Getting Tennessee Health Insurance with a Serious Medical Condition
6. If you have a serious medical condition or a disability...
...there are three main programs that may help you. Those programs are Medicare, Medicaid and Tennessee's high-risk pool, AccessTN.
Medicare
You might qualify for Medicare, even if you are under age 65, if you have a disability that is expected to last at least a year or is expected to cause your death. In order to get Medicare because you are disabled, you have to apply for Social Security Disability Insurance (SSDI), and you must receive SSDI for 24 months before you can enroll in Medicare. Until that time, you will have to find another source of health insurance, like COBRA (see Sections #1 and #2) or one of the other options discussed below.
TO LEARN MORE about SSDI, call the Social Security Administration's toll-free number at 1.800.772.1213 (1.800.325.0778 TTY). To learn more about Medicare, call 1.800.MEDICARE (633.4227) or go to www.medicare.gov.
Medicaid
If you are blind or have a disability and your income is low or you spend most of your income on health care, you may qualify for Medicaid. People who have a disability usually qualify for Medicaid because they get Supplemental Security Income (SSI), but you may be able to get Medicaid while you are waiting to find out if you are eligible for SSI. Even if you do not qualify for SSI, you may still be able to get health insurance through Medicaid.
TO LEARN MORE about the rules and how to apply, contact the Tennessee TennCare program toll-free line at 1.800.669.1851 (1.800.772.7647 TTY).
Tennessee's High-Risk Pool for People with Health Problems
High-risk pools are state-run programs that sell health insurance to a small number of people who are turned away by insurance companies or are offered very limited or expensive policies because they or a family member have an existing health problem.
TO LEARN MORE about Tennessee's high-risk pool, which is scheduled to begin taking applications in March 2007, contact AccessTN, part of the Cover Tennessee program, at 1.866.COVERTN or visit www.covertn.gov.
Find out if you qualify, which services are covered and how much it costs.
More Help Finding Your Way
Because these programs are so complicated, you may want help. For example, many people are turned down for Medicare or Medicaid coverage the first time they apply. You may need to appeal this decision more than once. The following may be able to help:
You can call Legal Aid of East Tennessee, Inc. at 865.637.0484 or visit www.laet.org to find the legal services office that is closest to where you live. You can also check www.lsc.gov.
State Health Insurance Assistance Programs (SHIPs) provide information, counseling and assistance to Medicare beneficiaries. Contact Tennessee's SHIP, the State Health Insurance Assistance Program, at 1.877.801.0044.
Protection and Advocacy (P&A) programs provide legal representation and other advocacy services under all federal and state laws to all people with disabilities. In Tennessee, call Tennessee P&A, Inc. at 1.800.342.1660.
Resources:
- » More Information on Obtaining Medical Equipment and Services for Those with Disabilities
- » Health Insurance & Health Care Coverage for Long-term Care
- » Long-Term Care Coverage by Health Insurance Plans, Medicare, or Medigap
- » Medicaid Coverage for Long-Term Care
- » Long-Term Care Coverage Through Medicare
Articles:
- » Long-Term Care Insurance Preparation and Options
- » Choosing a Long-Term Health Care and Health Insurance Policy
- » Finding The Best Long-Term Health Insurance Policy for You
Tennessee Health Guide Pages:
- » Looking at Those Without Tennessee Health Insurance
- » Statistics of Those Without Tennessee Health Insurance
- » A Guide to Finding Tennessee Health Insurance
- » Changes in Work or Family Status Affecting Tennessee Health Insurance
- » How Job Loss or Retiring can Affect your Tennessee Health Insurance
- » What to Do if You Can't Afford Tennessee Health Insurance
- » Getting Tennessee Health Insurance with a Serious Medical Condition
- » Getting Individual Tennessee Health Insurance Coverage
- » What to do if You Still Can't Find Tennessee Health Insurance
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