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 (if you are a 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?
If you or your covered dependent becomes entitled to Medicare prior to the age of 65, coverage will be terminated for the pre-65 Medicare entitled member.
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. You are not required to be enrolled in the basic health plan in order to enroll in , the vision plan as long as you meet the eligibility requirements for retiree vision coverage.
If I continue coverage in the retiree group health plan for myself only, can my spouse and I both enroll in the retiree vision plan?
Yes. If you meet the eligibility requirements for retiree vision coverage you and your spouse may be enrolled.
DENTAL COVERAGE
How do I know if I am eligible for retiree dental benefits?
Full retiree eligibility rules can be found at https://www.tn.gov/partnersforhealth/other-benefits/dental.html.
How do I know if my dependents are eligible for dental benefits?
If you are eligible for retiree dental coverage, your dependents are also eligible. You must provide documentation to verify your dependents’ eligibility before they can be enrolled in coverage.
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.
How will the state deduct my dental premiums?
Premiums will be deducted from your TCRS check each month. If there is not enough money in your TCRS check, the state will send a bill to your home.
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 often keep this coverage at the COBRA premium. This coverage lasts for 18 months. If you meet the eligibility criteria, you can enroll in retiree dental coverage when your COBRA coverage expires. You will need to contact Benefits Administration 60 days prior to the expiration of your COBRA coverage to request an application. You must indicate the requested future effective date when you submit your application.
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 can my retiree dental coverage, can I re-enroll at any time?
No. You can re-enroll during annual enrollment or special enrollment provision.