- Blue Cross Blue Shield of Tennessee
Learn more about each insurance carrier here: Aetna, Cigna, Cigna PDP, Golden Rule, Humana, UnitedHealthcare Life Insurance Company. Compare health insurance quotes from nearby states: North Carolina Health Insurance, Missouri Health Insurance
Shopping for health insurance in the state of Tennessee might seem like a daunting task. Thankfully, there are many options open to Tennesseans who are uninsured or underinsured. Whether you're healthy or not, this page will provide you with valuable information for obtaining health coverage. Read on to learn about the difference between group and individual coverage. If you're healthy enough to obtain coverage on the individual market or if you have a small business and qualify for small group, HealthPlanOne can help. If not, review the information on this page about TennCare (Medicaid), TENNder CARE, CoverKids, CoverTN, CoverRX, and AccessTN. All of these government programs can help those who are medically uninsurable or who cannot afford private insurance to obtain basic health coverage.
What Every Tennessean Should Know About Health Insurance
The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not medically underwritten, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.
Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through HealthPlanOne. Simply visit our Short-Term information page for your free quotes.
It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.
What If I'm Between Jobs?
As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs to invest in an individual/family insurance policy through HealthPlanOne.
With individual coverage you choose the health insurance carrier and benefits you want with the help of HealthPlanOne. We will quote plans for you and your family from all the different carriers available in Tennessee so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through HealthPlanOne could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Tennessee each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.
If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the HealthPlanOne quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.
If you're not healthy there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.
Small Group Plans
If you are self-employed you can apply for a small group plan. You must have 2 or more eligible employees who each work at least 30 hours per week. Small group plans are medically underwritten by all carriers in Tennessee. This means that though no one in the group can be denied coverage, the carrier can increase the rates based on the health history of employees enrolling. HealthPlanOne can help you by quoting plans for small groups. Simply call us toll-free (877) 567-5267.
TennCare is Tennessee's Medicaid managed care program. Medicaid works in practice much like having regular health insurance; if you qualify you'll receive a Medicaid card which you can show your doctor at an appointment. If your doctor participates in Medicaid, the State will pay the bill for the appointment minus any other health insurance you may have. The program pays for many medical services including acute care services, prescription drugs, and long-term services and supports, depending on need. There are several major categories of individuals eligible for Medicaid's full benefits and several others which qualify one for partial Medicaid coverage. The following link provides a list of the requirements (including income ceilings) for each enrollee eligibility category:http://www.tennessee.gov/tenncare/mem-categories.html
The Medicaid option for children under 21 is called TENNder CARE and offers services with an emphasis on preventive care. For more information, click here:
Click here for information on Tennessee Medicare plans
CoverKids provides free comprehensive health coverage to qualifying Tennesseans 18 and under. The program (part of the federally-mandated SCHIP program) is meant to provide coverage to children who do not qualify for Medicaid but who also cannot afford private insurance (under 250% of the federal poverty level). Services included put an emphasis on preventive care and coverage for physician services, hospital stays, vaccinations, well-visits, mental health, vision, dental, developmental screenings, and more. Co-pays for services are low and well-child visits and immunizations are covered at 100%. For more information including eligibility requirements, visit the program's website at http://www.covertn.gov/web/cover_kids.html
CoverRx is Tennessee's pharmacy assistance program. The program provides participants reduced-rate access to more than 250 generic medications in addition to some name brands for certain conditions. Cover Rx is meant for those who require medications but have no pharmacy coverage. The program is not health insurance and will not cover doctor's visits or hospitalizations. There is not a monthly premium, but participants' copay will vary with income. For more information check out their website at http://www.covertn.gov/web/cover_rx.html
CoverTN offers affordable, portable health insurance options to small-business owners, the self-employed and working individuals who otherwise couldn't afford coverage. The program is a limited-benefit insurance plan that provides low-cost coverage to uninsured Tennesseans over 19 who work for qualifying small-businesses, are sole proprietors, or work without health insurance benefits. To see whether you're eligible, click here:http://www.covertn.gov/web/cover_tn.html
AccessTN is the state's high risk pool. The program is the insurer of last resort for residents whose preexisting medical conditions have rendered them medically uninsurable on the private insurance market. The program provides comprehensive health insurance for Tennesseans through 3 different plan options. Members pay monthly premiums based on current market rates. For more information explore their website at http://www.covertn.gov/web/access_tn.html