The Tennessee Plan
The state offers The Tennessee Plan (Supplemental Medical Insurance to Retirees with Medicare) to retired state employees, local education and local government employees and their eligible spouses and dependents through POMCO/UMR. Please visit thetennesseeplan.com for plan details.
Individuals with Medicare coverage will likely need The Tennessee Plan to help cover some of the expenses that Medicare does not. This coverage helps fill most of the coverage gaps that Medicare creates.
- Any retired state employee or local education certified teaching staff hired by their qualifying employer prior to July 1, 2015, and receiving a monthly retirement allowance from the Tennessee Consolidated Retirement System (TCRS) or higher education optional retirement plan who is eligible for Medicare Part A may apply for coverage under this plan.
- Retired local education support staff and local government participants hired by their qualifying employer prior to July 1, 2015, and eligible for Medicare Part A who receive a monthly retirement allowance from TCRS are also eligible to apply for coverage.
- Your eligible dependents may also apply. Individuals who qualify and enroll for coverage within 60 days of their initial eligibility cannot be denied coverage because of age or health.
The Tennessee Plan offers quality coverage at lower group premium rates. Since the premiums are not based on age, they will not increase just because you get older. Best of all, if you have more than 15 years of service as a state employee or teacher, the state will pay part of your monthly premium.
See the premium webpage to determine your monthly cost for this coverage.
Please refer to The Tennessee Plan brochure or member handbook on the publications webpage for additional information.
Rule Changes to Enrollment in The Tennessee Plan
Effective January 1, 2015, a spouse of a retiree can be enrolled in The Tennessee Plan only if the retiree is also enrolled in the Tennessee Plan. If the retiree is not eligible for the Tennessee Plan at the time of retirement, or at the time the spouse becomes Medicare-eligible in the future, the spouse may not enroll in the Tennessee Plan.
The spouse may want to enroll in a commercial Medigap policy until the retiree becomes eligible and applies for the Tennessee Plan. According to the medicare.gov website, if you apply during your six-month Medigap open enrollment period, you can buy any Medigap policy the company sells, even if you have health problems, for the same price as people with good health.
Once the retiree is eligible for the Tennessee Plan, the retiree may apply to include the spouse on the Tennessee Plan if the retiree also elects the coverage. The spouse may be enrolled either when the retiree becomes Medicare eligible and enrolls in the Tennessee Plan, or the spouse may be added effective January 1 of the year following the retiree's initial eligibility and enrollment without going through the late applicant process. After January 1 of the retiree's initial eligibility, the spouse would have to apply as a late applicant, including a medical underwriting process, in order to be enrolled in coverage.
Prescription drugs are not covered under the Tennessee Plan and all supplemental plan members are encouraged to enroll in Medicare Part D for prescription drug needs. Look for information about plans in your area in the Medicare and your Handbook. If you have access to the internet, Medicare has a tool available on their website which will assist you in narrowing the choices of prescription drug plans based upon the drugs you are presently taking. You may also call Medicare at 800.MEDICARE (800.633.4227) to obtain additional information.
Click here for the State Notice of Creditable Coverage