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Tennessee has two public health insurance programs for children: TennCare and CoverKids!
This brochure will tell you about TennCare and how to apply. TennCare has great benefits for children. It covers visits to the doctor and
dentist, hospital care, medicine, mental health care, and even glasses for children who need them! This brochure will also give you tips about
how to keep your child’s TennCare longer! Does your child already have TennCare? Be sure to read the blue and green boxes on the back of
this brochure. If your child can’t get TennCare, apply for CoverKids! Call 1 (800) CoverTN or visit www.covertn.gov to learn more.
Now let’s find out if your child can get TennCare!
1
What is your family’s
monthly income?
2
Does your family have
unpaid medical bills?
M
M
This way is for kids under age 19. Pregnant
women can get TennCare this way too! It’s
easiest for kids under 6 to get PLIS, so
apply early! It’s ok to have savings or other
insurance. All that matters is family income.
Check the income chart below to see if any
of your children can get TennCare this way.
This way is for children under age 21.
Pregnant women can get TennCare this way
too. There is no income limit for Spend
Down. If your family has unpaid medical
bills and you have very few resources, your
kids may be able to get TennCare this way,
even if they have other insurance! Want to
know more about “resources”? Keep Reading!
aybe your child or teen can get
TennCare Medicaid PLIS.
If this does not fit your family,
read about #2.
2007 PLIS Income Guidelines
Babies
& pregnant Kids age
Family Size women*
1-5
Family of 1
Family of 2
Family of 3
Family of 4
Family of 5
Family of 6
$1574 / mo.
$2111 / mo.
$2647 / mo.
$3184 / mo.
$3720 / mo.
$4257 / mo.
$1132 / mo.
$1517 / mo.
$1903 / mo.
$2289 / mo.
$2674 / mo.
$3060 / mo.
Kids age
6-18
$ 851 / mo.
$1141 / mo.
$1431 / mo.
$1721 / mo.
$2011 / mo.
$2301 / mo.
* A Pregnant woman counts as two people.
These are only general guidelines! Apply at
DHS to see if your child is eligible!
aybe your child or teen can get
TennCare Medicaid Spend Down.
R
esources can be money you have saved or
anything you could sell to get money. For
example, land, a boat, or a second home you
don’t live in. If your family has many
resources, your kids may not be able to get
TennCare this way.
If this does not
fit your family,
read about #3.
3
Does your child have a
disability?
4
Do you get Families
First?
M
I
This way is for children or adults who
have a disability, even if they have other
insurance. SSI means “Supplemental
Security Income.” Children and adults who
getSSI checks also get TennCare Medicaid.
Does your child have a disability or mental
illness? Call Social Security to find out if
your child can get SSI: 1 (800) 772-1213.
Families First is for households where
one or both parents are absent, disabled,
unemployed, or unable to work for health
reasons. Families First offers cash
assistance, job training, and Medicaid for
the whole family, even if you already have
other insurance. After completing the
program, family members may still get
Medicaid for up to 12 more months.
This is called “Transitional Medicaid”.
aybe your child or teen can get
TennCare Medicaid SSI
If this does not fit your family,
read about #4.
f you do, your child or teen is
eligible for Families First Medicaid
E
ven if you don’t want cash assistance, it
may be a good idea to apply for Families
First. Sometimes families who aren’t eligible for any other kind of TennCare can get
Medicaid this way. You can apply for
Medicaid and Families First at your local
DHS office. Do you have questions about
Families First? Call 1 (866) 311-4287.
F
ind out how to apply
for TennCare!
How Do I Apply?
Have Questions?
Need Help! Call Us!
1. First, get an application.
Pick one up at your local Department of
Human Services office (DHS). Fill it
out, sign it, and turn it back in. You can
also mail or fax it in. Do you need help
finding DHS? Call HealthCare for
Children toll free: 1 (800) 280-8682
2. After DHS gets your application,
they will send you a letter about your
appointment. If you can’t make it to
your appointment, call 1 (866) 311-4287.
3. Take the papers listed below
with you to your appointment. If you
can’t find everything, ask DHS to help!
• Your photo I.D.
• Your child’s birth certificate
• Your child’s Social Security card
• Proof of your child’s legal U.S. status
• Proof of where your family lives
• Proof of your family’s income
DHS may also need proof of:
• Your family’s savings & resources
• If your work offers insurance
• Any medical bills your family owes
Important Note: Be sure to get your
case worker’s full name and number!
4. Wait for a letter from DHS,
If your child is approved, the letter will
tell you about your child’s health plan,
and what doctors your child can go to.
If your child isn’t approved, apply for
CoverKids! Call 1 (800) CoverTN to learn
more. Do you think DHS may have made
a mistake? Appeal! Call 1 (866) 311-4287.
Want to Keep TennCare?
Here’s How!
Once a year, kids with Medicaid have
to “recertify” to show that they are
still eligible. When it’s time to do your
paperwork, DHS will send the papers to
you in the mail. Always turn in your
DHS papers on time!
What if your income is too high to
keep Medicaid? We have good news!
Your kids may be able to get
TennCare Standard health insurance
instead! This is called “Rolling Over.”
TennCare Standard has all the same
benefits as Medicaid, but you may
have a co-pay for some services.
TennCare Standard is only for kids who
don’t have access to other insurance.
For the TennCare Standard income
guidelines, see the income box.
IMPORTANT:
If you don’t recertify on time, your
child will lose their insurance and may
not be able to get it back! Always do
your DHS paperwork right away!
HealthCare for Children
1 (800) 280-8682
www.healthassisttn.org
4 WAYS
to get TennCare
for Children & Teens!
Have you moved?
Every year, lots of kids lose their
TennCare because DHS doesn’t
have the family’s current address.
Call the Family Assistance Service
Center today to check your address:
1 (866) 311-4287
2007 Income Guidelines for
TennCare Standard
(only for kids losing Medicaid)
For Children Age 0 - 18 years
Family of 1 =
Family of 2 =
Family of 3 =
Family of 4 =
Family of 5 =
Family of 6 =
$1702 / month
$2282 / month
$2862 / month
$3442 / month
$4022 / month
$4602 / month
Learn more inside!
* Pregnant woman = 2 people!
Does your child have serious health
problems? Tell DHS! Your child may be
able to roll over to TennCare Standard
no matter what your income is!
... a message from
HealthCare for Children,
A Service of Health Assist Tennessee, 11/07