Medicaid Unwinding in Tennessee: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewals in Tennessee are changing because of the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This is being called the unwinding of Medicaid, and some people will lose coverage during this process.
During the PHE, Medicaid renewals were automatic, and enrollees had continuous coverage. As part of the unwinding process, automatic renewals for Medicaid and the Children’s Health Insurance Program (CHIP) stopped nationwide on March 31, 2023.
The Tennessee Medicaid program, known as TennCare, has restarted Medicaid eligibility reviews. Make sure TennCare has your current contact information. If the agency can’t reach you, or if you’re no longer eligible for Medicaid or CoverKids — Tennessee’s version of CHIP — your last day of coverage could be as early as May 31, 2023.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020. From January 2020 to February 2023, the PHE was renewed a dozen times.
People who were eligible for Medicaid coverage during the PHE got to keep their health insurance even if they no longer met eligibility requirements. This is because all states — including Tennessee — were required to provide continuous coverage during the PHE.
But the PHE officially ended on May 11, 2023, and automatic Medicaid renewals stopped on March 31, 2023. Over the next year, 5 million to 14 million enrollees nationwide could lose Medicaid coverage.
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The Tennessee Division of TennCare (TennCare), which runs the state’s Medicaid program, has resumed eligibility reviews for more than 1.7 million enrollees in Medicaid and CoverKids, the state’s CHIP program. This is called the redetermination process. Anyone who no longer qualifies could be disenrolled as early as May 31, 2023. In fact, an estimated 300,000 people in Tennessee could lose Medicaid or CHIP coverage.
Here’s what you need to know about Medicaid changes in Tennessee and what to do if you lose your insurance coverage.
Why is Medicaid changing nationwide?
Now that the PHE has ended, COVID-19 remains a public health priority — just not an emergency. As a result, Medicaid renewals will no longer be automatic.
The process of determining eligibility and enrolling in Medicaid will return to the way it was before the pandemic. This is being referred to as the unwinding of Medicaid.
The unwinding could affect millions of people in all states, Washington, D.C., and five U.S. territories.
What’s happening with Medicaid renewal in Tennessee?
TennCare’s redetermination plan lays out how the state plans to conduct eligibility reviews for current Medicaid enrollees.
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It’s important for TennCare to have current information about your household, such as your mailing address and phone number. You can confirm or update your information by:
Logging into your account on the TennCare Connect portal
Logging into your account on the TennCare Connect app
Calling the TennCare Connect at 855-259-0701
What to expect during the renewal process
In April 2023, TennCare began processing Medicaid renewals to determine who is still eligible for Medicaid coverage. The agency plans to continue this process through May 2024. You can confirm your renewal date through TennCare Connect or by calling 855-259-0701.
TennCare will attempt to automatically renew members using data sources on file, such as IRS information. TennCare officials expect to be able to automatically renew about half of enrollees this way. If you are eligible for auto-renewal, you’ll receive a letter informing you of continued coverage. If you cannot be automatically renewed, you will be sent a renewal packet.
You’ll have about 40 days after receiving your renewal packet to return it.
You can submit your renewal by:
Visiting the TennCare Connect self-service portal — which is the easiest way to complete the process
Calling 855-259-0701 to renew over the phone
Mailing your completed and signed packet to TennCare Connect, P.O. Box 305240 Nashville, TN 37230-5240
Faxing your completed and signed packet to 855-315-0669
Delivering the completed and signed packet to a Department of Human Services (DHS) county office
Using a kiosk to at a DHS office to complete your renewal
If TennCare sends you a letter or notification asking for more information, you'll have another 20 days to send the requested documentation. You can lose coverage if you don’t meet renewal deadlines.
You will receive a letter containing your renewal decision. If your coverage is not renewed, your information will be transferred to the Affordable Care Act (ACA) marketplace. If you no longer qualify for Medicaid, your last day of coverage could be as early as May 31, 2023.
If you lose coverage because you miss the renewal deadline, you have 90 days from the date your Medicaid ended to submit your renewal. If approved, your insurance will be retroactively reinstated with no gap in coverage.
If you need help with your renewal packet or need to reach TennCare by phone for another reason, call 1-800-342-3145.
Tribal health and Medicaid unwinding
Tennessee liaisons are reaching out to people who are enrolled in Medicaid and who are also affiliated with or members of Native American tribes.
The National Indian Health Board estimates that as many as 236,000 American Indians and Alaska Natives could lose coverage during the unwinding process. State advocates are working to ensure eligible people in these groups keep their Medicaid coverage.
What should I do if I lose my Medicaid coverage in Tennessee?
In order to receive Medicaid in Tennessee, you must meet all of the following criteria:
You must be a Tennessee resident.
You must be a U.S. citizen, permanent resident, or legal resident.
You must need assistance with access to healthcare or insurance coverage.
Your annual household income before taxes must be below the limit for your household size.
In Tennessee, you may also qualify for reasons in addition to income, including if you are:
Pregnant
Younger than 21
Responsible for the care of a child
Blind or have another disability
65 years old or older (and meet certain criteria)
A person who receives Supplemental Security Income (SSI)
A former foster child
In need of nursing home care
In need of treatment for breast or cervical cancer
If you no longer qualify for Medicaid, or if TennCare can’t reach you, you will no longer be able to use your benefits, which could leave you temporarily uninsured. You’ll receive a notice 20 days before your coverage ends to notify you about your Medicaid termination and how to appeal the decision if you think you still qualify.
Alternatives to Medicaid in Tennessee
If you choose not to reapply for Medicaid coverage, or if you’re no longer eligible, you may qualify for other low-cost or free healthcare options. You can also use GoodRx coupons to save on your prescription medications. In addition, you may be able to enroll in an alternative health insurance plan, such as:
ACA marketplace plan: You may be able to find an affordable health plan for $10 or less per month if you qualify for a premium subsidy. If you lose Medicaid, you can purchase a plan during the unwinding special enrollment period from March 31, 2023 to July 31, 2024.
Employer plan: Your company may offer employer-sponsored health insurance.
Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.
Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.
Special plans: Short-term insurance can be a great choice if you anticipate a better option, like job-based health insurance, to be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance.
Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.
U.S. Department of Veterans Affairs (VA) benefits: If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.
Tennessee Medicaid resources
Here are some resources where you can learn more about Medicaid in Tennessee and upcoming changes related to the end of the public health emergency:
Tennessee Medicaid office: The Tennessee Division of TennCare oversees and administers the state’s Medicaid program.
Tennessee Medicaid self-service portal: You can visit the TennCare Connect self-service portal and access your account online 24/7 to confirm or update your contact information.
Tennessee Medicaid redetermination: Read more about Tennessee’s Medicaid unwinding plan.
Tennessee Medicaid FAQs: Read the answers to frequently asked questions.
Tennessee Medicaid office phone assistance: You can call TennCare at 1-800-342-3145.
The bottom line
Automatic Medicaid renewals stopped on March 31, 2023 and the COVID-19 public health emergency concluded on May 11, 2023. These events prompted the end of continuous coverage and the unwinding of Medicaid nationwide.
The Tennessee Division of TennCare (TennCare) manages the state’s Medicaid program and is in the process of reviewing Medicaid eligibility. This process will last for a year, through May 2024.
About half of enrollees will be automatically renewed with information already on file. Others will be sent renewal packets. It's important for TennCare to have your current contact information for the renewal process and for other notifications.
No longer qualifying or not completing your renewal information by the deadline can end your Medicaid coverage. If you lose your Medicaid, you may be eligible for other coverage, such as an Affordable Care Act plan, job-based insurance, or Medicare.
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References
Administration for Strategic Preparedness & Response. (2020). Determination that a public health emergency exists.
Administration for Strategic Preparedness & Response. (2023). Renewal of determination that a public health emergency exists.
Centers for Medicare & Medicaid Services. (2023). Temporary special enrollment period (SEP) for consumers losing Medicaid or the Children’s Health Insurance Program (CHIP) coverage due to unwinding of the Medicaid continuous enrollment condition – Frequently asked questions (FAQ).
Kruesi, K. (2023). TennCare: Nearly 300k Tennesseans likely to lose coverage. The Associated Press News.
Medicaid.gov. (n.d.). Renew your Medicaid or CHIP coverage.
Medicaid.gov. (n.d.). Unwinding and returning to regular operations after COVID-19.
State of Tennessee Division of TennCare. (2023). It’s time to renew your coverage! (Coverage means TennCare, CoverKids, or Medicare QMB/SLMB).
State of Tennessee Division of TennCare. (n.d.). CoverKids.
State of Tennessee Division of TennCare. (n.d.). How to file an eligibility appeal?
State of Tennessee Division of TennCare. (n.d.). Preparing for renewals.
State of Tennessee Division of TennCare. (n.d.). TennCare Medicaid.
State of Tennessee Division of TennCare. (n.d.). TennCare renewals frequently asked questions.
Tennessee General Assembly. (2023). Commerce & labor committee.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
Tribal Health Reform Resource Center. (n.d.). Medicaid unwinding.
U.S. Department of Veterans Affairs. (2022). VA & TRICARE information.
