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The Tennessee Plan - Medicare Supplement Coverage
The State of Tennessee offers The Tennessee Plan to retired state employees, teachers and local government employees and their eligible spouses and dependents. 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. The Tennessee Plan is a standard Medicare supplemental policy comparable to Medicare Supplemental Standard Plan D.
Any retired state employee or local education certified teaching staff 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 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 of Tennessee will pay part of your monthly premium. See the premium page to determine your monthly cost for this coverage. Please refer to The Tennessee Plan brochure or member handbook for additional information.
Prescription drug 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. Insurance companies and other organizations are
authorized by Medicare to offer pharmacy benefit plans. These plans will help
you save money on your prescription drug costs. Medicare's prescription drug
coverage will pay a predetermined part of the cost of prescription drugs for a
monthly premium. Even if you don't use a lot of prescription drugs now, you
should consider taking Part D. If you delay enrollment past your initial eligibility period, a
late enrollment fee of approximately one percent will be added to your premium,
permanently, for each month you delay and you will pay it as long as you remain
in a Part D plan. For example, if you wait ten months after your entitlement to Medicare to enroll, your premium will be ten percent higher than
the regular monthly amount for your Part D coverage. Look for information about plans in your area in the Medicare and You Handbook.
If you have access to the internet, Medicare has a tool available on their web
site which will assist you in narrowing the choices of prescription drug plans
based upon the drugs you are presently taking. Please click on the link below
for instructions on how to use the prescription drug comparison tool. You may
also call Medicare at 1.800.MEDICARE (1.800.633.4227) to obtain additional
information.
www.medicare.gov
Instructions on using Medicare's prescription drug
comparison tool
The Tennessee Plan Benefit Summary
MEDICARE GAPS FOR 2009
What you owe after Medicare pays |
THE TENNESSEE PLAN
Benefits |
BASIC BENEFITS
$267/day for 61-90 days in hospital
$534/day for 60 lifetime reserve hospital days
$20% patient's share of approved medical expense
First 3 pints of blood |
Covered |
SKILLED NURSING
COINSURANCE
$133.50/day 21st-100th day |
Covered |
PART A DEDUCTIBLE
$1,068/hospital admission |
Covered |
PART B DEDUCTIBLE
$135/calendar year for medical expenses |
Not Covered |
PART B EXCESS
Medical expense over approved amount |
Not Covered |
FOREIGN TRAVEL
EMERGENCY
Emergency care beginning during first 60 days of trip outside USA (after
$250 deductible, benefits limited to $50,000/lifetime) |
Covered at 80% |
AT HOME RECOVERY
Up to $40/visit (limited to 7 visits/week and $1,600/calendar year) |
Covered |
PRESCRIPTION DRUGS
Outpatient prescription drugs covered through Medicare Part D |
Not Covered |
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