Tennessee Individual and Family Health Insurance

Get to know the various Tennessee affordable health insurance plans throughout the state, including the metropolitan areas of Memphis, New South Memphis, Nashville, Knoxville, Chattanooga, East Chattanooga, Clarksville, Murfreesboro, Jackson, and Johnson City.

The State of Affairs of Tennessee’s Health Insurance

Tennessee’s total health care expenditures were $32.1 billion in 2004, with most of the cost applied towards physician, professional, and hospital care fees.  In Tennessee, residents face rising healthcare costs that appreciate at 7% annually – making finding Tenessee health insurance plans and self employed health insurance plans paramount. 

The Volunteer State has over 6 million residents that call it home.  29% of the population receives Medicaid and/or Medicare benefits, while 50% or about 3 million access their Tennessee health insurance coverage through their work.  Employees, on average, pay a premium of $749 for individual health insurance and $2,799 for family health insurance plans.

Affordable Tennessee health insurance plans may appear hard to access.  However, this is not necessarily the reality today, which is good news for both employees and entrepreneurs seeking self employed health insurance. Health insurance plans with better premiums can be found on the individual market, and especially with the help of InsureMonkey, your health insurance agent.

Tennessee Health Insurance Providers

Tennessee’s High Risk Pool

In Tennessee, the high-risk pool program is named AccessTN. This program serves Tennessee residents who have been denied health insurance coverage because of their preexisting medical conditions. AccessTN offers three different health plans. These are:

1)    Plan One – premium assistance-eligible
2)    Plan Two – health savings account-eligible
3)    Plan Three – high deductible, non HAS-eligible

There are no income eligibility requirements, but the applicant must demonstrate that two private insurers have already denied him/her. The applicant must also submit evidence (e.g. physician’s statement) that he/she has one of the 50 medical conditions that has been pre-approved by AccessTN.

To get more details about these pre-approved medical conditions, other eligibility requirements, and premium rates, visit the website at http://www.covertn.gov/web/access_tn.html. Applications forms are available online. For help in filling out the form, call 1-866-636-0080. After completing the application form, it should be signed and mailed to this address:

AccessTN
c/o BlueCross BlueShield of Tennessee, Inc.
801 Pine Street
Chattanooga, TN 37402

Tennessee’s Uninsured

Based upon the 2006-2007 survey performed by the Urban Institute and the Kaiser Commission, Tennessee is home to more than 845,000 uninsured individuals.  Nearly 15% of this figure, or approximately 126,000, are uninsured children. 

The primary reason Tennesseans do not have health insurance coverage is their inability to afford the health plans. Many workers consider the employer-based Tennessee health insurance coverage unaffordable. This leaves many children uninsured and without adequate healthcare.

Families, however, remain concerned about the health of children. In the State of Tennessee, there are many options for these families. InsureMonkey was created to help families explore these options from state-sponsored programs to private insurers.

Tennessee SCHIP

CoverKids is Tennessee’s health insurance program to provide free comprehensive coverage for the state’s eligible children. The coverage will include preventative services, as well as vision and dental care. Some medical services may have low co-pays. The income eligibility limit is up to 250% of the Federal Poverty Level. This is equivalent to an annual income of $53,000 for a family of four.

CoverKids also provides coverage for pregnant women. The income eligibility limit is also set at 250% of the FPL. The benefits for children and pregnant women are described in detail at the website at
http://www.covertn.gov/web/cover_kids.html.

Applying for CoverKids can be performed online. Application forms can also be downloaded from the website. For help in the application process, contact the Department of Human Services at 1-866-620-8864.

Medicaid in Tennessee

The Medicaid Program in the State of Tennessee is more popularly known as TennCare. The State’s Medicaid program is unique from many other public healthcare programs because it utilizes the managed care model, which allows the state to generate savings while extending Medicaid benefits to people who would otherwise be deemed ineligible for Medicaid.

TennCare also emphasizes the need for high quality medical care and has created these major categories of eligibility:

1.    Pregnant women
2.    Newborns
3.    Medically needy
4.    Low-income individuals
5.    People receiving Supplemental Security Income (SSI), including the elderly
6.    Institutionalized individuals
7.    Women with breast or cervical cancer
8.    People with disabilities, both working and non-working

Here are the income eligibility requirements:

•    Children
      o    Infants Ages 0-1:  $32,560 or 185% of the Federal Poverty Level as of January 2009
      o    Children Ages 1-5:  $23,408 or 133% of the Federal Poverty Level as of January 2009
      o    Children Ages 6-19:  $17,600 or 100% of the Federal Poverty Level as of January 2009
•    Parents
      o    Non-Working:  $12,792 or 73% of the Federal Poverty Level as of January 2009
      o    Working:  $23,628 or 134% of the Federal Poverty Level as of January 2009
•    Women
      o    Pregnant women: $44,000 or 250% of the Federal Poverty Level as of January 2009

To apply for Medicaid, the recommended approach is to visit the local office of the Department of Human Services or to call this Family Assistance Service Center toll-free hotline: 1-866-311-4287. When in Nashville, the number to call is 743-2000. For more information about Tennessee’s Medicaid program, visit http://state.tn.us/tenncare/.

(Facts throughout this page provided by the Kaiser Family Foundation at www.statehealthfacts.org and by The New Health Insurance Solution at www.tnhis.com.  Commentary provided by InsureMonkey.)

State Resources

Department of Health
Website: http://health.state.tn.us/
Phone: (615) 741-3111

Cover Tennessee
Website: http://www.covertn.gov/
Phone: 1-866-2683786

Department of Human Services
Website: http://www.state.tn.us/humanserv/
Phone: (615) 313-4700

Tennessee Department of Insurance
Website: http://www.state.tn.us/commerce/
Phone: 615-741-2241