Tennessee Medicaid Application

For the state of Tennessee, the Medicaid program is named TennCare. Between 2013 and 2014, the state’s Medicaid participation rose three percent. While the Affordable Care Act was created for each state to expand Medicaid, Tennessee chose to not do so. Expanded Medicaid would have supplied 161,650 low-income Tennessee residents the ability to get free or low cost medical insurance coverage.

The Affordable Care Act was enacted in 2010 with the intent of expanding Medicaid in each state so that countless residents would have access to affordable medical care. Since opting out, it’s been estimated that Tennessee will be missing out on $22.5 billion from 2013 to 2022. Additionally, people living in the state will be forced to pay $7.8 billion in federal taxes to be able to provide Medicaid growth in other states.

What’s Covered Under TennCare

• Dental and vision care
• Durable medical equipment
• Mental health and substance abuse services
• Ambulance and non-emergency transportation
• Screenings, laboratory testing, and x-rays
• Inpatient and outpatient hospital services
• Pharmacy services
• Occupational therapy
• Psychiatric inpatient, rehabilitation, and residential treatment services
• Renal dialysis
• Speech therapy
• Physical examinations and checkups
• Doctor services
• Nursing and home healthcare
• Hospice

Who’s Covered Under TennCare

Since the state has failed to expand its Medicaid program, coverage isn’t available for residents that aren’t disabled, pregnant, or without dependents. These groups of people can apply for participation in the present plan:

• Adults with dependents whose income does not exceed 105 percent of the federal poverty level
• Pregnant women and infants under one-year-old whose family income does not exceed 195 percent of the federal poverty level
• Kids between the ages of 5 and 1 whose family income does not exceed 142 percent of the poverty level
• Kids between the ages of 6 and 18 whose family income does not exceed 133 percent of the poverty level
• The CHIP program is available for children whose family income does not exceed 250 percent of the poverty level

Governor Bill Haslam has broached the topic of creating an expanded Medicaid program named Insure Tennessee. It’s been met with great opposition, leaving countless Tennessee residents uninsured.

In 2012, Governor Haslam declared that the state of Tennessee would default to a federally-facilitated health benefits market. Residents are encouraged to utilize the federal benefits traded located at healthcare.gov or telephone 1-800-318-2596 so as to apply for TennCare.

Applications may also be obtained in-person at any Department of Human Services office in the state. Programs are supplied online for residents wishing to send them via the email. Completed applications should be sent to the following address:

Following the Application Procedure

Residents may be given a notification letter in email should the section require additional data so as to make an eligibility decision. In the event that the resident was accepted, a medical card will be sent via the mail.

Applicants should be given a notification of acceptance or denial within a 45 day time period. For responses taking longer than 45 days, applicants may request a “delay hearing” by phoning 1-855-259-0701.

Hearings on Program Decisions

Applicants who were denied coverage under TennCare may file an appeal. Healthcare.gov offers advice on what could be appealed. Appeal request kinds should be sent to by mail.

Appeals are taken regarding the following choices:

• Enrollment Beyond the open registration period
• Qualification for reduced insurance costs based on income level
• Eligibility for Medicaid or CHIP coverage
• Exemptions in the Medical Insurance requirement
• Qualification for Different Kinds of coverage

Appeals will be replied within 90 days of receipt.

There aren’t any open enrollment periods for the TennCare program and residents are invited to apply through the year. Changes to household information has to be reported to the Health Insurance Marketplace within 30 days of the change. Changes to family income and other variables may impact eligibility for participation in TennCare.

Households that contain up to four individuals who make a household income of around $95,400 may be eligible to get low cost or free health insurance under TennCare. To be eligible, applicants must reside in the state of Tennessee, be a United States citizen or qualified alien, and be pregnant, disabled, or elderly. Applicants that are not able to complete the application procedure can designate a responsible party to help them in the procedure.