Governor Bredesen Announces CoverTN Benefit Improvements for Members, Doctor Visits Doubled
Tuesday, September 30, 2008 | 7:00am
NASHVILLE – Governor Phil Bredesen announced today that there will be no rate increase in CoverTN premiums in 2009 and the number of primary care physician visits will be doubled.
“Keeping premiums low while providing access to quality health benefits for our CoverTN enrollees is incredibly important, especially during these tough economic times," Bredesen said. “The hallmark of this program is its affordability and I’m very pleased we’ve been able to maintain that while adding important benefits.”
The expanded CoverTN benefits, which take effect Jan. 1, 2009, include:
- Increasing the number of preventive doctor visits to 12 per year in both CoverTN plans. Previously, the limit was five visits for Plan A and six visits for Plan B.
- Adding a category for specialist doctor visits where members in Plan A get up to five visits per year, with a $15 co-pay for each visit, and members in Plan B get up to six visits per year, with a $20 co-pay for each visit. Previously specialist visits were counted toward doctor visits overall in both plans.
- Removing the quarterly maximum for diabetic medications and supplies in both CoverTN plans, and also reducing co-pays from $25 to $10 for diabetic medications and supplies. Previously, CoverTN counted diabetic medications toward the $250 prescription drug quarterly limit in Plan A and the $75 quarterly limit in Plan B.
The largest benefit improvement, providing an increase in the number of primary care physician visits to 12 per year, includes internal medicine, OB/GYN, family practice, general practice and nurse practitioners. Co-pays for these visits will remain at $15 or $20, depending on which CoverTN plan option a member chooses.
“It has always been the goal of CoverTN to offer preventive services first so that members have access to most of the health services they’ll need in a year, like doctor visits and prescription medications,” Bredesen said. “I am particularly glad that we can expand the benefits current members receive while helping more people who don’t have health insurance get into CoverTN.”
Premiums for the program will remain at 2008 levels and will continue to be divided equally, by thirds, between the state, the employer and the employee. One-third of CoverTN’s monthly premium averages $54. In cases of individual enrollment, the state will continue to contribute one-third of the monthly premium while the member is responsible for the remaining two-thirds.
The announcement of these improvements, which become effective Jan. 1, 2009, comes on the heels of the addition of a new eligibility category known as Tennesseans Between Jobs. This new category allows unemployed Tennesseans 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 for health insurance through CoverTN.
Currently, 15,767 members are enrolled in CoverTN statewide, with 3,595 participating small businesses. Open enrollment for the program, which is administered by BlueCross BlueShield of Tennessee, takes place in October and allows current members to change plans and employees of CoverTN businesses who aren’t currently members to enroll in the program if they wish.
CoverTN is one of four programs in Cover Tennessee, Governor Bredesen’s multi-pronged effort to extend health insurance to Tennessee’s uninsured. Cover Tennessee’s other programs include CoverKids, a comprehensive health insurance for qualifying children 18-years-old and younger; CoverRx, a pharmacy assistance program providing uninsured Tennesseans access to affordable prescriptions; and AccessTN, a comprehensive health insurance for Tennesseans with uninsurable or catastrophic health conditions.
For more information on any of the Cover Tennessee programs or to enroll, visit www.CoverTN.gov or call 1-866-COVERTN.
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