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Tennessee CoverKids

CMS Rating not applicable

CHIP

Tennessee CoverKids provides free, comprehensive health coverage for qualifying children age 18 and younger and pregnant women. It covers preventive health services, doctors visits, hospital visits, vaccinations, well-child visits, developmental screenings and mental health. Children also get vision and dental care. 

More information on eligibility and enrollment can be found on the TennCare website.

View and manage health benefits online with TennCare Connect. For more information, visit tenncareconnect.tn.gov.

Find providers and coverage for this plan.

Find a provider

Search for doctors, hospitals and specialists.

View drug list

Find medications covered by this plan.

View behavioral and mental health Information

Find information about behavioral health and what to do in mental health emergencies.

View eye care information

Find information about vision care.

We obey federal and state civil rights laws.  We do not treat people in a different way because of their race, color, birth place, language, age, disability, religion, or sex.  Do you think we did not help you or you were treated differently because of your race, color, birth place, language, age, disability, religion, or sex?  You can file a complaint by mail, by email, or by phone. Download and print the information (PDF 30.64 KB) or see below:

UnitedHealthcare Community Plan
Attn: Appeals and Grievances
P.O. Box 5220
Kingston, NY 12402-5220
Phone: 800-690-1606 TTY: 711

Health Care Finance and Administration
Office of Civil Rights Compliance
310 Great Circle Road, Floor 3W
Nashville, Tennessee 37243
Email: HCFA.Fairtreatment@tn.gov
Phone: 855-857-1673 (TRS 711)

You can get a complaint form online at:
http://www.tn.gov/hcfa/article/civil-rights-compliance

You can get a complaint form online at:
http://www.hhs.gov/ocr/office/file/index.html

Or you can file a complaint online at:
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

U.S. Department of Health & Human Services
Office for Civil Rights
200 Independence Ave SW, Rm 509F, HHH Bldg.
Washington, D.C. 20201
Phone: 800-868-1019 (TDD): 800-537-7697

Benefits & features

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Well and Sick Care

Get the care you need to stay healthy — or to get better if you are injured or sick. And pregnant moms get support to keep you and your baby healthy. Member benefits include:

  • Well Visits. Preventive checkups, shots and lab tests.
  • Healthy First Steps®. A program to help you and your baby stay healthy.
  • Nurse Hotline. Speak with a registered nurse 24/7.
  • Shots and Vaccines. Routine shots help protect against illness.
  • Lab and X-rays. Lab tests and x-rays are covered.

Nothing is more important than the health and well-being of you and your baby. That’s why our TennCare Medicaid plan benefits include:

  • Choice of Doctor. Find an OB/GYN you trust in our network.
  • Prenatal Visits. Care for you before your baby is born.
  • Healthy First Steps®. Get extra support and rewards to keep you and your baby healthy.
  • Choice of Birth Centers. Pick from hospitals all across Tennessee.

If you have asthma, diabetes or another long-term condition, you can depend on us. Our TennCare Medicaid plan makes sure you get the care and services you need. Benefits include:

  • Mental Health. Counseling and other treatments are available.
  • Care Management. Personal support from an experienced professional.
  • Population Health Services. Help to manage your ongoing health or chronic condition.

Make sure sight, teeth and hearing are at their best. Benefits include:

  • Dental. Exams and dental work covered for age 18 and younger. 
  • Hearing. Tests and hearing aids covered for age 18 and younger. 
  • Vision Care.. Regular eye exams and glasses, if needed, can help you see more clearly.
    • Members age 18 and younger receive: an exam and glaucoma testing) per calendar year, one set of lenses (including bi-focal, tri-focal, etc..) per calendar year; and one set of eyeglass frames every 2 calendar years.
    • For pregnant women age 19 and older, vision services are limited to medical evaluation and management of abnormal conditions and disorders of the eye. The first pair of cataract glasses or contact lens/lenses after cataract surgery are covered.

Where you have your baby is an important choice. That’s why you can pick from hospitals all across Tennessee.

We encourage you to tour the hospital’s birthing center. This way you will be familiar with it. And you’ll be more relaxed when you have your baby.

Cleanings, checkups and dental work are covered for ages 18 and younger. 

Exams and cleanings every six months help keep teeth and gums strong and healthy. If there is a dental problem that needs to be fixed, we’ll fix it as well.

Your health and safety at home are important.

Our plan covers medical equipment ordered by your doctor or case manager. This can include supplies like:

  • Hospital beds.
  • Oxygen tanks.
  • Walkers or wheelchairs.

Free classes to help improve your health or address a condition. Our plan includes classes on diabetes, nutrition and more. 

Hearing Care

Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to help protect the hearing of members age 18 and under.

We cover:

  • Exams, therapy and tests.
  • Hearing aids.

Healthy First Steps®

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $20 just for signing up. 

We will help you:

  • Choose a pregnancy provider and a pediatrician (child’s doctor).
  • Schedule visits and exams and arrange rides to your visits.
  • Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
  • Get supplies, including breast pumps for nursing moms.
  • Connect with community resources such as Women, Infants and Children (WIC) services.

Hospitalization

This includes:

  • Nursing care.
  • Room and board.
  • Supplies and equipment.
  • Treatment and therapies.
  • Diagnostic tests and exams.

And after you leave the hospital, you are not alone. We make sure you get follow-up care to continue healing at home.

Internet

Do you know about the Affordable Connectivity Program? It’s a new program that helps pay for high-speed internet.  You can use the internet for work, school, healthcare, and more. What do you get with this program?  You may get up to $30 per month off your internet bills.  There is also a one-time $100 discount off a laptop, tablet, or computer. Who can get this program?  Any household that has at least one person enrolled in Medicaid.  How do you get this program?  You must enroll to get it.  Go online to getinternet.gov and enroll today.

Learn more

Interpreters

Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your appointments.

We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language.

Lab and X-rays

Knowing what's wrong and finding it early can make all the difference. Our plan covers:

  • Labs and testing.
  • X-rays, scans and other imaging.

We’ll help you get the information needed to improve your health or be at your best.

Language Help

You can receive information in your preferred language. Just ask. We also have people at our member service centers who speak more than one language. Chances are, we have someone who speaks your language.

Maternity Services

Prenatal and postpartum care.

Member Services

Understanding your health care options can be confusing. We can answer your questions simply and completely.

We help you find:

  • Doctors.
  • Pharmacies.
  • Hospitals or other health facilities.
  • Local resources.

Mental Health

Mental health is as important as physical health. That’s why we have the same coverage for both.

Required care is 100% covered with no copay. This includes:

  • Mental health therapy.
  • Substance abuse treatment.
  • Medications.

No Copays

Members have no copayments for:

  • Preventive care.
  • Annual checkups.

Nurse Visits

Sometimes continued care is needed after leaving the hospital or urgent care. For example, after a serious illness, surgery or injury. In these cases, a nurse will make home visits to:

  • Provide medical care for you.
  • Answer your questions and concerns.

Nurse Hotline

Medical questions and situations can sometimes come at inconvenient times. When you have questions about your health or your child’s health, you can call a trained nurse 24/7.

Our Nurse Hotline nurses will: 

  • Listen to the symptoms.
  • Guide you on self-care.
  • Advise you about getting care at a doctor visit or an urgent care center.
  • Help you know when to go to the emergency room.

Prenatal Visits

A pregnancy is a journey you'll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

All of your recommended prenatal clinical visits and tests are covered.

At these visits, the clinic will:

  • Make sure you and your baby are healthy.
  • Explain what to expect at each stage of your pregnancy.
  • Answer your questions.

Preventive Care

Well-baby, well- child visits/ Immunizations

Primary Care Provider

You get a primary care physician (PCP) who is your main doctor. Use the Doctor Lookup tool to see if your doctor is in our network.

Your PCP is your main doctor for:

  • Preventive care.
  • Treatment if you are sick or injured.
  • Referrals to specialists for certain conditions.

To change your PCP:

  1. Find a new PCP in the CoverKids network. To find a new PCP, look in our Provider directory. Or you can go online at myuhc.com/CommunityPlan, or call 1-866-600-4985.
  2. Then call the new PCP to make sure that he or she is in the CoverKids provider network. Be sure to ask if he or she is taking new patients.

Need help finding a new PCP? Call us at 1-866-600-4985 We’ll work with you to find a new PCP who is taking new patients.

 

Quitting Tobacco

You know the bad health effects of smoking.

You know you need to quit. We support you while you quit with the help of coaches and supplies. The only thing you won't get from us is a lecture.

Shots and Vaccines

Routine shots help keep you healthy. So, our plan covers:

  • Recommended shots and vaccines.
  • Influenza shots.

Vision Care

Regular eye exams and glasses, if needed, can help you see more clearly.

Members age 18 and younger receive: an exam and glaucoma testing) per calendar year, one set of lenses (including bi-focal, tri-focal, etc..) per calendar year; and one set of eyeglass frames every 2 calendar years.

For pregnant women age 19 and older, vision services are limited to medical evaluation and management of abnormal conditions and disorders of the eye. The first pair of cataract glasses or contact lens/lenses after cataract surgery are covered.

Weight Control

Our plan encourages a healthy approach to eating and living. To help our members be their best, we cover:

  • Screening for obesity.
  • Support for healthy diet and exercise choices.
  • Health coaching.

Well Visits

Well visits with your doctor can help keep you healthy. These visits can help catch health problems early so they can be treated. Preventive services include:

  • Checkups for adults and children.
  • Well-baby care.
  • Care for women expecting a baby.
  • Routine shots and tests.
  • Mammograms.

You will not have a copayment for preventive care.

Member resources

Healthier Tennessee is a priority of the Governor’s Foundation for Health & Wellness, involving action promoting healthier behaviors in schools, workplaces and in places of worship. More information is available at www.healthiertn.com. 

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TN Disclaimer
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If you think you have been treated differently for any of these reasons: Race, Color, National Origin, Disability, Age, Sex, Religion or Any other Status/Group protected by Law, you can file a free online complaint by following the link: https://www.tn.gov/tenncare/members-applicants/civil-rights-compliance.html

Last Updated: 09.30.2024 at 09:37 AM CDT

Disclaimer information
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Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® (Medicare-Medicaid plan)

UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook. 

UnitedHealthcare Senior Care Options (HMO SNP) plan

UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 / TTY 711, or use your preferred relay service.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.