PLANS & PROGRAMS

All the important details in one place

We have two TennCare plans – BlueCare and TennCareSelect. Members with specific needs may also qualify for one of our four programs – SelectKids, SelectCommunity, CHOICES, and Employment and Community First CHOICES.
Older man hugging grandchildren on sofa

Are you a CoverKids member?

We can get you started and walk you through your plan.

Grandmother giving a kiss to her young granddaughter Grandmother giving a kiss to her young granddaughter

You may be eligible for TennCare

Based on your TennCare℠ eligibility, you may be enrolled in BlueCare℠ or TennCareSelect.
Here's some helpful information for you
Do you qualify for BlueCare?

BlueCare provides coverage for:

  • Children under age 21
  • Pregnant women
  • Parents or caretaker relatives of a minor child (child must live with you and be a close relative)
  • Women who need treatment for breast or cervical cancer
  • People who live in a nursing home with a monthly income of less than $2,205 or get other long-term care services that TennCare pays for

You can learn more about BlueCare benefits below.

Are you eligible for TennCareSelect?

TennCareSelect is a statewide health plan that provides care for specific groups of people like:

  • Children under age 21 who receive Supplemental Security Income (SSI)
  • Children under age 21 receiving long-term services and supports
  • TennCare members living in areas with fewer health care providers
  • TennCare members temporarily living out-of-state
  • Foster children (including those age 18-20) in state care. Plus children who have left state custody for six months as long as they remain eligible. This program is called SelectKids.
  • TennCare members with intellectual and developmental differences. This program is called SelectCommunity.

You can learn more about TennCareSelect benefits below.

Can I disenroll from BlueCare Tennessee or TennCare?

Yes. Here are some reasons your plan could end:

  • You feel we treat you differently or don’t cover the services you need because of your religion.
  • You can’t get all the related services you need in our provider network. (For example, a cesarean section and a tubal ligation.) And your doctor says getting the services at different times would hurt your health.
  • You’d have to change one of your support providers because they leave our provider network. This could cause a disruption in where you live or work. (This is only for LTSS members.)
  • You have problems with your care, such as:
    • You’re not getting high quality care.
    • You can’t get services TennCare covers.
    • You don’t have access to providers who can meet your needs.
  • You choose another managed care organization (MCO). You can choose one during the 90-day change period after you enroll or during the annual choice period.
  • TennCare lets you change MCOs because you meet certain requirements.
  • You win your TennCare appeal to change MCOs due to hardship, and you’re enrolled in another MCO.
  • TennCare assigns you to us by mistake, and you’re enrolled in another MCO.
  • You move outside our service area and change to another MCO.
  • You’re a CHOICES/Employment and Community First CHOICES member and you ask to change MCOs because you meet the guidelines in TennCare Rule. (This is for all MCOs except TennCareSelect)
  • TennCare decides it’s in the best interest of you and them.
  • You aren’t eligible for or are removed from TennCare.
  • You choose to leave our plan, and you’re enrolled in another MCO.
  • We don’t take part in TennCare anymore.

Your plan will not end for the following reasons:

  • Adverse changes in the enrollee’s health.
  • Pre-exisiting medical or behavioral health conditions.
  • High cost medial or behavioral health bills.
  • Failure or refusal to pay applicable TennCare cost sharing responsibilities; except when this results in loss of eligibility for TennCare.
  • Enrollees utilization of medical or behavioral health services.
  • Enrollee’s diminished mental capacity.
  • Enrollee’s uncooperative or disruptive behavior resulting from his or her special needs (except when his or her continued enrollment in the MCO seriously impairs the entity’s ability to furnish services to either this particular enrollee or other enrollees).

We’ll only ask you to leave our plan if staying enrolled with us makes it harder for us to serve you or other members.

BlueCare Tennessee benefits overview

We want you to get the most from your benefits. So we put together these helpful details. Your coverage depends on your age and benefit level. Your benefit level is determined by TennCare. You can find that on the front of your Member ID card.

All members get medical and behavioral health care. Prescription drugs too. Behavioral health includes mental health and substance misuse. Care must be medically required to be covered. If you’re also on Medicare, note that your prescriptions come through Medicare.

Enrolled in Medicaid, but also eligible for Medicare?

Our Medicare with Medicaid plan (BlueCare Plus) has extra medical, dental and vision benefits at no extra cost.

Two friends sitting on chairs at home

SelectCommunity

TennCareSelect members with intellectual and developmental disabilities could be eligible for SelectCommunity. Especially if they get services from the Department of Disability and Aging (DDA). This program helps them get the care they need.

Our nurse care managers work with the member, family caretaker relatives, other caregivers and family, and providers. Paying attention to every detail. So they can manage the care and services covered by the member’s health plan.
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We’re glad to talk about whether this program is right for you. Call us at 1-800-292-81961-800-292-8196. Or learn more at the TennCare DDA site.

Visit TennCare DDA
Father and son on walk with grandmother in wheelchair Father and son on walk with grandmother in wheelchair

CHOICES

This is our long-term services and supports program for adults age 21 and older with a physical disability, as well as seniors age 65 and older. CHOICES offers services to help a person live on their own. But it can also provide care in a nursing home.

Our CHOICES team is made up of care coordinators and advocates. Both work directly with everyone involved. That includes you. Plus the agencies, individuals and companies that provide care.

We’re happy to discuss whether this program can help you. Call us at 1-800-468-96981-800-468-9698. You can also read more about the program in your member handbook.
Here's some helpful information for you
CHOICES groups

Only TennCare can decide if you qualify and what kinds of services you need. And you have to be either a BlueCare or TennCareSelect member. If you are eligible for the program, you’ll be in one of these groups:

  • Group 1 for people of all ages who receive nursing home care
  • Group 2 for adults with disabilities and seniors who receive home care instead of nursing home care
  • Group 3 for adults with disabilities and seniors who don’t meet the requirements for nursing home care, but need some extra support to help them stay at home

Adults are aged 21 and older. Seniors are aged 65 and older. Other conditions and restrictions apply. Visit TennCare CHOICES or our member handbooks for complete details.

Protecting yourself and loved ones

We want to protect your aging or ill loved ones in the care of others. Serious situations may include:

  • Abuse – physical, sexual or emotional
  • Neglect – not providing services and support that prevent physical or mental harm
  • Exploitation – stealing or misusing money or belongings

If you know about or suspect any of these activities, call as soon as possible:

If you or a loved one feels threatened or unsafe, call 1-888-747-89551-888-747-8955. Your BlueCare Tennessee care team is here to help.

Find a CHOICES provider

You can find providers and companies that provide the kind of care covered by CHOICES. This includes services like meals on wheels, pest control, home improvements and more.

Mother and grandmother embracing special needs toddler
Mother and grandmother embracing special needs toddler

The Katie Beckett Program

This program helps children with disabilities or complex medical needs who don’t qualify for Medicaid. It provides extra benefits to allow their families to meet their child’s needs at home. No one knows how to care for these children better than their family and we’re proud to be part of their team. Learn More
Mother and daughter on couch

How do you
change your plan?

TennCare assigns your plan when you enroll. But they also make it possible to change plans. If you’re new to TennCare, you have 90 days to request a change. After that, give us a call at the number on the back of your ID card and we’ll walk you through it.

You can also talk to TennCare Connect about making a change at 1-855-259-07011-855-259-0701. Or visit TennCare for more details.