A note from Hope Johnson:
The Bureau of TennCare is currently working to redetermine eligibility for our members. This year’s redetermination process will look different than in previous years due to CMS allowing states to use several options for streamlining the eligibility redetermination process.
In May and September the state redetermined eligibility for approximately 720,000 individuals through the first phase of this streamlined process. In Phase 1, TennCare performed a SNAP match in cooperation with the Department of Human Services. We were able to redetermine eligibility for this population using SNAP data that was available to us. Most of these individuals were provided notice in May that they had been redetermined eligible and their TennCare would continue. A second smaller group were notified in September. No members lost eligibility as part of Phase 1.
As Phase 2 of our redetermination process, TennCare will be sending notice to an additional group of selected members giving them the opportunity to self-attest that they have not had a change in circumstances since their last eligibility review. These letters will be mailed in October, November and December. Individuals can complete the form and fax or mail it to TennCare to complete the redetermination process. No members will lose eligibility as part of Phase 2.
We ask for your help in working with your clients to submit these notices back to TennCare. It is especially important that all notices are returned to the address and/or fax number noted on the notice. As a reminder, these are individual notices, so each family member will receive their own form to fill out and send back in.
Phase 3 of the redetermination process will start December 1st. This step will be familiar to most people since it is similar to the historic redetermination that has been performed by TennCare. Individuals due for redetermination, whose eligibility was not redetermined in phase 1 or 2 will be mailed a renewal packet and asked to complete the packet and return it to TennCare within 30 days. The returned information will be reviewed and the member will be provided notice whether they are still eligible for TennCare. If they are determined not to be eligible or they do not respond to the notice, they will receive advance notice of termination.
We ask for your help in working with your clients to submit the requested documentation to the specified address or fax number within the appropriate timeline.
Tennessee Division of Health Care Finance & Administration
310 Great Circle Rd | Nashville, TN, 37243 T: 615-507-6459 | tn.gov/tenncar