Post on 26-Jan-2019
* TennCareisTennessee’sMedicaidprogramforchildren,caretakers,pregnantwomen,andafewotherselectgroupswhomake138%ofFPLorlower;itiscomprehensivecare* CoverKidsisforchildreninaslightlyhigherincomebracket(255%ofFPL);someco-paysarerequiredforsomeservices* TheMarketplaceisforthosewithincomesatpovertylevelorabovewhocannotobtaininsurancethroughtheiremployers
TennCare,CoverKids,orMarketplace?
• LivedinMurfreesborothelast10years
• Homelessafterlosingchildcareandthenherjob
• Noincome;SNAPbenefits
CarrinaandDestiny
DoIhaveinsurance?CanIgetit?
DoIhaveTennCare?
PresumptiveNewbornEligibility
• Usuallycompletedatthehealthdepartment,clinic,orhospital• Mustapplyathealthcare.govwithin60daystomaintaincoverage
CarrinaandDestiny
Childrenuptoage19cangetTennCare.
TennCareforChildrenIncomeLimitsHHSize 1 2 3 4 5 6 7Child6-18:138%FPL
1354 1832 2311 2789 3268 3767 4224
Child1-5:147%FPL
1442 1952 2461 2971 3481 3990 4500
<1:200%FPL 1962 2655 3349 4042 4735 5459 6122
3/10/2016
* Kidsunder19cangetcoverageunderthestate’sCHIPprogram,calledCoverKids.* Cannotbeenrolledinanotherhealthplan.* Applythroughthefederalmarketplace.
CoverKidsIncomeLimitsHHSize 1 2 3 4 5 6 7255%FPL 2502 3386 4270 5153 6038 6922 7806
3/10/2016
CarrinaandDestinyDoIhaveinsurance?Probably–throughTennCare,althoughTennCareisnotaninsurancecompanyCanIgetit?Yes!
JakewasjustreleasedfromincarcerationinKentuckyRe-gainedcustodyofMadisonfromvariousfamilymembersandmovedtoTNParttimejobTransitionalhousingprogramAppliedforSNAPbenefitsanddidnotreceiveassistancewithTennCare(?)
CanIgetTennCare?How?
JakeandMadison
WhoiseligibleforTennCare?
• Children• Pregnantwomen• Parentsandcaretakerrelatives• Disability-related• BreastandCervicalCancer• FormerFosterChildren
InordertoqualifyforTennCare,youcannotbereceivinghealth
carebenefitsfromanotherstate’sMedicaidprogramYoumustbearesidentofTennessee.
Youmustcancelpoliciesheldinanotherstateandwaitforthatstatetocancelthebenefits.
Callforhelp!
* Healthcare.gov* Requiresanemailaddressandamailingaddress* Documentation* 2hourprocess
HowdoIapplyforTennCare
* TennCareShelterEnrollmentProject* LocalClinics* GetCoveredTennessee* CertifiedAccountCounselor* HealthNavigator
Wheretofindhelp…
WhenwasthelasttimeMadisonsawaprovideroranyonewhoevaluatedherhealth?WhenwillthatbeconvenientforJake?
JakeandMadison
• CametoyourprogramfromClarksvilletoescapeanabusivespouse
• Emmadoesnotseemtorespondtonoisesaroundher
• NowEmmahasafeverandacoughthatisprogressivelygettingworse
• LucyhasTennCarebuthasnotneededmedicalcaresincearrivinghere
HowcanIfindadoctor?WhatwillTennCarecover?
LucyandEmma
Callthenumberonyourinsurancecardtofindyourassignedprovider
IfyouvisitanewTennCareprovider,youwillneedtocompletepaperworktonotifyTennCareofthechange–
youcanalwaysswitchback,ifneeded
WhatdoesTennCarecover?
* Everything!* Transportation* Sickandwellchildvisitstoaprovider* Dental* Vision* Substanceabuseservices* Behavioralhealth
• 25yearsold• Droppedoutofschoolat5thgrade;
justleftrehab• Chronicallyhomeless;historyof
substanceabuse• Complainsofchronicbackand
abdominalpain,nausea,headaches• Parttimejob;difficultykeepingjobs
andcommitmentsduetohealthissues
CanIgethealthinsurance?What can I do about my health issues?
Sydney
TheCoverageGap:• Unqualifiedimmigrants• Thosewhoseincomeislessthan100%FPLandhavenochildrenwithnoemployerinsuranceoptions• Thosewhosespouseshavefamilyplansthattheycannotafford(non-workingspousemaynotbeabletogetcoverage)
Optionsforthoseinthecoveragegap…
Insuranceoptions
* Apply!* Ageoutoffostercare?* Victimofhumantrafficking?* Disabilitydetermination?
Treatmentoptions
* www.needymeds.org* Clinicsfortheuninsured* Hospitalswithindigentcareprograms
EmergencyMedicaidServicesApplyonthedayyouareadmitted!OnlylifethreateningemergenciesWillonlycovertheemergencyepisode
CanIgethealthinsurance?ProbablynotWhat can I do about my health issues? Housing, employment, d&a treatment - all will likely fail if she cannot get well.
Sydney