Health Care

We Have You Covered
Tennessee’s new health-care initiative caters to working adults, kids and the chronically ill

Thanks to Cover Tennessee, working Tennesseans are now able to purchase affordable and portable health insurance.

At one time, Tennessee had one of the most generous government-sponsored health-care programs in the country – TennCare. But when it threatened to bankrupt the state, it was clear change was in order.

“We had one of the most extensive and expensive Medicaid programs in the nation, yet we had one of the worst health status scores in the country,” says Laurie Lee, Tennessee’s deputy executive director for insurance administration. “Basically, we had spent a lot of money without improving our state’s health status.”

Another problem was that even at the height of TennCare, more than 600,000 Tennesseans were still uninsured.

“We did a survey in 2005, and we found that most of the adult population that was uninsured were working 40 hours a week, and more than half of those were working for small businesses that couldn’t afford health insurance,” Lee says.

In response, the state created Cover Tennessee – a new health initiative administered by BlueCross BlueShield that will address the problem of working adults who have no health insurance, as well as uninsured kids and chronically ill adults who’ve been deemed uninsurable due to pre-existing medical conditions.

Launched in early 2007, Cover Tennessee offers a family of three insurance products – CoverTN for adults working for small businesses, CoverKids for children and pregnant women, and AccessTN for chronically ill adults with pre-existing conditions.

“CoverTN is really unique, because it’s a partnership between the state, an employer and an employee,” Lee explains. “The state, employer and employee each pay equal shares, or one-third, of the premium.”

Monthly premiums under the CoverTN plan are approximately $150 per month, with the employee paying $50 per month on average. There are no deductibles, and pricing is straightforward: a $20 co-payment for a doctor’s office visit and $10 for most prescription drugs. The plan also includes coverage for hospitalization, diagnostic tests and other basic medical needs.

“It’s a terrific way to bring people into the health-care system who’ve never had access to it,” Lee says.

To promote personal responsibility, premiums vary based on age, smoking status and weight.

“A person could pay between $34 and $99 per month,” Lee says. “People will see if they smoke or are obese, they’ll pay a little more than a non-smoker at their target weight.”

Another benefit of CoverTN is its portability, meaning if a person leaves their employer, they can take the insurance with them if they agree to pay the employer’s share.

“This is not Medicaid, and it’s not TennCare. CoverTN is funded exclusively through state funds,” Lee says. “We wanted flexibility in the program design, and we wanted it to reflect the priorities and principles important to Tennessee.”

Small businesses can visit www.covertn.gov or call 1-866-COVERTN to see if they qualify.

“Governor Bredesen describes it as the first step to help solve the problems of the uninsured,” Lee says. “It’s a national problem, but this is a wonderful start to solving it close to home.”

Story by Jessica Mozo