By Memphis Senior Advisor Care Team · October 12, 2026
Middle-income families can use OPTIONS for Community Living (no income limit, sliding fee), adult day care, VA Aid and Attendance, long-term care insurance and careful timing of a TennCare CHOICES application. The key is planning the order of steps before savings run low.
The middle-income squeeze
At Tennessee's 2025 medians, assisted living costs about $5,595 a month and full-time home care about $5,911. A parent with $2,500 a month of income and $120,000 in savings is not eligible for TennCare long-term care (the resource limit is $2,000) but cannot pay the full gap for long, either. That is the situation of many Memphis families, and it is solvable with sequencing.
| Monthly income | Savings | Monthly gap at assisted living median | Months until savings near $2,000 |
|---|---|---|---|
| $1,800 | $60,000 | $3,795 | 15 |
| $2,500 | $120,000 | $3,095 | 38 |
| $3,200 | $200,000 | $2,395 | 83 |
Step one: stretch time at home
OPTIONS for Community Living is the program most middle-income families have never heard of. It is state-funded, open to adults with limitations in daily activities, has no income limit and charges a sliding fee, and provides homemaker services, personal care and home-delivered meals, subject to funding. Adult day care, at about $80 a day at the Tennessee median, can cover a working caregiver's day for far less than the same hours of home care.
Both start with the Aging Commission of the Mid-South at (901) 222-4111, which serves Shelby, Fayette and Tipton counties.
Step two: use the benefits that do not depend on poverty
VA Aid and Attendance has its own net worth limit ($163,699) rather than TennCare's $2,000, and unreimbursed care costs reduce countable income. For a veteran or surviving spouse, it can add up to $2,424 or $1,558 a month. Long-term care insurance policies, if a parent has one, often cover licensed assisted-care living facilities as well as home care; read the policy's definition of a covered facility and the elimination period before move-in.
Step three: plan the TennCare transition before it is urgent
If savings will eventually run down, choose a facility that accepts TennCare CHOICES members, or confirm what the plan will be when they run out. CHOICES can pay for ACLF services in Groups 2 and 3, with the member paying room and board, and for nursing home care in Group 1. Keep five years of financial records for TennCare's look-back, and get elder law advice before any large transfer, house sale or trust.
The families who come through this period best are those who sat down early, ran the numbers, and decided in advance which move they would make at which point. A free first conversation with the Aging Commission of the Mid-South, and a paid hour with an elder law attorney, cost little compared with a rushed decision.
The house question
For many Memphis-area families, the parent's house is the largest asset. It does not count toward TennCare's $2,000 resource limit while it is the home, but once sold, the proceeds count. Renting it out produces income without spending down the asset, though the rent counts as income and management takes work. Some families use the house's value to fund a few years of private-pay assisted living and plan a TennCare application for later.
There is no single right answer, and the right one depends on whether a spouse still lives there, how long care is likely to last, and the family's wishes about the house. Get advice before selling, renting or transferring, because TennCare's five-year look-back and estate recovery both apply.
A simple planning worksheet
Write down four numbers: monthly income, countable savings, the expected monthly cost of the care being considered, and the value of the house. Divide savings by the monthly gap to see how many months private pay can last. Then list which programs could change the numbers: OPTIONS hours at home, adult day care, VA Aid and Attendance, a long-term care insurance policy, and eventually TennCare CHOICES. Revisit the worksheet every six months or after any hospital stay.
Families who do this once are usually surprised in a good way: the picture is clearer, the options are more numerous than they feared, and the decision points are visible in advance.
Where middle-income families find help in the Memphis area
The Aging Commission of the Mid-South, at (901) 222-4111, is the single best first call: it screens for TennCare CHOICES, enrolls people in OPTIONS for Community Living, and lists caregiver services, home-delivered meals and senior centers. TN SHIP, at 1-877-801-0044, reviews Medicare plans, which can lower out-of-pocket costs that compete with care spending. Accredited veterans service officers help with VA claims at no cost. And an hour with an elder law attorney before any large financial move is usually money well spent.
None of these resources replaces the family's own decisions, but together they turn a vague worry into a plan with dates and numbers.
Frequently asked questions
Is there help with home care for families who are not poor?
Yes. OPTIONS for Community Living has no income limit and uses a sliding fee, subject to funding.
Can we use TennCare later if we pay privately now?
Yes, if a parent becomes eligible, but plan ahead: choose a facility that accepts CHOICES and keep records for the five-year look-back.
Does long-term care insurance cover assisted living in Tennessee?
Many policies do, but check the policy's definition of a covered facility and its benefit triggers.
Who gives free advice on programs?
The Aging Commission of the Mid-South at (901) 222-4111; TN SHIP at 1-877-801-0044 for Medicare.
