Vulnerable Tennesseans are at higher risk for health conditions and complications. TennCare, the state’s Medicaid program, supports these residents by providing benefit plans to cover their health care needs.
Now, many enrolled in TennCare may need to find new health care. Every state is required by federal law to periodically review Medicaid eligibility and disenroll those who no longer meet the guidelines.
In March of this year, the federal government lifted its three-year freeze that prevented states from removing people from Medicaid. Now states are assessing whether nearly 100 million low-income Americans still qualify for their benefits. Nearly 4 million Americans have already been disenrolled — a number that could rise to 24 million.
We’ve supported TennCare members for more than 30 years through BlueCare Tennessee, a subsidiary of BlueCross BlueShield of Tennessee chosen by the state to help manage its Medicaid program. If you no longer qualify for TennCare, we can help find the right plan for you.
Cheri Moreland is Vice President, Member Engagement and Systems Innovation, with BlueCare. We spoke with her about how redetermination will affect Tennesseans, when this change goes into effect, and how we’re connecting with members who no longer qualify for TennCare.
What advice would you give to those concerned about losing their coverage?
Cheri: The first and easiest thing they can do if they’re uncertain is visit tenncareconnect.tn.gov. Members can create an account and see when they’re up for renewal and when to expect a packet from TennCare.
All TennCare enrollees, many of whom are BlueCare members, must complete this packet that’s sent by mail. Some members may receive by email. The timing of the packet is dependent on their enrollment anniversary.
We’ve encouraged members to use that portal to verify their renewal date and make sure they’ve updated their contact information and addresses. If TennCare doesn’t have the right contact information, the member won’t receive the packet. And as soon as members receive it, they need to fill it out and return it.
Members who are losing TennCare coverage are eligible to sign up for Health Care Marketplace plans. Up to 90% of people may qualify for government help that lowers their monthly cost. So, if they don’t think they can afford a Marketplace plan, they may be surprised.
Even if members didn’t qualify in the past, they might be able to get more help now. Members can visit healthcare.gov/lower-costs to see if they qualify. Qualifying income levels are based on the federal poverty level [FPL]. The FPL numbers we have heading into 2024 are $14,580 for a single person, $30,000 for a family of four and up to $40,280 for a family of 6. Individuals and families can make up to 400% of the FPL and still qualify for federal assistance.
Our walk-in Blue of Tennessee centers have BlueCross customer service staff knowledgeable about the Medicaid redetermination process and can help get members on a Marketplace plan if they were to lose their coverage.
Do Marketplace plans offer the same benefits as TennCare plans?
Generally speaking, the benefits are very similar. The main difference is that TennCare members aren’t used to paying a monthly premium or paying a member cost share for many, if any, of their services. They may now have to pay part of the cost for some of their care. While some of these folks may qualify for a $0 premium plan in the Marketplace, many may not, and thus will have to pay a monthly premium.
The good news here is we’re introducing new plans with lower prices, making BlueCross a more competitive option than in 2023.
In addition, in 2024, every BlueCross Marketplace plan includes $0 virtual care.
Do affected BlueCare members have to wait until the Marketplace annual enrollment period to enroll?
They don’t have to wait. This redetermination can result in a loss of essential health care coverage, and those affected can be part of a Special Enrollment Period (SEP).
If the member answers “yes” to the application question asking if their Medicaid coverage ended recently or will end soon, and they also provide the date of that loss of coverage, they’re eligible to enroll in a Marketplace plan anytime between March 31, 2023, and July 31, 2024. So, members can start the process of applying for a Marketplace plan now.
Backing up a bit, why are some Tennesseans losing TennCare coverage?
Worth noting is not everyone affected by these changes will lose their coverage at the same time. We’ve been proactively communicating with our members who will be affected.
The renewal process is a federal and state requirement, and TennCare has to renew our members’ coverage annually. Due to the COVID pandemic, the renewal process had been paused for about three years. Late last year, the federal government decided the renewal process would be re-implemented. TennCare and BlueCare immediately began working together on outreach and education efforts for our affected members.
What are some of the ways we’re making members aware of this change?
We’re working to meet members where they are. We’re aware of more than 100,000 BlueCare members so far who’ve been impacted by redetermination, and we’re reaching out to all of them.
We’re sending text messages and postcards, providing updates on social media, and holding community events to raise awareness and answer questions. For members who have complex medical issues, we’re calling them directly to ensure they have the support they need. Our care coordinators are very involved with some of these members, walking them through the processes and helping them fill out their packets.
We’re also partnering with our in-network provider practices to make sure they’re aware of their members who may lose coverage. We’re sending lists every month to many of our Patient Centered Medical Home providers and behavioral health providers.
Additionally, we’re providing affected members with information on how to enroll in a Marketplace plan.
If they lose TennCare coverage between March 31, 2023, and July 31, 2024, they can submit or update a Marketplace application anytime at HealthCare.gov or call our sales team at 888-995-7786.
Purchasing a Marketplace plan through BlueCross ensures members get the same level of support when they call that they’re accustomed to.
You can also visit LocalHelp.HealthCare.gov to get help from a professional in your area. This service is free and can help you better understand your health care options.
Is it possible for those who lose coverage abruptly to re-enroll in TennCare?
Yes. Members can appeal if they feel they lost their coverage inappropriately or in an error. If a member doesn’t submit an appeal, they can submit a new application. We’re here to answer questions and help ease this process.
I know this is an unsettling development for so many people who are at risk of losing their TennCare coverage. Regardless of how quickly things are changing, BlueCare remains committed to ensuring our members are given all the resources possible to continue to be covered and have peace of mind.
Jesse joined the BlueCross BlueShield of Tennessee corporate communications team in 2017. A Chattanooga native, he has more than 15 years’ experience in content creation, management, and strategy for consumer audiences, including a six-year stint in health care marketing.