Tennessee Health Insurance

According to the Center for Disease Control, and average of 11.8% of Tennessee residents went uninsured for Tennessee health insurance each year between 2001 and 2003.

Tennessee Health Insurance Regulations

Any individual covered under a group or employer health insurance policy in Tennessee cannot be denied or limited access to coverage based on health. Unless an individual is HIPAA eligible, any Tennessee health insurance company can turn down an applicant for individual health insurance based on health, age, or any other factor. Most policies are guarantee renewable which means that any individual is guaranteed the right to renew any existing Tennessee health insurance policy provided the individual paid all premiums on time and did not provide any false information.

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HIPAA-Eligibility

All Tennessee health insurance companies offering individual health insurance plans must provide options for HIPAA-eligible individuals seeking health insurance. Tennessee health insurance companies must offer at least two types of standard plans (high and low), their two most popular individual health insurance plans, or they may also offer such individuals a choice of any of their individual health insurance policies.

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Pre-Existing Conditions

Tennessee health insurance companies can impose both elimination riders and pre-existing condition exclusion periods. Elimination riders exclude certain medical conditions or body parts from coverage for the duration of the Tennessee health insurance plan. Pre-existing condition exclusion periods are limited to two years during which time any condition treated, diagnosed, or, according to the insurance company, should have been treated or diagnosed prior to the beginning of the health insurance policy is not covered. HIPAA eligible individuals cannot have pre-existing exclusion periods on policies.

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Pregnancy

Pregnancy is considered a pre-existing condition and can be subjected to pre-existing exclusion periods under Tennessee health insurance law. Once an individual is covered under Tennessee medical insurance, however, all newborns and newly adopted children are automatically covered under the policy for the first 31 days after birth or adoption, provided the policy covers dependents. Disabled children may also continue coverage as dependents past the age at which dependent coverage usually ends.

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Rates

Tennessee health insurance rates vary depending on age, health, gender, family size and other factors. If the insurance company believes an individual is a higher risk for coverage, the company can charge more for an individual Tennessee medical insurance policy.

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Temporary Health Insurance

Some companies sell temporary individual health insurance. Any individual who is not covered under Tennessee health insurance because he or she is between policies or employers may have the option of purchasing temporary coverage for this period of time.

Alternative Tennessee Health Insurance Options

For individuals who have difficulty obtaining individual Tennessee health insurance, the state has a program called TennCare which helps residents obtain health insurance coverage. It provides the following services to Tennessee residents:

• Medicaid to eligible residents
• Low-income health care program to eligible residents
• Children’s health insurance program for children whose families are not eligible for the Medicaid program but may not be able to afford Tennessee health insurance.

Tennessee Department of Insurance

Insurance Division
500 James Robertson Pkwy
Fourth Floor
Nashville, TN 37243

(615) 741-2218
1-800-342-4029

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For other Tennessee Insurance Resources, See:

• Tennessee Auto Insurance
• Tennessee Home Insurance
• Tennessee Health Insurance

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