NASHVILLE – Governor Phil Bredesen today announced benefits improvements for CoverTN and also shared that, for the third year in a row, there will be no premium increase for the state-sponsored plan in 2010.
“The goal of CoverTN has always been to provide quality benefits and coverage while maintaining an affordable premium and I’m pleased the program continues to achieve that goal,” Governor Bredesen said. “As CoverTN continues to grow, we’re able to make improvements and still operate within our existing budget without passing on additional costs to members.”
Introduced in 2007 as a limited benefit health insurance plan for small businesses and the working uninsured, CoverTN offers two plans that cover the services most needed by most people. In addition to the current benefits, which include up to 12 primary care and five or six specialist visits per year, CoverTN will make the following improvements in 2010:
• Increase the number of outpatient non-surgical visits from two to three per year.
• Increase the number of outpatient surgical visits from one to two per year.
• Cover annual mammogram screening at 100 percent, without being subject to benefit limits.
• Add coverage of Tamiflu, Relenza and other flu treatment medications to the prescription drug formulary, without being subject to pharmacy limit.
All benefit improvements will be effective Jan. 1, 2010, with the exception of coverage for flu medications, which took effect earlier this fall in preparation for flu season.
In addition to these improvements, CoverTN will have no premium increase for 2010, marking three consecutive years of constant premiums.
“From the beginning, I wanted this program to be within reach financially for Tennessee’s working uninsured,” Governor Bredesen added. “Responsible and commonsense management of CoverTN has let us keep a steady price point that most people can afford.”
The average CoverTN member pays $60 per month for his or her coverage, which represents one-third of the total monthly premium. The state and employer cover the costs of the remaining two-thirds. Self-employed and individuals working without health insurance pay two-thirds of the monthly premium while the state still pays the remaining one-third share.
CoverTN is open to small businesses with 50 or fewer full time equivalent employees, individuals who work but don’t have health insurance, the self-employed and those who have recently become unemployed. Complete eligibility information and an online application are available at www.CoverTN.gov.
CoverTN, which serves more than 20,000 members, is a program of Cover Tennessee, Governor Phil Bredesen’s initiative to address the health care needs of Tennessee’s uninsured. Cover Tennessee offers three other programs, including CoverKids, a free comprehensive health insurance program for qualifying children 18-years-old and younger. CoverRx provides Tennesseans who lack pharmacy benefits with access to affordable prescriptions and AccessTN offers comprehensive health insurance for those who are uninsurable due to pre-existing medical conditions.
For more information about any of the Cover Tennessee programs, visit www.CoverTN.gov or call 1-866-COVERTN.