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In Tennessee, Medicaid is called TennCare. TennCare is for Tennesseans who fit into certain categories, including uninsured women under age 65 who need treatment for breast and cervical cancer must meet eligibility requirements. Legal Aid of East TN has eligibility information. There are additional TennCare categories for some children and families with children.
Children and pregnant women with high medical bills are also eligible for TennCare. You may change MCOs once within the initial 45 days of the date of the assignment letter. Before choosing a TennCare plan, think about desired doctor, hospital, and pharmacy, as well as other necessary medical services. Check with each MCO to learn which services are provided—for example, eye and dental care, geriatric assessment.
Check with all health-care providers to learn which MCO plans they accept. Choose the MCO that offers the greatest number of needed services and the doctor, hospital, and pharmacy you prefer.
TennCare MCOs must provide transportation for plan members who do not have transportation to medical services. Call your MCO to get instructions about arrangements, which must be made in advance, sometimes as many as five days. Even in an emergency, call your MCO for instructions about obtaining transportation. TennCare provides pharmacy benefits to eligible enrollees. However, enrollees who also have Medicare receive pharmacy benefits through Medicare Part D. Enrollees should contact TennCare Connect with questions.
A person who:. Lives in a nursing home and meets monthly income and resource requirements, or. Gets other long-term-care services that TennCare pays for. Resource Directory. Community Partners. Volunteer Opportunities. Applications, Forms, Brochures. Video Library. FTDD Foundation. Contact Us. Site Map. Use tab to navigate through the menu items. Community-Based Residential Alternatives Places to live that offer care and support for someone who can no longer live alone that include the following: Assisted Care Living Facility — A place you live that helps with personal care needs, homemaker services, and taking your medicine.
It's only for: Adults 65 years of age and older; OR adults 21 years of age and older who have physical disabilities. Consumer Direction is a way of getting some of the kinds of home care you need. This means that you must do the things an employer would do, like hire, train, schedule, supervise, and even fire workers.
The number is on your TennCare card. They include both medical and financial questions, as well personal information like date of birth and Social Security Number. Statements should be provided for each financial account, including checking, savings, IRA, CD, stocks, bonds, and k. The following information must be included: company name, address, policy numbers, date issued, face value and cash value for each policy.
These types of services are called home- and community-based services or HCBS. They will help you do things in the community that you want to do—to help you build relationships and reach your goals. If you live at home with your family, they will also help your family support you in planning for and reaching your goals. There is a limited amount of funding to serve people each year.
This means that not everyone who wants to apply can enroll or get services right away. To get on the referral list, you can complete a self-referral. You must qualify to enroll in the program. There must be room in the new program to enroll you. AND, you must be in one of the groups that may qualify to get services now. OR they can fill out the form for you with the facts you provide.
What is a PAE? This is the document that determines if the applicant meets the medical guidelines to be eligible for Long-Term Care Medicaid.
What is Medicaid? Medicaid is operated and administered by the state governments and subsidized by the federal government. In Tennessee, the Medicaid program is called TennCare. What is the difference between income and resources? Why do I have to show my financial information, especially the life insurance policies? Your life insurance policies may be whole life and have a cash value which TennCare considers part of your total resources.
In addition, TennCare wants to see who the owner of the policy is, and what the face value of the policy is. TennCare will let you know if you need to assign a life insurance policy irrevocably to a funeral home to take care of any cash value.
Is the government going to take my house? This is called Estate Recovery. Estate recovery only occurs after your death and the death of your spouse, and your family is not personally responsible for the debt. Where do I send financial documentation needed for my application? We will ensure that it is sent to TennCare, and will keep a record of it.
Roan St. Someone has contacted me to follow up on the home visit. Who is this? Another agency, Ascend, may also be calling to meet with you to review the recent visit from one of our qualified assessors.
They regularly conduct these visits after us to ensure our compliance in the application process. I received a letter saying my PAE was approved. The next step is waiting for approval for the financial part, which is Medicaid. Why can't I get services if I'm approved for Group Three? What is a denial?
The letter you receive will explain why the PAE or Medicaid was denied. If your PAE was denied, you may be able to have it resubmitted. If not, you can follow the guidelines listed in your denial letter to appeal the decision within 30 days of the date on the denial letter. If you are able to supply the verifications, or complete the requests, such as a spend-down or completing a qualified income trust, your application may be reopened.
If not, you can follow the guidelines listed in your denial letter to appeal. What is an MCO? This is the insurance company that coordinates the services that the enrollee will receive.
When will my services start after I get approved? Once the visit has been completed, services should start within 20 days. How much help will I get? When the Care Coordinator meets with you, a plan will be developed that is centered around meeting your needs.
The Care Coordinator will be able to explain the specific types of services for which you are eligible, and how many hours can be provided. This should be done as soon as possible. If you do not make the request within the day period after you are assigned, you will not be able to make a change until the next open enrollment period unless certain hardships exist. If you do not know who your Care Coordinator is, you can call member services.
The number is located on the back of your Medicaid insurance card.
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WebAmerigroup Community Care is committed to supporting you in providing quality care and services to the members in our network. Here, you will find information for assessing . WebDec 22, · UnitedHealthcare Community Plan UnitedHealthcare Community Plan is your TennCare health plan, and we will also be managing your long term services and supports. The TennCare long term services and supports program is called CHOICES UnitedHealthcare has a great deal of experience helping long term services and supports . WebMay 8, · All Exclusive Stations; All Music Stations; All News & Talk Stations; All Sports Stations.