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TennCare Medicaid

TENNESSEE HEALTH INSURANCE QUOTES

 

The Medicaid program in Tennessee providing health insurance coverage to low-income residents is called TennCare.

This program covers over a million Tennesseans in need of health insurance, providing a source of affordable medical coverage and access to care. TennCare is one of the oldest Medicaid managed care programs in the country, and is the sole state to enroll every public health program member in managed care. Operating under a demonstration waiver from the Centers for Medicaid and Medicare Services, TennCare strives to serve as an example that by using managed care exclusively, the state will generate enough savings to offer coverage to a greater number of people.

TennCare offers coverage to various groups of residents. You may qualify if your income meets the guidelines and you fall into of the following groups:

  • Pregnant women
  • Children and young adults up to age 21
  • Parent(s) or caretaker relative(s) of a child under age 19 (must reside in the same household and be a close relative)
  • Women in need of breast or cervical cancer treatment
  • Supplemental Security Income (SSI) beneficiaries
  • Individuals who have received both an SSI check and a Social Security check in the same month at least once since April, 1977 AND who still receive payment from Social Security

 

Each group is eligible for preventive services, hospital and emergency care, physician visits, and prescription coverage. Certain health services are personalized to different groups and individual needs, such as maternity care for women and Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) for children. Long term care services are also available for those in need of such support. For those who are disabled and require medical supplies and equipment, TennCare accommodates such needs.

 

TennCare Eligibility

To qualify for the TennCare Medicaid program, you must be a resident of Tennessee, a legal immigrant or U.S. citizen, and earn a specific income according to your eligibility group. Adults who qualify for the program must either be single parents or caretaker relatives and have a child living at home, or a couple with a child at home one of whom has lost a job or work hours, or has a mental health condition expected to last 30 days. All qualifying applicants must be currently uninsured, and not be receiving benefits through their job, COBRA, or a temporary health plan. Eligibility is determined by your total household income and size in relation to the most recent poverty guideline.

 

Current Federal Poverty Level

Covered Benefits

Benefits covered vary for the separate TennCare beneficiary groups. Not all services are consistently covered from one group to another. Depending on whether or not you are also enrolled in Medicare or Standard Spend Down, or receive long term care, TennCare Medicaid benefits adjust based on what your other coverage includes. Below are some of the services covered by each of the TennCare Medicaid benefit packages.

 

  • Chiropractic
  • Community health clinics
  • Dental care (for those under 21)
  • Durable Medical Equipment
  • Emergency transport and ambulance
  • Home health care
  • Hospice care
  • Inpatient hospital care
  • Lab and X-ray
  • Medical supplies
  • Mental health care
  • Occupational therapy
  • Outpatient hospital care
  • Pharmacy
  • Preventive care
  • Private duty nursing
  • Reconstructive breast surgery
  • Renal dialysis
  • Speech therapy
  • Vision care

 

Managed Care

Based on which part of the state you live in, there are different health plans offering TennCare services. These include UnitedHealthcare Community Plan, TennCare Select, BlueCare, and Amerigroup. Your managed care organization must be chosen once you are approved for TennCare, and you can select a primary care physician through your health plan to coordinate your care. For any questions regarding your benefits, plan, or health care needs, you must contact your health plan.

West Tennessee MCOs

Health Plan Member Services
AMERIGROUP
https://www.amerigroup.com
Community Care
Three Lakeview Place
22 Century Blvd., Suite 310
Nashville, TN 37214
1-800-600-4441
BlueCare
BlueCare
1 Cameron Hill Circle, Suite 0002
Chattanooga, TN 37402-0002
Fax 800-357-0453
1-800-468-9698
UnitedHealthcare Community Plan
UnitedHealthcare Community Plan
3175 Lenox Park Blvd. Suite 400
Memphis, TN 38115
1-800-690-1606
TennCare Select
TennCare Select
1 Cameron Hill Circle, Suite 0002
Chattanooga, TN 37402-0002
FAX: 800- 218-3190
1-800-263-5479
Counties: Benton, Carroll, Chester, Crockett, Decatur, Dyer, Fayette, Gibson, Hardeman, Hardin, Haywood, Henderson, Henry, Lake, Lauderdale, Madison, McNairy, Obion, Shelby, Tipton and Weakley

 

Middle Tennessee MCOs

AMERIGROUP
https://www.amerigroup.com
Community Care
Three Lakeview Place
22 Century Blvd., Suite 310
Nashville, TN 37214
1-800-600-4441
BlueCare
BlueCare
1 Cameron Hill Circle, Suite 0002
Chattanooga, TN 37402-0002
Fax 800-357-0453
1-800-468-9698
UnitedHealthcare Community Plan
UnitedHealthcare Community Plan
8 Cadillac Dr., Suite 100
Brentwood, TN 37027
1-800-690-1606
TennCare Select
TennCare Select
1 Cameron Hill Circle, Suite 0002
Chattanooga, TN 37402-0002
FAX: 800- 218-3190
1-800-263-5479
Counties: Bedford, Cannon, Cheatham, Clay, Coffee, Cumberland, Davidson, DeKalb, Dickson, Fentress, Giles, Hickman, Houston, Humphreys, Jackson, Lawrence, Lewis, Lincoln, Macon, Marshall, Maury, Montgomery, Moore, Overton, Perry, Pickett, Putnam, Robertson, Rutherford, Smith, Stewart, Sumner, Trousdale, Van Buren, Warren, Wayne, White, Williamson and Wilson

 

East Tennessee MCOs

AMERIGROUP
https://www.amerigroup.com
Community Care
Three Lakeview Place
22 Century Blvd., Suite 310
Nashville, TN 37214
1-800-600-4441
BlueCare
BlueCare
1 Cameron Hill Circle, Suite 0002
Chattanooga, TN 37402-0002
Fax 800-357-0453
1-800-468-9698
UnitedHealthcare Community Plan
UnitedHealthcare Community Plan
2035 Lakeside Centre Way Suite 200
Knoxville, TN 37922
FAX: 865-293-0573
1-800-690-1606
TennCare Select
TennCare Select
1 Cameron Hill Circle, Suite 0002
Chattanooga, TN 37402-0002
FAX: 800- 218-3190
1-800-263-5479
Counties: Anderson, Bledsoe, Blount, Bradley, Campbell, Carter, Claiborne, Cocke, Franklin, Grainger, Greene, Grundy, Hamblen, Hamilton, Hancock, Hawkins, Jefferson, Johnson, Knox, Loudon, Marion, McMinn, Meigs, Monroe, Morgan, Polk, Rhea, Roane, Scott, Sequatchie, Sevier, Sullivan, Unicoi, Union and Washington

 

How to Apply

In order to apply for TennCare, you may fill out a form online, print the form and complete it, pick up an application at your local Department of Human Services office, or call your local DHS to have one sent to you. When you have filled out your paper application, send it to the closest DHS office.

Apply online

Locate a DHS office by county

 

Resources

TennCare

You can Apply online for TennCare via the federal Health Insurance Marketplace:

Online: healthcare.gov 

By Phone: 800-318-2596

 

Please open and read all mail received from TennCare upon submission of your application. When received, please follow instructions on the TennCare program forms and send in all requested information with your application.

Family Assistance Service Center: 866-311-4287

TTY or TDD: 877-779-3103

TennCare Benefit Packages

TennCare Medicaid Rules

 

Sources:

 

1. TennCare. http://www.tn.gov/tenncare/.

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