Tennessee provides both public and private health care options. Almost all Tennessee residents are covered either by a public health care plan or a private plan. Public coverage allows people who couldn't otherwise afford it to get health care for themselves and their children. Private health plans require people to see doctors affiliated with the plan. High-risk persons--patients who have pre-existing conditions--can also get health care coverage in Tennessee.
Public Health Insurance
Tennessee offers public health insurance to residents who otherwise would not be able to afford insurance. Tennessee has several programs available for qualified persons. Cover Tennessee offers insurance for small business owners and employees, as well as individuals who cannot afford insurance on their own. Individuals covered by this program pay $37 to $109 per month as of July 2010, depending upon their medical history. There is no deductible, and prescriptions are not covered. This plan is an individual plan; an employee keeps the plan if he leaves a company that offers it.
As of 2010, Cover Tennessee is not accepting new applications because of budget restraints. However, CoverKids--a complementary program for people under age 18--is still operating. CoverKids covers preventative services for kids. Well-kid visits, such as appointments for vaccinations, are completely covered, and parents pay a small co-pay for all other visits. Dental health is also covered through this plan.
Access TN is a health insurance plan for people who cannot get coverage because of a pre-existing condition. Members are responsible for paying monthly premiums, although assistance is available for people who cannot afford health insurance.
Health Maintenance Organizations
Health Maintenance Organizations (HMOs) cover all of a Tennessee resident's medical care in exchange for a monthly fee. This type of health insurance is common in Tennessee. Companies such as TennCare offer this type of plan. HMOs contract with particular doctor's offices; services are not covered at offices not affiliated with the HMO.
Preferred Provider Organization
Preferred Provider Organizations (PPOs) are similar to HMOs in that they are affiliated with particular doctors. Unlike HMOs, PPOs allow patients to visit a doctor outside the network; patients pay a larger fee, but some services are still covered. PPOs are less common in Tennessee than HMOs are. USAccess is an example of a PPO that has affiliations with doctors in Tennessee.
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