What is Amerigroup TennCare?
Amerigroup TennCare is an managed care organization (MCO) that is a subsidiary of Anthem, Inc. that offers healthcare coverage to people enrolled in the Tennessee Medicaid Program, also known as TennCare. TennCare is a state-sponsored program that provides healthcare to low-income families, pregnant women, children, and people with disabilities. Amerigroup TennCare is one of three MCOs that provides TennCare benefits. The other two MCOs are BlueCare and UnitedHealthcare Community Plan.
As an MCO, Amerigroup TennCare is responsible for contracting with healthcare providers to offer medical services to TennCare enrollees. These providers include doctors, hospitals, labs, and pharmacies. Amerigroup TennCare also works to coordinate care among various providers to ensure that enrollees receive the most appropriate, highest quality care.
One of the key features of Amerigroup TennCare is its focus on preventative care and disease management. The organization offers wellness programs and care management services that help enrollees understand and manage their health conditions. These services may include health coaching, medication management, and other initiatives that promote healthy behaviors and lifestyle choices.
To enroll with Amerigroup TennCare, individuals must first be eligible for TennCare. This includes people who meet income requirements and other eligibility criteria. Once enrolled in TennCare, individuals can then select Amerigroup TennCare as their MCO.
Overall, Amerigroup TennCare is committed to improving the health and well-being of its members by providing access to quality healthcare services and programs that promote healthy living.
Benefits and Eligibility of Amerigroup TennCare
Amerigroup TennCare is a healthcare program that provides low-income families and individuals with affordable health coverage. The program is designed to help those who are struggling financially, who are uninsured, or underinsured. It covers a wide range of health services, including preventive care, prescription drugs, hospitalization, and mental health services. This healthcare program can be a lifesaver for those who need medical services but cannot afford them.
The eligibility criteria for Amerigroup TennCare varies depending on factors such as income, age, and other demographics of the applicant. It is necessary to meet specific requirements to be eligible for this healthcare program. The following are some of the eligibility criteria for Amerigroup TennCare:
Income Level
One of the most critical factors in determining eligibility for Amerigroup TennCare is income level. Applicants should have a household income that is within the set limits. The threshold for income differs based on the number of members in the household. For instance, an individual with an annual income of $16,971 or less, or a family of four with an annual income of $34,846 or less, may be eligible for Amerigroup TennCare.
Age
Eligibility for Amerigroup TennCare is also determined by age. Infants and children under the age of 19, pregnant women, and parents or caretakers of children who meet the eligibility criteria may be eligible for this healthcare program. Adults without children may also be eligible under specific circumstances.
Citizenship
Amerigroup TennCare is open to U.S. citizens, nationals, and qualified aliens. Non-citizens may be eligible for TennCare services depending on their immigration status and residency status. However, individuals in certain categories, such as individuals on parole or probation, are not eligible for Amerigroup TennCare services.
Other Eligibility Criteria
Other eligibility criteria for Amerigroup TennCare include residency, disability, and medical need. To be eligible for this healthcare program, applicants must be legal residents of the state of Tennessee. They must also have a medical need for healthcare services. Applicants who are disabled or require long-term care may also be eligible for TennCare services.
In conclusion, Amerigroup TennCare is a cost-effective healthcare program available to eligible Tennessee residents. It offers comprehensive health coverage, including preventive care, prescription drugs, hospitalization, and mental health services. To be eligible for Amerigroup TennCare, applicants should meet specific criteria, including income, age, and citizenship status. Those who meet the eligibility criteria can apply for the program and receive affordable healthcare services. If you believe that you are eligible for this healthcare program, you should apply today to get the medical attention you need and deserve.
Amerigroup TennCare services and offerings
Amerigroup TennCare offers a range of health care services and programs to eligible members. The TennCare program is a Medicaid program that provides health care coverage to low-income individuals and families, pregnant women, and children under the age of 21, who are Tennessee residents. Amerigroup TennCare is one of the managed care organizations (MCOs) that administer TennCare benefits to eligible members.
Amerigroup TennCare provides services such as medical, dental, vision, and behavioral or mental health care to eligible members. They also offer additional services such as transportation assistance, family planning, and access to wellness programs such as fitness and nutrition.
One of the unique offerings that Amerigroup TennCare provides its members is the Personal Care Attendant (PCA) program. This program provides in-home personal care services to eligible members who need assistance with activities of daily living, such as bathing, dressing, and grooming. Members can choose their personal care attendant who is trained and supervised by Amerigroup. This program is especially beneficial for seniors and individuals with disabilities who want to age in place in the comfort of their homes.
Amerigroup TennCare also offers a Healthy Rewards program that rewards members for participating in activities that promote healthy habits. Members can earn points by completing preventive health screenings, participating in healthy behavior programs, and attending wellness events. The points can then be redeemed for a variety of rewards such as gift cards, fitness equipment, and healthy snacks.
In addition, Amerigroup TennCare offers a Health Advocate program that provides members with assistance in navigating the complex health care system. Health Advocates are trained professionals who can help members with finding a primary care physician, scheduling appointments, and explaining health care benefits. The program also provides support in managing chronic conditions and connecting members with community resources that may help them improve their health and well-being.
Amerigroup TennCare is committed to providing quality health care to its members and has a network of qualified health care providers and hospitals throughout the state. Members can choose their primary care physician from a list of participating providers and receive care from specialists as needed with referrals provided by their primary care physician.
The MCO also provides access to telemedicine services, which is especially important during the COVID-19 pandemic. Members can receive medical care through video or phone calls from the comfort and safety of their homes.
In conclusion, Amerigroup TennCare provides a comprehensive range of health care services and programs to eligible members, including medical, dental, vision, and behavioral health care. They also offer unique programs such as the Personal Care Attendant and Healthy Rewards to improve members’ health and well-being. The Health Advocate program provides essential support in navigating the health care system, while the network of qualified providers and hospitals ensures members receive quality care.
Choosing the right Amerigroup TennCare plan
Choosing the right Amerigroup TennCare plan can be overwhelming, but it is a crucial decision that will impact your healthcare options. There are four types of Amerigroup TennCare plans you should consider when deciding which one is right for you:
1. Amerigroup Community Care (ACC)
Amerigroup Community Care is a traditional Medicaid plan that offers comprehensive healthcare benefits at a low cost or no cost to eligible Tennesseans. ACC is the largest plan in the Amerigroup TennCare network and employs its own medical staff, care coordinators, and navigation services.
ACC members receive a range of benefits, including prescription drug coverage, primary care physician services, medical specialist consultations, and elective services such as dental and vision coverage. ACC members also have access to an extensive network of providers, including hospitals, clinics, and community health centers.
2. Amerigroup STAR+PLUS
Amerigroup STAR+PLUS is a Medicaid Managed Care Program for people who have disabilities or are over the age of 65. STAR+PLUS offers many of the same benefits as traditional Medicaid, as well as long-term care services for eligible individuals.
STAR+PLUS members have access to a variety of healthcare services, including medical, behavioral, and long-term care, as well as prescription drug coverage and transportation. They also have access to a network of specialists, such as ophthalmologists, audiologists, and dentists, who offer elective services to members.
STAR+PLUS is designed specifically for those who need long-term care and support, and provides care coordination services to help them manage their healthcare needs more effectively.
3. Amerigroup Dual Eligible (ADE)
Amerigroup Dual Eligible is a plan that provides healthcare coverage to individuals who qualify for both Medicare and Medicaid. ADE helps to coordinate benefits between the two programs, providing a comprehensive package of services to eligible individuals.
ADE members receive a range of benefits, including prescription drug coverage, primary care physician services, medical specialist consultations, and elective services such as dental and vision coverage. ADE members also have access to an extensive network of providers, including hospitals, clinics, and community health centers.
ADE is an excellent option for those who need multiple services and would like to have them coordinated by one plan provider.
4. Amerigroup CHOICES
Amerigroup CHOICES is a plan designed for individuals with physical disabilities, traumatic brain injuries, or who are elderly waiver clients. CHOICES provides a comprehensive package of healthcare services to eligible individuals, including integrated care management, assessments, and support services.
CHOICES members have access to a network of specialized providers who offer support services such as personal care, nursing, therapy, and behavioral health services. CHOICES also offers support services to help members manage their everyday life activities.
CHOICES is great for individuals who need specialized services to support their daily activities and overall health.
Choosing the right Amerigroup TennCare plan is a critical decision that will impact your overall healthcare experience. It is essential to consider your healthcare needs, budget, and priorities when deciding which plan is right for you. You can speak with an Amerigroup representative to discuss your options, and they can help you choose the best plan that fits your needs.
Common Misconceptions about Amerigroup TennCare
There are many misconceptions when it comes to Amerigroup TennCare. However, these misconceptions can prevent people from making informed decisions about their healthcare. This article aims to address some of the most common misconceptions about Amerigroup TennCare so that individuals can have a better understanding of the program and take advantage of the benefits it offers
TennCare only covers low-income individuals
One of the main misconceptions about Amerigroup TennCare is that it only covers low-income individuals. While it is true that TennCare was initially created to provide healthcare coverage to low-income individuals, it has since expanded to cover other groups, such as children, pregnant women, and individuals with disabilities. TennCare also covers individuals with moderate to high incomes who may not have access to affordable healthcare through their employer.
TennCare is divided into groups; these include TennCare Medicaid, TennCare Kids, CoverKids, and TennCare Standard. Each group has its own eligibility requirements, which individuals can check on with an Amerigroup representative in their state.
Doctors and healthcare providers do not accept TennCare
Another common misconception about Amerigroup TennCare is that doctors and healthcare providers do not accept TennCare. This misconception could not be farther from the truth. Amerigroup has a large network of doctors, dentists, hospitals, and other healthcare providers who accept TennCare. Individuals who enroll in Amerigroup can use their online provider search tool to find healthcare providers in their area that accept TennCare.
Enrolling in Amerigroup TennCare is very complicated
Another misconception about Amerigroup TennCare is that enrolling in the program is complicated and time-consuming. However, enrolling in Amerigroup is straightforward and easy. Individuals can apply for TennCare online, by phone or mail, or by visiting their local Department of Human Services. Amerigroup representatives are always available to answer any questions and guide individuals through the enrollment process.
Once an individual has enrolled in Amerigroup, they will receive a TennCare card, which they can use to access healthcare services. The card is presented to the healthcare provider during a visit, and the provider will bill Amerigroup directly for the services rendered.
Amerigroup TennCare only covers basic healthcare services
Some people assume that Amerigroup TennCare only covers basic healthcare services. However, the program covers a wide range of healthcare services, including doctor visits, hospital stays, emergency care, dental care, vision care, and prescription drug coverage.
Additionally, Amerigroup provides care coordination services for individuals who need help managing their healthcare needs. Care coordinators can assist individuals in finding healthcare providers, scheduling appointments, and coordinating care between different providers. This service is particularly beneficial for people with complex healthcare needs.
Once enrolled, individuals cannot switch healthcare providers
Finally, some believe that once they have enrolled in Amerigroup TennCare, they cannot switch healthcare providers. This is not true. Amerigroup members can change healthcare providers at any time for any reason. Individuals can browse Amerigroup’s provider directory online, and if they find a provider they want to switch to, they can contact Amerigroup to make the change.
In conclusion, Amerigroup TennCare is an excellent program that provides comprehensive healthcare coverage to individuals who may not have access to affordable healthcare elsewhere. Understanding the program’s benefits and debunking these common misconceptions can help people make informed decisions about their healthcare and take advantage of the benefits that Amerigroup TennCare offers.
