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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.

AccessTN

AccessTN provides comprehensive health insurance for Tennesseans who are uninsurable due to pre-existing medical conditions.

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 PPO health plan with three different deductible options. Deductible options will include $1,000, $3,000 รข?" to be HSA compatible, and $5,000. A maternity rider will be made available to those seeking maternity coverage.

Plan Benefits

AccessTN offers a range of In-Network deductibles, including a $1,000, $3,000 HSA compatible and $5,000 deductible. The maximum out-of-pocket limit, which includes the deductible, is $5,000 on the $1,000 deductible plan, $5,800 on the $3,000 deductible HSA compatible plan and $10,000 on the $5,000 deductible plan.

AccessTN Brochure

Maximum Benefit Limits
Maximum lifetime benefits for AccessTN is $1 million.

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 or a qualified legal alien
  • 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 three months 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.
  • You must have any one of the specified medical condition
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 $284 per month to over $1,225 based on age, tobacco use and the plan option selected.

Pre-Existing Condition Waiting Periods

There is a 6-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
312 Rosa L. Parks Avenue
Suite 2600
Nashville, TN 37243
Telephone: 1-866-COVERTN

AccessTN Website

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