About 38,000 of the 323,000 are "dual eligibles" who also qualify for coverage under the federal Medicare program that covers people over age 65, according to figures provided by J.D. Hickey, TennCare director.
As for children, all those now on the program will remain, Hickey
said.The program covers about 612,000, children.About 112,000 would have been cut from the program in a reversion to basic Medicaid.
, "children" means people under age 21 if they qualify for Medicaid, but only those 19 and under if they are part of the "expansion population."
In the future, all children eligible for Medicaid will be enrolled and will receive full benefits just as under the present TennCare program.But, in general, those who would now be eligible under the "expansion program" will not be enrolled, Hickey
For adults remaining in the program after the transition, new limits will be in effect for prescription drugs, doctor visits, hospital visits and laboratory work. Hickey
said the state plans to formally file its new plan with the federal Center for Medicare and Medicaid
by the end of the week and has received "strong indications" that the federal agency will approve.
The new plan will be implemented in stages, Hickey
said, and will not be completely in place until sometime early next year.The new limits on benefits will go into effect first, taking effect in "late spring," he
For those to be removed from TennCare rolls, he
said, the first step will be sending them a letter giving notice.Hickey
said at least another 60 days will pass before the first notice can go out.