Questions and Answers

If I am Medicare eligible when I retire, can I continue to cover my spouse who is not yet Medicare eligible?
If you meet the criteria to continue group health coverage and are in paying status (TCRS participant), you may continue your spouse’s group health coverage. If you do not continue spouse coverage immediately upon retirement, you cannot add your spouse to coverage at a later date.

If you are enrolled in coverage based upon the eligibility of your deceased spouse, you cannot add your new spouse to coverage if you remarry.

If I become eligible for Medicare prior to the age of 65, will my insurance be terminated? What about my dependents?
You must maintain enrollment in Medicare Parts A and B to keep group health coverage.  Plan Coverage will terminate once eligible for Medicare based on age.

Medicare will become primary and the state group health plan will pay secondary. If parts A and B are not taken when first eligible, coverage will be terminated.

Is my spouse eligible for The Tennessee Plan?
If you are enrolled in The Tennessee Plan, you may apply to cover your Medicare-enrolled spouse. If you do not apply within 60 days of initial eligibility, your spouse must apply as a late applicant and will be subject to approval.

If you are enrolled in coverage based upon the eligibility of your deceased spouse, you cannot add your new spouse to coverage if you remarry.

If I do not continue group health coverage when I retire because I will have coverage through my spouse, can I apply for coverage later?
If you met the minimum criteria to continue group health coverage when you retired, you may apply for the state’s group health plan through a special enrollment provision if you lose other creditable health coverage. You must still meet the plan eligibility rules.

Can I change my health insurance option or carrier when I continue coverage at retirement?
You will continue with the same health insurance option you were enrolled in immediately prior to retirement.  You will have an opportunity to make changes to your coverage elections during the plan’s annual enrollment period.

 

VISION COVERAGE

If I am over age 65 and enrolled in the state’s The Tennessee Plan, am I eligible to enroll in the retiree vision plan?
Yes.  If you meet the eligibility requirements for retiree vision coverage you may be enrolled in both the vision coverage and The Tennessee Plan.

Full retiree eligibility rules can be found on the Partners for Health website under Vision.

 

DENTAL COVERAGE

How do I know if I am eligible for retiree dental benefits?
To qualify for retiree dental coverage, you must receive a monthly retirement check from TCRS and have been hired before July 1, 2015. Effective January 1, 2026, and thereafter, eligibility to participate in the state retiree dental plan is only open to Retirees of an LEA that is participating in the state dental plan at the time of retirement. If the LEA subsequently terminates participation in the state dental plan, its retirees are no longer eligible to continue retiree dental coverage.

How do I know if my dependents are eligible for dental benefits?
The complete retiree eligibility rules are available on the Partners for Health website under the Dental section.

How do I find out which dentists are considered in network?
To find up-to-date network information, call the dental carrier directly or do an online search on the carrier’s website.

My old school system provides other dental coverage. Can I still apply for state-sponsored dental coverage?
If your school system provides dental coverage to retirees, you can enroll in the school system’s dental plan, one of the state’s dental plans or a combination of the two. If you wish to enroll in both the school system and state’s plans, you will need to contact the dental carriers to see if coordination of benefits is possible. Benefits Administration can only assist you with questions about the state-sponsored dental coverage.

How will the state deduct my dental premiums?
Premiums will be deducted from your TCRS check each month. If your TCRS check will not cover the dental premium, the state will send a bill to your home and you will have the option to pay by check, money order, or online.

If I live out of state, can I still enroll in dental coverage?
Yes. If you select the DHMO plan you must still select and use a network dentist.

What if I recently retired and now have COBRA dental coverage?
If you had dental coverage when you stopped working, then you can keep this coverage at the COBRA premium for up to 18 months. If you meet the eligibility criteria, you can enroll in retiree dental coverage instead of continuing coverage with COBRA or after your 18 month COBRA coverage ends.  To switch from COBRA to retiree dental, you must  contact Benefits Administration and submit an application to enroll in the retiree dental plan before the expiration of your COBRA coverage.

Can I cancel retiree dental coverage if I change my mind?
You may only cancel your enrollment during the Annual Enrollment period in the fall (with a Jan. 1 effective date) unless you meet the cancellation provisions described in the dental certificates of coverage.

Who do I call if I have questions about my dental benefit?
For information on covered services, please contact the dental carriers directly.

If I cancel my dental coverage, can I re-enroll at any time?
No, you can only re-enroll in coverage during annual enrollment or through the special enrollment provision.