Tennessee Risk Pool - Health Insurance for the Uninsurable
Risk Pool Name / Acronym
AccessTN
Insurance Regulation Establishing Risk Pool
Established in 2006 as part of Governor Bredesen’s Cover Tennessee program.
Funding
Funding for AccessTN comes from federal funding and assessments in insurance carriers operating in the state of Tennessee. Premium payments from plan members are expected to cover 60% of operating costs.
Plans Offered
AccessTN will offer one basic comprehensive health plan with three different deductible options. Deductible options will include $1,000, $2,500 – to be HSA compatible, and $5,000. A maternity rider will be made available to those seeking maternity coverage.
Plan Benefits
Plan benefits are yet to be determined but are said to be modeled after and similar to the state employee health plan. There will be no waiting period for preventive care, pharmacy or outpatient therapy; however, a 6 month pre-existing condition waiting period shall be enforced.
Maximum Benefit Limits
Maximum lifetime benefits for AccessTN have not been determined at the time this summary was updated.
Eligibility
You must be a current resident of Tennessee and have been so for a period of at least 6 months.
You must be a U.S. Citizen
You must be age 19 or over
You must be uninsurable and able to provide proof of such.
You must have been without health insurance coverage for at least six month prior to the application process and have no access to insurance at the time of application.
COBRA benefits must be exhausted prior to applying for coverage under AccessTN.
Enrollment Periods
There is no set enrollment period for the AccessTN program. Any person meeting the eligibility requirements may register at anytime. Coverage will become effective on the first day of the month following the date of application.
Premium Payments
The determination of monthly premiums for AccessTN will be based upon age, tobacco use, obesity status and plan chosen. Premium payment assistance will be available to persons that have income less than 250% of the federal poverty level.
Premium Calculations
Premiums for the AccessTN program are capped at 1.5 to 2 times the standard markets rates. Premiums will range from $273 per month to over $1,000 based on age, tobacco use and the plan option selected.
Pre-Existing Condition Waiting Periods
There is a 3-month waiting period on pre-existing medical conditions. The waiting period applies to all members, even those that have prior creditable coverage. The waiting period has been waived for prescription drug coverage.
AccessTN Contact Information
Cover Tennessee
Department of Finance & Administration
Tennessee State Capital
Nashville, TN 37243-0285
Telephone: 1-866-COVERTN
AccessTN Website
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