TennCare Switch Worries Families

TennCare Switch Worries Families

CREATED Mar 26, 2007

Major changes in TennCare are approaching in two weeks. Blue Cross Blue Shield will stop serving as the insurance provider for Tenncare, and two new managed care companies Amerigroup and AmeriChoice will take over.

The change on April 1 will affect more than 300,000 kids and severely disabled adults in middle Tennessee, including Diane Rancourt's 17-year-old adopted daughter Rebecca who has cerebral palsy and several other serious ailments.

Rancourt said the problem is that none of her daughter's current doctors, including the many specialists she sees are willing to take the new insurance.

The companies that provide her feeding tubes and home health care nurse weren't sure they would either.

"It's just so frustrating. I'm a nervous wreck," Rancourt said.

The head of TennCare said families have nothing to worry about.

"I think we're more than prepared," said Darin Gordon, the Deputy Commissioner of the TennCare Bureau.

Both new companies insisted TennCare patients will be taken care of, but the NewsChannel 5 investigation found some serious gaps in their coverage.

Under Blue Cross Blue Shield, TennCare enrollees had more than 4,000 doctors to choose from. As of Friday night, Amerigroup had less than half that -- only 1,900 doctors. AmeriChoice had even fewer, with less than 1,700 doctors to serve all of middle Tennessee.

"None of the doctors in town are taking that," Rancourt said.

While every major hospital in the area accepts Blue Cross Blue Shield, only 30 hospitals in all of middle Tennessee have agreed to take AmeriChoice, while just 24 have agreed to accept Amerigroup.

Advocates for TennCare patients like Michele Johnson were especially alarmed that as of April 1, neither Vanderbilt nor Vanderbilt Children's Hospital will accept either of the plans.

"This is laughable and it means real devastation for Tennessee families," Michele Johnson with the Tennessee Justice Center said. "It's immoral and outrageous. It doesn't make sense."

In fact the only hospital in Nashville that will take TennCare patients will be Metro General.

Gordon said he expected more doctors and hospitals, including Vanderbilt, to sign on to the new plans before the changes take place.

Patient advocates aren't convinced the network will be ready in time, and neither are many TennCare families who said a change this big shouldn't be treated as if it were a game.

"I think the people that are making these decisions don't have any clue what it's like to parent kids with a lot of problems," Rancourt said.

What's making it even more frustrating for TennCare patients is that both plans' websites and provider manuals are outdated, which makes it difficult to find out which doctors are accepting the new plans.

TennCare randomly assigned enrollees to the two plans and will give them 45 days to switch.

Anyone with questions, should call the TennCare hotline at 1-866-311-4287.

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