agency
Division of TennCare (Tennessee Department of Finance and Administration)
- Who holds the hearing
TennCare (Eligibility Appeals Unit / Member Medical Appeals); hearings before an administrative judge
- Hearing deadline
40 days
The date of the termination or denial notice (eligibility appeals)
- If you are late
An eligibility appeal filed after 40 days may be accepted if you show good cause for filing late.
- How to ask for a hearing
- Phone: Eligibility appeals: TennCare Connect 855-259-0701. Medical (service) appeals: TennCare Member Medical Appeals 1-800-878-3192 (Monday-Friday 8 a.m.-4:30 p.m.)
- Online: Sign in to your TennCare Connect account at tenncareconnect.tn.gov (or the mobile app) and file an eligibility appeal or choose 'File a Medical Appeal'
- Mail: Eligibility appeals: Eligibility Appeals, P.O. Box 23650, Nashville, TN 37202-3650. Medical appeals: TennCare Member Medical Appeals, PO Box 593, Nashville, TN 37202-0593
- Fax: Eligibility appeals: 844-563-1728. Medical appeals: 1-888-345-5575 (toll-free)
- Form: TennCare Eligibility Appeal Form or TennCare Medical Appeal Form (or a letter on plain paper)
- Mail address
Eligibility Appeals, P.O. Box 23650, Nashville, TN 37202-3650
- What to include
For an eligibility appeal on plain paper: your full name, Social Security number, names of anyone else in your household with the same problem, your daytime phone and best time to call, why you want to appeal (as many facts as you can), and any proof. Keep a copy and the date you sent it.
Source: and the fax confirmation page
- Keeping your benefits during the appeal
Eligibility appeals: your TennCare continues if you appeal within 20 days of the notice, or before your coverage end date if that is later. Medical (service) appeals: ongoing care can continue if you appeal within 10 days of the date of the notice or before the date of the change, whichever is later, and ask to keep the care. If you lose, you may have to pay TennCare back.
Law: Tenn. Comp. R. & Regs. 1200-13-13-.01(20)
- When the hearing is held
Medical appeals are usually decided within 90 days after you file them.
- Faster (expedited) hearing
If waiting 90 days could put your life or physical or mental health in real danger, call 1-800-878-3192 to ask for an expedited medical appeal. Your doctor can ask for you with your written OK and can fill out the Treating Provider's Certificate: Expedited TennCare Appeal form. If granted, a decision comes in about one week (longer if your health plan needs more time to get your medical records).
Medicaid health plan (managed care) in Tennessee
- Appeal to the plan first
TennCare members are in managed care health plans, but medical appeals are filed with TennCare itself (TennCare Member Medical Appeals), not a separate plan appeal first. You have 60 days to appeal after you find out there is a problem, such as a denial, a cut or stop in care, waiting too long, or unpaid bills. Call your health plan first; it may fix the problem. TennCare and your plan review the appeal, and if it is not resolved you get a hearing; most appeals are decided within 90 days.
Write my appeal: free letters
Sources
The official sources for Tennessee are listed on the Tennessee page.