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Tennessee Health Insurance: Will Healthcare Reform Help You Get Coverage?

March 15th, 2022

Healthcare reform will start increasing protection for those who need health insurance in Tennessee as of September 23, 2010. That protection will expand coverage to more people and extend coverage beyond previous insurance limits. More people will be able to keep their Tennessee health insurance plans because insurers will no longer be allowed to cancel your policy if you get sick. That provision alone can help to protect people who buy Tennessee individual health insurance plans from dishonest insurance practices.

Your choice of doctors will increase, too. Woman will no longer have to get prior authorization to see an ob-gyn doctor. Members in new health insurance plans will also be free to select any participating primary care provider. September 23 also sounds the death toll for the practice of denying children who have known health problems, such as asthma, access to health insurance. If your child has had to endure years in this predicament, you can start to relax soon.

Adults with known health problems are also getting more help. As of last July 1, $96.8 million federal dollars was made available to Tennessee to provide coverage for people with pre-existing conditions who have been denied health insurance in Tennessee.

This new transitional high-risk pool program is funded completely by the federal government to help people survive until the health insurance exchange becomes available in 2014. If Tennessee does not to run the high-risk pool program, the Federal government will administer it for Tennessee residents. If your medical claim is denied, you’ll also be getting additional help with that. New Tennessee health insurance plans will be required to develop an appeals process to make it easier for you to dispute the denial of your medical claims.

Health Insurance In Tennessee Will Have Fewer Limits

If you are among the 3.2 million Tennessee residents who rely on private insurance coverage, you can stop worrying about being left to face devastating out-of-pocket costs when your bills exceed lifetime limits placed on your coverage. Insurance companies will no longer be able to restrict your coverage to such lifetime limits. In addition, the use of annual limits on coverage will be regulated so you are not denied access to needed care. This will protect the 2.8 million residents who get Tennessee health insurance from an employer as well as those who get new health plans in Tennessee.

What Does Healthcare Reform Mean For Small Businesses?

The 71,900 small businesses in Tennessee can take advantage of the new small business tax credit. This credit is designed to help them provide coverage for employees and to make premiums more affordable. Until now, small businesses have unfairly had to pay 18 percent more, on average, than large businesses paid for the same healthcare coverage. That prevented many small businesses from protecting their employees with healthcare.

Will Seniors Be Affected By Healthcare Reform?

In 2009, about 85,000 Medicare beneficiaries in Tennessee lost coverage for their prescriptions as they sank into the infamous “doughnut hole.” That’s a huge gap in Medicare Part D drug coverage that takes away all coverage for prescription drugs. Seniors have been forced to cut their medications in half or go without all together. In 2010, Tennessee Medicare beneficiaries who are stuck in the doughnut hole are automatically being mailed a $250 rebate check. These mailings began in mid-June and the $250 checks will continue to be mailed each month as additional seniors lose their prescription coverage to the doughnut hole.

Healthcare reform continues to provide seniors with additional discounts in future years until no one will be subjected to the doughnut hole by 2020.

What if you retire before you’re eligible for Medicare at age 65? It’s estimated that 84,700 Tennessee residents do retire before they are eligible for Medicare. With the rising cost of insuring employees, fewer employers now cover their retirees. As of June 1, 2010, a temporary reinsurance program has been set up to support the practice of companies providing health care for their retirees. Not only companies, but also local and state governments and unions are all eligible to participate in this $5-billion program.