Co-pays other than pharmacy co-pays

TennCare Medicaid adults have pharmacy co-pays only. You don't pay co-pays for other TennCare services. But some TennCare Standard members with incomes at or above 134% of poverty do have co-pays for other kinds of services.

Poverty Level	Copayment Amounts
0%-133%	$0
134% - 199%	$8.20, Hospital Emergency Room for non-emergency services (waived if admitted) $5.00, Primary Care Provider and Community Mental Health Agency Services other than preventive care $5.00, Physician Specialists (including Psychiatrists) $5.00, Inpatient Hospital Admission (waived if readmitted within 48 hours for the same episode)
200% and above	$50.00, Hospital Emergency Room for non-emergency services (waived if admitted) $15.00, Primary Care Provider and Community Mental Health Agency Services other than preventive care $20.00, Physician Specialists (including Psychiatrists) $100.00, Inpatient Hospital Admission (waived if readmitted within 48 hours for the same episode)

Your co-pays may change during the year if there are changes in your family size or income. Tell Tenncare about changes to your family size or job. To report a change, call TennCare Connect at 855-259-0701 or use your TennCare Connect account at tenncareconnect.tn.gov.

Important: TennCare must tell you in writing before we can make any changes to benefits or the amount you must pay (co-pays) for services.