Tennessee Governor Phil Bredesen recently announced both benefit and eligibility expansions for the state’s CoverTN program and no rate increases for 2009. The program has also seen significant enrollment growth since its launch in March, 2007. Currently, 16,020 members and 6,504 businesses are enrolled.
CoverTN is a three-share program with premiums shared by the state, businesses, and employees. Individuals pay between $35 and $99 per month depending on age, tobacco use, and body weight. The plans emphasize preventative care and have premiums that average $150 per member per month. In order to participate, the employee must work for a low-wage firm and not previously have been offered coverage. The plans have a yearly limit of $25,000 per person along with limits on prescription drugs and physician visits.
Starting January 1, 2009, the program will expand its benefits by:
- Increasing the number of preventive doctor visits to 12 per year. Previously the limit was five or six, based on the plan selected.
- Adding a category for specialist doctor visits with five or six visits allowed. Previously specialist visits counted toward overall doctor visits.
- Removing the maximum for diabetic medications and supplies and reducing their co-payment.[1]
In addition, the state will add a new eligibility category called Tennesseans Between Jobs. This enables individuals who have worked at least one 20-hour week in the previous six months or who have had their work hours reduced to less than 20 hours per week to qualify to enroll in the program.[2]
