Key Phone Numbers:

• TennCare questions: Family Assistance Center at 1-866-311-4287 (www.tennessee.gov/tenncare)
• Safety Net questions: CoverTennessee and Health Options Hotline at 1-888-486-9355 (www.tnhealthoptions.com)
• Medicare questions: State Health Insurance Program at 1-877-801-0044

A summary of the recent announcements regarding coverage for TennCare enrollees, Safety Net programs for those disenrolled and services to assist those who are uninsured are listed below.

For Current TennCare Enrollees:

12-21-05 TennCare has announced a policy that will allow patients to receive care at home or in community settings instead of going to nursing homes. A new presumptive eligibility policy for enrollees who need traditional nursing home care provides the effect of Medicaid eligibility from the first instead of the thirtieth day of admission, so enrollees do not have the enter a nursing home before accessing a home or community based services (HCBS) option. The full announcement is available at
http://tennessee.gov/tenncare/news/2005_Releases/HCBS_Presumptive_Eligibilty122105.pdf

12-20-05 TennCare will continue to offer Private Duty Nursing to eligible enrollees and will postpone the implementation of non-pharmacy limits on doctor visits, hospital stays and other non-pharmacy services. The full announcement is available at
http://www.state.tn.us/tenncare/news/2005_Releases/TennCare_SafetyNet_Extensions122005.pdf

12-6-05 Pending CMS approval, enrollment in the Medically Needy eligibility category of TennCare will open sooner and with more generous eligibility criteria than previously planned. Instead of July 1, 2006, the date originally agreed upon in the April Memorandum of Understanding, the State will be prepared to begin bringing new enrollees on the program as early as February 1, 2006. The full announcement is available at
http://www.state.tn.us/tenncare/news/2005_Releases/Bredesen_Opens_Medicaid_Category120605.pdf

11-15-05 TennCare is partnering with Weight Watchers to provide weight loss services to enrollees who have a body mass index (BMI) of 30 or more or who have a referral from their physician for a serious weight-related condition. The new program is a cost-effective alternative to the rapidly growing rate of obesity and the medical conditions that result from obesity. The full announcement is available at
http://www.tennessee.gov/tenncare/news/2005_Releases/Weight_Watchers_Partnership111505.pdf

For more information on TennCare, visit www.tennessee.gov/tenncare or call the Family Assistance Center at 1-866-311-4287.

For TennCare Disenrollees:

12-20-05 Strong fiscal management has made it possible to extend Safety Net programs for special disenrollee populations into 2006. Special transitional programs exist for disenrollees with hemophilia, those on dialysis, those who received a solid organ transplant while on TennCare or those who were diagnosed with cancer and prescribed a course of chemotherapy/radiation at the time of disenrollment. The full announcement is available at
http://www.state.tn.us/tenncare/news/2005_Releases/TennCare_SafetyNet_Extensions122005.pdf

11-23-05 Pharmacy assistance for TennCare disenrollees through Rx Outreach has been extended into 2006. Rx Outreach provides a formulary of 55 generic drugs plus 5 additional drugs negotiated by the state of Tennessee. These drugs are available for free for TennCare disenrollees. Diabetic supplies and insulin are also available for disenrollees for a small co-payment. For disenrollees who qualify for Medicare, these programs are extended through February 28, 2006 to allow ample time for enrollment in Medicare Part D. For all other disenrollees, these programs are extended until June 30, 2006. The full announcement is available at
http://www.tnhealthoptions.com/news/2005_releases/112305_Extending_Rx_Assistance.pdf

For more information on the Safety Net, go to www.TNHealthOptions.com, call the Health Options Hotline at 1-888-486-9355.

For the Uninsured:

12-27-05 By January 3, 2006, 39 county health departments will be offering an expanded list of adult primary care services to uninsured residents of Tennessee, with eight more counties scheduled for implementation later in the year. Basic medical services will be offered on a sliding fee scale based on income with a $5 minimum fee. The full announcement is available at
http://www.tnhealthoptions.com/news/county_health_departments.pdf

This is the third prong of the initiative to expand affordable access to primary care services building on the grants made to Federally Qualified Health Centers (FQHCs) and to community and faith-based clinics across the state. Those announcements are available at http://www2.state.tn.us/health/Newsreleases/90205b.htm and http://www2.state.tn.us/health/Newsreleases/93005.htm

For more information on programs for the uninsured, go to www.TNHealthOptions.com or call the Health Options Hotline at 1-888-486-9355.

Regarding Medicare Part D:

11-28-05 TennCare enrollees covered by the federal government’s Medicare plan have been auto-enrolled in the new Medicare Part D pharmacy coverage effectively moving all of their medical coverage from TennCare to Medicare effective January 1, 2006. The full announcement is available at
http://www.tennessee.gov/tenncare/news/2005_Releases/MN_PartD113005.pdf

The State is prohibited from auto-enrolling TennCare disenrollees covered by Medicare in Medicare Part D. Those Tennesseans should consult with their pharmacist for help selecting a plan and completing enrollment.

For more information on Medicare, Part D, and related insurance call the State Health Insurance Program at 1-877-801-0044.