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Tennessee Risk Pool - Health Insurance Provided for the Uninsurable

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Acronym or name of the risk pool: Access TN.

Regulation establishing risk pool: It was set up in 2006 as a part of the cover Tennessee programme of governor Bredesen.

Funding: The programme receives funds from premium payments by members. At least 60% of the funds are supposed to come from premium payments of members. Funds are also received from assessments on health plans of companies and reinsurance agencies operating in Tennessee.

Plans offered: Access TN offers one basic comprehensive plan with three different deductibles. The options are of $1000, $5000 and the $2500 HSA eligible one. Maternity riders are available to those seeking maternity covers.

Plan benefit: The benefits to be offered are yet to be determined. But they are set to be along the lines of ones provided in other states. There will not be a waiting period for pharmacy, outpatient services or preventive care.

Maximum benefit limits: Contact the Access TN programme directly for information on this provision.

Eligibility: (1) The person must be a resident of Tennessee. (2) You must have received a letter rejecting your application for insurance. (3) You are not under COBRA coverage or any other state coverage.

Enrollment periods: The enrollment period for Access TN programs are not fixed. A person conforming to the eligibility criteria may apply for covers at any time. Coverage usually starts on the first of the following month.

Premium payments: Your age, gender, tobacco usage and plan selection determines the premium you pay. Payment assistance for premium is usually provided to people having an income less than 250% of the federal poverty level.

Premium calculations: The rate capped is at 1.5 to 2 times that of the standard rate charged by the leading insurance companies in the state. Premiums range between $273 to $1000 and more in a month.

Pre existing condition waiting period: A waiting period of three months is provided for a person with a pre existing condition. The waiting period is also applicable to people who have had prior coverage. It is waived for prescription drug coverage.

Contact information: Cover Tennessee. Department of Finance and Administration. Tennessee state capital. Nashville TN 372430285. Telephone-1866 COVERTN. Official Website.

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