Federal and state laws impact medical insurance options.
Four health insurance options exist for residents of Tennessee, though all of these options come with restrictions. These options are employer provided coverage, individual private health insurance, Medicare and TennCare. Restrictions for these programs range from income levels to patient age and disability and employment status. The type and amount of coverage provided by each type varies from policyholder to policyholder, and also hinges on the nature of the provider.
Employer Provided Coverage
Employer provided health insurance is exactly what it sounds like, that is, health insurance coverage provided in part by the employer of the policyholder. Employers may present employees with options for different health insurance plan types or just offer one, and they normally pay most or all of the monthly premiums. Employers that require employees to contribute toward their premiums withhold the cost from paychecks.
According to nonprofit health care watchdog organization Kaiser Family Foundation, 2,848,000 Tennessee residents, or 54 percent of the state's non-elderly population, received employer provided health coverage as of 2009. The Patient Protection and Affordable Care Act, a federal law enacted in 2010, requires that all American employers with more than 200 employees automatically enroll all employees in a group health insurance plan starting March 1, 2013.
Individual Health Insurance
In many cases the same health insurance companies that provide coverage to employees through their employers offer individual health insurance plans. Individual health insurance plans differ from employer provided coverage only in enrollment method; the same types of policies are available to individuals, though cost may vary greatly from employer provided group insurance, and until full implementation of the Affordable Care Act in 2014, applicants can be denied coverage based on pre-existing conditions. To enroll in individual health insurance plans, potential policyholders contact health insurance companies directly and work out a plan with a company agent. Individuals or families enrolled in such plans pay all premium costs directly to the insurance provider monthly. According to Kaiser Family Foundation, 297,600 Tennessee residents, or six percent of the state's non-elderly population, were covered by individual health insurance plans as of 2009. Individual health insurance providers in Tennessee include Blue Cross Blue Shield, United Health, Aetna, Celtic and the IHC group.
Medicare
The federal government administers the Medicare program, which provides health insurance to retired or disabled Americans. Four types of Medicare are available, Part A, Part B, Part C and Part D. American citizens, including Tennessee residents, aged 65 or older who receive Social Security or Railroad Retirement benefits may enroll in Medicare Part A free of charge. Part B and Part C comprise more complex forms of coverage and may require premiums, depending on a policyholder's eligibility. Part D provides prescription drug coverage. Those with End-Stage Renal disease or assessed with a permanent disability by a doctor may also be eligible. The medicare.gov website provides enrollment and eligibility information.
TennCare
The state of Tennessee provides Medicaid coverage to citizens through the TennCare program. Medicaid is a program jointly funded by federal and state governments and administered at the state level. It provides coverage for low-income citizens without health insurance. According to the official TennCare website, the program provides coverage for 1.2 million low-income individuals. This comprises the majority of the 1,312,400 Tennessee residents living below the poverty level as of 2009. Kaiser Family Foundation, however, reports that TennCare dropped approximately 100,000 program participants who were also receiving federal Supplemental Security Income benefits in 2010. TennCare maintains 12 coverage groups and provides particularly extensive coverage for children. The state Department of Human Services handles enrollment.
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