Paul Sanchez
If you're wondering how to change your TennCare Medicaid insurance provider, you've come to the right place. TennCare is a health plan that provides healthcare coverage to those who qualify in Tennessee. When you first sign up for TennCare, you have 45 days to change your plan, and after that, you can only make changes during your open enrollment month, which varies depending on your location. In this article, we'll guide you through the process of switching providers, including the different ways you can apply for TennCare Medicaid and the steps you need to take to change your primary care provider (PCP).
How to change TennCare Medicaid insurance provider:
| Characteristics | Values |
|---|---|
| Methods to apply for TennCare Medicaid | Online, over the phone, or with a paper application |
| Portal to apply for TennCare | TennCare Connect |
| Phone number to apply for TennCare over the phone | 855-259-0701 |
| Phone number for those with a hearing or speech problem | Tennessee Relay Service (TNRS) at 800-848-0298 |
| Time limit for new TennCare members to change their plan | 45 days |
| Time to change the plan after the initial 45 days | During the "open enrollment" month |
| Frequency of changing the Primary Care Provider (PCP) | Any time |
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What You'll Learn
New members can change their plan within 45 days
New members can change their TennCare plan within the first 45 days of receiving their coverage. If you are a new member and you want to change your plan, you can do so by calling TennCare Connect at 855-259-0701. This service is free to call and can help you with any questions or issues you may have regarding your coverage.
Alternatively, you can contact your chosen health plan directly. If you have medical bills for care received after your coverage began, your health plan may be able to help. They must receive your receipts and/or bills within 60 days of the date on the letter. You can find the name of your health plan and their contact information on your TennCare card. If you need a new card, you can contact your health plan to request one.
If you are unsure about your coverage or have any questions, TennCare Connect can help. They can provide assistance with understanding your benefits, checking your status, reporting changes, and more. You can also use the TennCare Connect self-service portal to manage your account and access important information.
It's important to note that TennCare Connect is not just for new members. Existing members can also use this service to make changes to their plan, ask questions, or get help with any issues they may be experiencing. So, whether you're a new or current member, don't hesitate to reach out to TennCare Connect for support.
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Change your PCP online
If you are a new TennCare member, you have 45 days to change your plan. After that, you can only change your plan during your "open enrollment" month, which depends on where you live. You can change your Primary Care Provider (PCP) at any time.
To change your PCP online, you must first log in to your secure account. From there, you can change your PCP. If your PCP is not in the Wellpoint plan network, they can help you select a new one. You can also use the Find Care tool to find a provider in your area.
If you do not have a TennCare account, you can apply for one online through the TennCare Connect self-service portal. Here, you can create an account, apply for benefits, check your status, report changes, and more. You can also apply for TennCare over the phone or with a paper application.
If you need to change your health plan, you can do so by calling TennCare Member Medical Appeals at 1-800-878-3192.
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Open enrollment month depends on where you live
Open enrollment is a period when you can enroll in or change your marketplace health plans. The open enrollment period typically begins on November 1, and during this time, you can make changes to your health plans for the coming year. However, it's important to note that the specific dates for open enrollment may vary depending on your state of residence.
While some states may align their open enrollment period with the federal timeframe, others might have different start and end dates. This variation exists because each state has the autonomy to set its own schedule for open enrollment within certain parameters. Therefore, it is always advisable to check the specific dates applicable to your state.
For instance, if you reside in a state that operates its own health insurance marketplace, the open enrollment period might be extended beyond the federal timeframe. This extension could provide a longer window for individuals to enroll, renew, or modify their health insurance plans. Conversely, some states might have a shorter open enrollment period, so staying informed about the relevant dates for your state is crucial.
Additionally, it's important to be mindful of special enrollment periods. These are periods outside of open enrollment when you can make changes to your health plans due to specific life events or changes in your circumstances. Examples of qualifying life events include getting married, having a baby, gaining or losing a dependent, moving, or experiencing a change in income. So, if you miss the open enrollment deadline, you may still have the opportunity to make adjustments to your health insurance plan during a special enrollment period.
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You can keep your PCP if they're in the Wellpoint plan
If you are a TennCare member and want to change your Medicaid insurance provider, you can do so by enrolling in a Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) in Tennessee. With a D-SNP plan, you can keep your Medicaid benefits and gain Medicare Advantage benefits, including additional dental, vision, hearing, and prescription drug (Part D) coverage, all with $0 or low monthly premiums.
Wellpoint, a Medicare Advantage organization with a Medicare Contract, offers HMO, HMO D-SNP, HMO C-SNP, HMO I-SNP, LPPO, and PDP plans. If you choose to switch to Wellpoint, you can keep your PCP if they are in the Wellpoint plan. Wellpoint offers extra coverage beyond basic Medicaid benefits, including a wide range of prescription and over-the-counter (OTC) drugs. You can earn rewards for completing healthy activities through their Healthy Rewards program.
Wellpoint also provides additional benefits to its members, such as coverage for complex rehabilitation technology (CRT) and access to local providers trained to help patients fight opioid addiction and abuse. If you are a caregiver of a Wellpoint member, you can access various resources, including articles, books, and webinars on caregiving topics, as well as tips on self-care and managing your role.
To change your TennCare Medicaid insurance provider to Wellpoint, you can apply online, over the phone, or with a paper application. You can use the TennCare Connect self-service portal to create an account, apply for benefits, check your status, and more.
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Call 800-878-3192 to change your plan
If you are looking to change your TennCare plan, calling 800-878-3192 is a great first step. This number will connect you with the Tennessee Relay Service (TNRS), which can assist you with a range of TennCare-related inquiries and issues.
The TNRS is designed to help individuals with hearing or speech problems, so if you are facing difficulties with your TennCare plan or application due to these issues, this service will be particularly useful. They can connect you with the relevant departments or services to address your specific needs.
When you call 800-878-3192, be prepared to provide information about your current TennCare plan, as well as any specific changes you wish to make. It is also a good idea to have your personal and medical information ready, as they may ask for these details to verify your identity and better understand your situation.
By calling this number, you can receive assistance with changing your TennCare plan, but also with a range of other TennCare-related tasks. For instance, you can apply for TennCare Medicaid and Medicare Savings Programs (MSP) over the phone by calling this number and asking to be connected with TennCare Connect. Additionally, if you are facing issues with your TennCare coverage, the TNRS can direct you to resources like the "How to File an Eligibility Appeal" webpage, which can guide you through the process of appealing any decisions that may impact your coverage.
Remember, if you have any questions or concerns about your TennCare plan, don't hesitate to call 800-878-3192 to receive the support and guidance you need.
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Frequently asked questions
You can apply for TennCare Medicaid online, over the phone, or with a paper application.
No, TennCare will assign a health plan for you. If you are happy with your plan, you don't need to do anything.
If you are a new TennCare member, you have 45 days to change your plan. After that, you can only change your plan during your "open enrollment" month, which depends on where you live.
