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Need Help? Call TennCare Connect at 855-259-0701

CoverKids FAQ

The Children’s Health insurance Program (CHIP) is a federally sponsored program that provides health insurance to uninsured children in all 50 states and the District of Columbia.  In Tennessee, this program is called CoverKids.

CoverKids offers free health coverage for pregnant women and children who don’t have insurance and who don’t qualify for TennCare. Preventive health care is free!  Sick visits and medication have very low-copays.  Children age 18 and under also get dental and vision benefits. And pregnant women get prenatal, delivery and 60 days postpartum care.

To be eligible for CoverKids, you must:

  • Be a Tennessee resident
  • A child under 19 years of age and also a U.S. citizen or qualified alien OR a pregnant woman
  • Meet the income requirements for CoverKids

Please note:

  • Enrollees who are Native American/Alaskan Native may be eligible for additional benefits.
  • CoverKids must be your only health plan. To get benefits, you can’t be part of any other plan (special rules apply to pregnant women).

Visit CoverKids Eligibility to learn more about eligibility for CoverKids.

Visit TennCare Eligibility Reference Guide  for a summary of TennCare and CoverKids income limits.

Fill out an application online by visiting tenncareconnect.tn.gov or by calling TennCare Connect at 855-259-0701.

YES! You can get in-person help at the Department of Human Services in your county. Visit Office Locator - Family Assistance to find a location near you.

There are two different CoverKids application options that are available to pregnant women.

  • An application may be filed online at tenncareconnect.tn.gov or by phone toll-free at 855-259-0701, or

In-person application assistance is available at local health departments throughout the state. To find a list of local health departments visit Local and Regional Health Departments.

You can still go to a local health department. They will help you apply in person. A list of local health departments by county is available at Local and Regional Health Departments.

If you already have CoverKids, call 855-259-0701 immediately after your baby is born. We will enroll your baby in coverage. Your baby will either get TennCare or CoverKids. Either way, coverage will start on the day your baby was born.

 

YES! You can get in-person help at your local health department. Visit Local and Regional Health Departments to find a location near you.

Yes. CoverKids is a guaranteed issue policy and there are no pre-existing condition exclusions for its members.

The custodial parent can submit a CoverKids application for the child(ren). The child(ren) must reside in the household with the custodial parent.

Once a child is enrolled in CoverKids, coverage is for 12 months. After the first year, eligibility for the program will be verified annually.

CoverKids coverage will begin the date of receipt of the completed CoverKids application.

No, a provider statement is not needed.

If you are a pregnant woman, no immigration documents are required.

 

Once a child is enrolled in CoverKids, he or she will receive 12 months of coverage. CoverKids will not re-examine an enrollee's eligibility during this time.

If your household circumstances change you must report it to TennCare Connect within 10 days. You can call TennCare Connect at 855-259-0701 to report changes.

Yes. If all eligibility criteria are met, having access to health insurance doesn’t mean you can’t get CoverKids.  However, you can’t have other health insurance.  In order to get benefits, CoverKids must be your only health plan.

A family can apply for CoverKids at any time, but the coverage will begin on the date of receipt of the completed and signed CoverKids application.

Families are encouraged to apply for the CoverKids program before children become injured or ill.

CoverKids provides comprehensive health insurance that provides the following preventive health services:

  • Vaccinations and well-child visits
  • Physician services
  • Hospitalization
  • Mental health services
  • Physical, speech and occupational therapy
  • Children also get vision and dental care

CoverKids provides services children need most, such as well-baby and well-child visits, as well as age-appropriate immunizations according to the schedule and endorsement of the American Academy of Pediatrics.

 

CoverKids covers inpatient and outpatient mental health care and substance abuse treatment for low co-pays without limits. Prior authorization is required for these services.

Yes, for children. Children must have one year of continuous enrollment to be eligible for orthodontic services.

Families who meet the income guidelines don’t pay a monthly premium for CoverKids, but will be required to make co-payments for certain services. Co-payments will vary based on income. By federal guidelines, a family's total annual out-of-pocket expenditures cannot exceed five percent of the annual household income.

No. Families will have a listing of participating physicians in their area and can select the health care provider they are most comfortable seeing. Families are encouraged to select a physician to be their medical care coordinator so their children can have continuity and quality of care.

 

CoverKids is part of BlueCross BlueShield of Tennessee's TennCareSelect network with providers across the state. This network provides access to at least one physician, hospital and pharmacy within 30 miles of any member, which is consistent with the standard guidelines for access to care.

 

Contact us at 1-866-620-8864 for language assistance.

CoverKids is specifically intended for children, not adults. As a result, a child is no longer eligible for CoverKids after age 19.

Once ineligible due to age, a member should explore other coverage options such as health insurance through the marketplace at www.healthcare.gov or employer sponsored insurance.

Information is available at www.tn.gov/coverkids. For more detailed questions about CoverKids, call 855-259-0701.