Disenrollment of Medically Needy

Despite no mention of it at Tuesday’s TennCare oversight meeting, roughly 25-thousand TennCare medically needy enrollees started receiving notices last week that they’re losing their TennCare coverage as of December 31st.

The medically needy enrollees have medical expenses significant enough to leave their net income well below the federal poverty line. The group that started receiving notices last week are also eligible for Medicare, and the Medicare prescription drug benefit which begins January first.

Spokeswoman for the American Association of Retired Persons Mary Liz Knish, says TennCare won’t have to pay for drugs starting in January, but TennCare covers expanded services for this population, which she says keeps them out of nursing homes.

“So one of the largest costs to TennCare is going to be taken over by Medicare. The services left that keep these people independent and at home with their families are home health care, transportation and other case management services that manage their health care.”

The AARP says if these individuals end up in nursing homes it’ll cost the state two to three times what it spends on them now.

However, TennCare spokesperson Marilyn Elam says this group of TennCare “dual-eligibles” have always had their medical coverage paid for by the federal government. And she says it’s been common knowledge that these kinds of expanded services with TennCare would come to an end…

“Some of the extra add-on services that TennCare has gone above and beyond and paid for that hardly any other state’s Medicaid program pays paid for or really the federal government even pays for is a sign of how generous TennCare has been in the past and one of the reasons why we had the sort of fiscal crisis that we’ve been digging ourselves out of this last year.”

Elam says the move is good news for the program because 25-thousand other medically needy Tennesseans will now be able to have TennCare coverage.