TennCare is Tennessee's Medicaid program. Medicaid is a federally and state-funded health insurance program managed by the state. TennCare offers full health benefits to those who qualify. Unlike Medicare or group health insurance, in which you can enroll only during a defined open enrollment period, you may apply for TennCare at any time. Benefits become available as soon as you are approved and may be retroactive to the time of your application submission.
Eligibility
The Tennessee Department of Health Services determines the eligibility criteria for TennCare programs. You must meet the criteria in one of several categories including financially needy, pregnant, newborn, medically needy or institutionalized, among others, to qualify for services. The DHS outlines the specific qualifications for each program. Contact your local DHS office to inquire about eligibility and if you meet the qualifications.
Apply
Each TennCare applicant must submit an application to DHS. You can apply online at the DHS website and sign the application electronically. You may also download and print a paper application from the DHS site in English or Spanish. If you do not have access to the Internet, call your county DHS office and ask for an application to be mailed to you or visit the office to obtain one in person. The application must be submitted by mail, fax or in-person to your local county DHS office. Find a list of local DHS offices on the DHS website or call 866-311-4287.
Benefits
Managed Care Organizations make up the plan designs for the TennCare programs. The plans allow for you to visit a network provider for little or no cost. Most plans cover a full range of benefits and services including emergency care, comprehensive illness, hospitalization, lab services, mental health and other therapies. Plans for children also include dental care. Each plan is different and may contain limitations on these services. Upon enrolling, you will receive a guide that outlines the specific benefits of your plan and the limits, if applicable.
Managed Care Organizations
TennCare offers two managed care organizations. Which one you use depends on where you live. In Western and Eastern Tennessee, you may have the option of selecting AmeriChoice or Blue Care. If you live in Central Tennessee, AmeriChoice and AmeriGroup are your options. Additionally, if TennCare Select is another plan for specific enrollees such as those living out of state, offering a wider provider network base. Regions are divided by county and your local DHS office can assist you with your options.
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