CoverKids is full health coverage for children 18 and under and pregnant women whose families cannot afford employer-sponsored insurance or individual insurance and who make too much to be eligible for TennCare. CoverKids is part of the Children’s Health Insurance Program, which provides health insurance to uninsured children in all 50 states.
Any child or pregnant woman who is eligible for TennCare will be covered by TennCare, not CoverKids. Children and pregnant women who aren’t eligible for TennCare may be eligible for CoverKids.
For qualifying families, there is no monthly premium—only copayments, for sick visits and medications. However, you can’t be part of any other health plan.
- CoverKids must be your only health plan.
- To get benefits, your child cannot be covered under any other plan.
- You cannot use CoverKids as a second health plan.
How to apply:
CoverKids applicants applying for child (non-pregnant) coverage must apply online by visiting www.healthcare.gov or toll-free 1-800-318-2596. - See more at: https://www.tn.gov/coverkids/topic/coverkids-application#sthash.AOdP80cw.dpuf
There are four different CoverKids application options are available to pregnant women:
- An application may be filed online at www.healthcare.gov or by phone toll-free at 1-800-318-2596, or
- In-person application assistance is available at local health departments throughout the state. To find a list of local health departments visit http://www.tn.gov/health/topic/localdepartments, or
- A paper application with a signed cover page may be faxed to CoverKids at 1-866-913-1046, or
- A paper application with a signed cover page may be mailed to CoverKids at P.O. Box 305230 Nashville, TN 37230-5230.
What services are covered?
CoverKids provides full health insurance with an emphasis on preventive health services and includes the following:
- Vaccinations and well-child visits
- Physician services
- Mental health services
- Physical, speech and occupational therapy
See a list of CoverKids benefits
What are the eligibility requirements for CoverKids?
- Tennessee resident
- U.S. citizen or qualified legal resident (babies born in the U.S. will be considered
- Age 18 or younger
- Not eligible for TennCare
- Household income up to $60,750 annually for a family of four
- Children who are Native American/Alaskan native may be eligible for additional
benefits and should include federally recognized tribal paperwork with the
- Maternity coverage available for pregnant women at or below 250% of the Federal Poverty Level who meet other eligibility criteria
- CoverKids must be your only health plan. To get benefits, your child cannot be
part of any other plan.
Does CoverKids include a maternity benefit?
Pregnant women of any age who meet CoverKids eligibility criteria may be eligible for maternity benefits through the program, with no monthly premium. However, if you already have other maternity coverage, you are not eligible for CoverKids CoverKids can’t be used as a secondary plan.
What are the income requirements for CoverKids?
Your family's household income must be below 250% the federal poverty level. You can view federal poverty level qualifications here: http://www.tn.gov/assets/entities/tenncare/attachments/eligibilityrefguide.pdf
Will CoverKids cover uninsurable children and children with special health needs?
Yes. CoverKids is a guaranteed issue policy, and there are no pre-existing condition exclusions for its members.
What is the cost associated with CoverKids?
Families who meet the income guidelines will not pay monthly premiums for CoverKids but will be required to pay fees, called copayments, for certain services. Copayments will vary based on income. By federal guidelines, a family’s total annual out-of-pocket costs cannot exceed 5 percent of the annual household income.
My child is eligible for TennCare. Can I switch coverage to CoverKids?
No. Any child who is eligible for TennCare will be covered accordingly. In fact, every application for CoverKids will first be screened for TennCare eligibility before enrolling the child in CoverKids.