Medical Insurance & Financing
Organizations related to paying for medical care are listed here. Most, but not all, are associated with public insurance (Medicare and TennCare). TennCare MCOs are listed.
For an explanation of services, products, types of coverage listed here, and a review of Medicare options, see the Action Guide. Also see the Action Guide for more information about TennCare. For information about programs that help low-income seniors with medication costs, see Prescription Drug Assistance.
AMOS – Affordable Medicine Options for Seniors (CAC): 524-2786
Office on Aging
2247 Western Avenue, 37921 (street)
P.O. Box 51650, 37950-1650 (mailing)
Provides one-on-one advising, group presentations, and training sessions on Medicare. Individual assistance is available to learn about Medicare options, choose a plan, and maximize health benefits at the lowest cost. AMOS helps advocate for Medicare beneficiaries. Free.
Health Insurance Marketplace: 1-800-318-2596
A service that helps people who not are not eligible for Medicare to shop for and enroll in health insurance. The federal government operates the Health Insurance Marketplace, available at HealthCare.gov. Applications for Medicaid/TennCare can also be submitted through the Health Insurance Marketplace.
KEPRO: 1-888-317-0751
KEPRO, Tennessee’s Medicare Quality Improvement Organization, answers questions, explains rights, makes appropriate referrals regarding Medicare, and helps with filing appeals. Responds to written complaints about quality of medical care received in hospitals and skilled care facilities, such as nursing homes and hospices. Works with providers to improve quality of care. www.acentra.com
Legal Aid of East Tennessee: 637-0484
607 W. Summit Hill Dr. SW, 37902
Legal assistance on medical insurance issues, including Medicaid/TennCare and Medicare. Call to apply.
Medicare: 1-800-MEDICARE (633-4227)
TTY (for deaf only): 1-877-486-2048
www.medicare.gov
Federal health insurance for those 65+, younger persons who have drawn disability benefits (SSDI) for two years and people with End-Stage Renal Disease or ALS (Lou Gehrig’s Disease). Phones answered by agents 24 hours a day, seven days a week; closed only for federal holidays.
Medicare Parts A & B (Original Medicare)
Information and answers regarding individual claims about hospital and medical coverage. Can also provide information about Medicare-participating physicians and equipment suppliers. Some services can be accessed on the Medicare website, medicare.gov, which includes information about quality of service from health-care providers (including hospitals, nursing homes, and home-health agencies).
Medicare Part C (Advantage Plans)
Contact customer service at your Medicare Advantage plan (most are open 24 hours/7 days a week). The toll- free number is on the back of your member ID card. For general information about Part C, call Medicare or go to medicare.gov, which includes comparisons of all Advantage plans. For help in choosing or enrolling in a Part C/Advantage plans, contact Medicare, AMOS (page 130) or SHIP for assistance.
Medicare Part D (Prescription Drug Plans)
Contact customer service at your Medicare Part D plan (most are open 24/7). The toll-free number is on the back of your member ID card. For general information about Part D, call Medicare or go to medicare.gov, which includes comparisons of all Part D plans. For help in choosing or enrolling in a Part D plan, contact Medicare, AMOS, or SHIP for assistance.
Medicare Extra Help for Part D: 1-866-331-9091
Social Security Office
9031 Cross Park Drive, 37923
Extra help with prescription costs through the Low Income Subsidy (LIS) for eligible Medicare enrollees with low income and assets. Apply online at secure.ssa.gov/ i1020/start. For application assistance, call AMOS or SHIP.
Medicare Savings Programs (MSP): 594-6151
TN Dept. of Human Services
2700 Middlebrook Pike, Suite 100, 37921
Qualified Medicare Beneficiaries (QMB), Specified Low- Income Medicare Beneficiaries (SLMB), and Qualifying Individuals 1 (QI1) programs help low-income seniors pay for Medicare coverage. To apply, call TennCare Connect
1-855-259-0701 or apply online at https://tenncareconnect. tn.gov/services/homepage. For application assistance, call AMOS or SHIP.
Medicare Supplement Insurance (Medigap Policy)
Contact customer service at your Medigap plan (most are open 24/7). The toll-free number is on the back of your member ID card. For general information about Medigap policies, call Medicare or go to medicare.gov, which includes supplement comparisons. More specific quotes are available by contacting the plan directly. For help in choosing a supplement plan, contact Medicare, AMOS, or SHIP for assistance.
State Health Insurance Assistance Program (SHIP): 1-844-887-7447
TTY (for deaf only): 1-800-848-0299
East TN Area Agency on Aging & Disability
9111 Cross Park Drive, Suite D-100, 37923
Provides counseling and advocacy on health insurance issues at no cost as a beneficiary benefit, including information and assistance with Medicare, Medicare Health Plans, Medicare Part D, Medicare supplemental (Medigap) insurance, and applying for Medicare Savings programs and Low-Income Subsidy. Go to www.tnmedicarehelp.com for more information.
TennCare Advocacy Program: 1-800-758-1638
TTY (for deaf only): 1-877-779-3103
TN Community Services Agency
Hours: 8 am – 5 pm, Mon.-Fri.
Helps consumers determine how to apply for or re-verify TennCare enrollment and explains qualification criteria. Helps enrollees understand benefits, available services, how to access them, and file appeals. Press “2” for help with mental healthcare or substance abuse. Helps consumers of behavioral health and substance abuse services with TennCare with advocacy, applications, benefit information; accessing services; filing complaints/ grievances; and starting the appeal process.
Family Assistance Service Center: 1-866-311-4287
Answers questions about services including SNAP and Families First. Mon.-Fri., 8 am-4:30 pm.
Savings CheckUp / Benefits Enrollment Center: 546-6262
Office on Aging/Senior Information & Referral
2247 Western Avenue, 37921 (street)
P.O. Box 51650, 37950-1650 (mailing)
Service to help low-income older persons and persons with disabilities find and enroll in all the money-saving benefits programs for which they are eligible. Focus on connecting people to the core benefits: Medicare Part D Extra Help/Low- Income Subsidy (LIS), Medicare Savings Programs (MSPs), Medicaid, Supplemental Nutrition Assistance Program (SNAP), and Low-Income Home Energy Assistance Program (LIHEAP), and other state or local benefits programs. Visit www.benefitscheckup.org to learn more about potential benefits.
TennCare Managed Care Organizations Amerigroup: 1-800-454-3730
Three Lakeview Place, 22 Century Blvd., Ste 220, Nashvile, 37214
BlueCare: 1-800-468-9736
1 Cameron Hill Circle, Suite 0002, Chattanooga, 37402-0002
TennCare Select: 1-800-276-1978
1 Cameron Hill Circle, Suite 0002, Chattanooga, 37402-0002
United Healthcare Community Plan: 1-800-690-1606
2035 Lakeside Centre Way, Suite 200, Knoxville, 37922.
TennCare Member Medical Appeals: 1-800-878-3192
Helps file appeals for TennCare medical, dental, and pharmacy denials. Also takes requests to change health plans, and takes requests for reimbursement for medical and prescription services paid for out-of-pocket.
Tennessee Health Care Campaign: 1-615-227-7500
1423 Kensington Square Court, Murfreesboro, TN 37130
Works for affordable access to high-quality health care for all Tennesseans. Also provides a statewide, toll-free number 1-844-644-5443, to find local help for enrollment in the Affordable Care Act Healthcare Marketplace and TennCare. Also provides assistance to resolve issues with TennCare.
TennCare Connect: 1-855-259-0701
P.O. Box 305240, Nashville, 37230-5240
TennCare service center for questions about TennCare/ Medicaid, to report changes in your personal information, and more. Mon.-Fri., 7 am – 7 pm CST. 8 am – 8 pm EST. You can use TennCare Connect to apply for TennCare, CoverKids, and Medicare Savings Programs (like QMB or SLMB) to get help with your Medicare cost sharing. You can also set up a TennCare Connect account at tenncareconnect.tn.gov to renew coverage, report changes, and see your letters about your eligibility.