Tennessee

---

The following information details health insurance and assistance programs available to uninsured people in Tennessee. If you currently have health insurance or have just lost health insurance coverage within the past 60 days, visit the health insurance section of our Web site for options available to you.

Tennessee Department of Commerce and Insurance - (800) 342-8385
In Tennessee, state law allows health insurance companies to turn people down for individual health insurance coverage based on the status of their health. In most cases, diabetes is considered an “uninsurable” condition. Even though you can be turned down for an individual policy in Tennessee, you can never be turned down for health insurance that is offered through an employer.

If you are having a problem with your state-regulated health plan and you are unable to resolve it with the plan directly, file a complaint with the Department of Commerce and Insurance. They may be able to provide you with assistance in reaching a conclusion.

Cover Kids (Beginning in January, 2007)
Cover Kids will be available to all children under the age of 19 and pregnant women who have been uninsured for at least 3 months. Monthly premiums are based on your income, with some individuals paying no premium at all. Co-pays do apply. Enrollment for Cover Kids will begin in late fall, 2006.

CoverRx (Beginning in January, 2007)
CoverRx will be available to any state resident who is uninsured or who does not have prescription drug coverage under their current health insurance plan. Prescription drug co-pays do apply, and are based on income. Coverage is limited to 5 prescriptions per month; however, insulin, diabetes supplies, and some mental health medications are exempt from the 5 drug per month limit. Enrollment for Cover Kids will begin in late fall, 2006.

Tennessee Department of Finance and Administration, Bureau of TennCare - (800) 669-1851
TennCare provides health insurance assistance to Tennessee residents in a number of different ways - it is the state Medicaid and low-income health care program as well as the state children’s health insurance program. To apply, you must go in person to your local Department of Human Services offices. There is an office located in each of Tennessee’s 95 counties. By contacting TennCare, you can find out more information on their eligibility criteria.

If you’ve lost TennCare coverage, your diabetes needs may still be covered through December 2005. Contact your pharmacist to learn whether you are eligible. Below is information provided by the State on which items are covered and what the co-pay requirements are*:

• Insulin vials: 3 vials/month
• Pre-filled insulin: 15 pre-filled devices/month
• Test strips: 102/month (two drums of 51)
• Lancets (100/month)
• Syringes: The State has indicated it will limit coverage of syringes. Contact your pharmacist for more information.
• Alcohol swabs will NOT be covered. Glucometers will NOT be covered.

*The State has verified that there will be a $5 co-pay on each prescription for insulin and each diabetic supply item. Insulin-dependent Tennesseans who are losing TennCare coverage can call the state’s Health Options hotline for more information at 1-888-486-9355.

If you or your loved one is unable to see a physician due to the cost of care, there may be a local community health clinic in your area. These clinics generally are free or require a very fee for patients to receive care. Find a clinic in your area.

Perscription Assistance
Most pharmaceutical companies offer financial assistance programs to persons who are uninsured. This assistance is available to help cover the cost of medications and supplies when they cannot be paid for out-of-pocket. Each pharmaceutical company has specific criterion that needs to be satisfied in order for an individual to be considered eligible for a financial assistance program.

Contacting the pharmaceutical companies that make insulin and medications

Here you will find phone numbers and information on pharmaceutical companies  who manufacture diabetes medications and supplies and may  be able to help with your needs. If you are unsure, you should ask your doctor or local pharmacist for the name of the pharmaceutical company that makes your diabetes insulin, supplies, and medications.

Important note: Users of the LifeScan One Touch, and Abbott Precision Xtra, and Freestyle blood glucose meters may be eligible for reduced-priced meters and test strips. Visit their Web site TogetherRX Access or call 1-800-444-4106 for more information. Some diabetes medications are available at a reduced rate through this program. Unfortunately, we are unaware of other manufacturers of blood glucose meters and testing strips that have established patient assistance programs for people who are unable to purchase their test strips out-of-pocket.

If you or your loved one is unable to see a physician due to the cost of care, there may be a local community health clinic in your area. These clinics generally are free to patients or require a very small fee. Find a clinic in your area.

Having trouble finding or keeping adequate or affordable health insurance coverage? Become a diabetes advocate!