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Frequently Asked Questions


CoverKids

What are the requirements for eligibility?
Tennessee resident
U.S. citizen or qualified legal alien (babies born in the U.S. will be considered citizens)
Age 18 or younger
Household income up to $59,625 annually for a family of four
Children who are Native American/Alaskan Native may be eligible for additional benefits and should include federally-recognized tribal paperwork with the application
CoverKids must be your only health plan. To get benefits, your child cannot be part of any other plan.
A pregnant woman with maternity coverage is not eligible for CoverKids HealthyTNBabies. CoverKids HealthyTNBabies can't be used as a secondary plan.

If a child has access to a parent's employer-sponsored health insurance, but the family declined the coverage because it was too expensive, is the child eligible for CoverKids?
Yes. Access to coverage is not a factor in CoverKids eligibility. If all other eligibility criteria are met, it is simply a matter of whether the child is insured or uninsured.

One exception is access to state employee insurance. Federal guidelines do not allow children with access to state employee health insurance to participate in CoverKids.

What services are covered?
CoverKids provides comprehensive health insurance with an emphasis on preventive health services and includes the following:
Vaccinations and well-child visits
Physician services
Hospitalization
Mental health services
Physical, speech and occupational therapy
Vision
Dental

Is special assistance available for help completing the CoverKids application?
Yes. Those who need special assistance completing the CoverKids application may call 1.866.620.8864 and request help with completing their application.

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AccessTN

What is AccessTN?
AccessTN is a comprehensive health insurance program for Tennesseans who are uninsurable because of pre-existing medical conditions or health history. AccessTN functions as Tennessee's high-risk insurance pool.

As a result of new regulations put in place by the Affordable Care Act the AccessTN program enrollment is closed

For current members who are above the federal poverty level and/or are NOT currently receiving premium assistance, your coverage ended April 30, 2014.



CoverRx

What are the requirements for eligibility?
Tennessee resident (six months)
U.S. citizen or qualified legal alien
Age 19 to 64
Uninsured or insured with no pharmacy coverage
Household income below 2013 federal poverty level ($23,550 per year for a family of four)

What is the cost for participating in CoverRx?
Because CoverRx is not insurance, there are no monthly premiums and no cost to join. Members are responsible for affordable, income-based co-pays when they fill prescriptions. Participants will pay a discounted price for any drugs that are not covered.

How do I apply?
Applications are available for download from at www.CoverTN.gov or by calling 1.866.CoverTN or 1-88-560-2649 ext. 361240.

Is there a way to get brand name drugs with CoverRx?
The program does not pay for medications not on the covered drug list. Howver, the CoverRx card can be used as a discount card to purchase brand name drugs.  When available, members are encouraged to use patient assistance programs offered by many drug manufacturers.

What prescriptions are covered?
The list of covered drugs will be included in every welcome packet, but can also be found here. You can request a copy be mailed to you by calling 1-888-560-2649.

If I go to the pharmacy but do not have my ID card, how can I get a prescription filled?
Provide this information to the pharmacist to process your order.
Step 1 Enter Bin 003858
Step 2 Enter Processor Control Number A4
Step 3 Enter Rx Group TCXA
Step 4 Enter Participant's SSN
Step 5 Enter Participant's Date of Birth


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Cover Tennessee

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Cover Tennessee | 310 Great Circle Road | Nashville, TN 37243 | 1.866.CoverTN