CoverTN is a limited-benefit health plan designed to cover the medical services needed by most people.

Offered by BlueCross BlueShield of Tennessee, CoverTN allows individuals to choose from two different plans — Plan A and Plan B. Since CoverTN is designed to provide coverage for the most needed services, the plans have no deductible. Members pay low co-pays for medical services.

CoverTN has a 12-month pre-existing condition waiting period. No benefits will be paid for conditions that are present during the immediate six months prior to enrolling in CoverTN for the first 12 months of the policy. After the member has been enrolled in CoverTN for 12 months, CoverTN will begin covering these conditions.

CoverTN benefits include coverage for doctor visits, emergency treatment, inpatient and outpatient care, as well as pharmacy coverage. The chart below shows both plan options, including co-pays.

CoverTN members who become pregnant will remain enrolled in CoverTN but will receive maternity benefits and pregnancy-related services through CoverKids HealthyTNBabies or TennCare.

Benefit	Plan A	Plan B
Primary Care Doctor Visits *	$15 copay Up to 12 visits per year	$20 copay Up to 12 visits per year
Preventive Care	100% one free adult physical per year one free well woman visit per year (included in the 12 primary care visits per year)	100% one free adult physical per year one free well woman visit per year (included in the 12 primary care visits per year)
Preventive Mammogram	100% included with one well woman visit per year	100% included with one well woman visit per year
Specialist Visits	$15 copay; up to five visits per year	$20 copay; up to six visits per year
Inpatient	$100 copay; $10,000 annual maximum	$100 copay; $15,000 annual maximum
Emergency	two visits per year	two visits per year
Outpatient Surgery	$25 copay; two surgical visits per year	$25 copay; two surgical visits per year
Outpatient Diagnostic	$25 copay; three non-surgical visits per year	$25 copay; three non-surgical visits per year
Durable Medical Equipment (prosthetics, medical supplies)	100% $500 annual maximum	Not covered
Prescription Drugs	$10 copay generic Quarterly maximum $250	$8 copay generic Quarterly maximum $75
Insulin and Diabetic Test Strips	$10 brand copay; Does not count against the pharmacy maximum	$10 brand copay; Does not count against the pharmacy maximum
Diabetic Supplies (needles, syringes, lancets, alcohol swabs)	$5 copay	$5 copay

* Must see a primary care physician (PCP) - A PCP includes Internal Medicine, OB/GYN, Family Practice, General Practice and Nurse Practitioner.

Both plans have a maximum annual benefit limit of $25,000 per year. Individuals who reach the annual benefit maximum during the year are responsible for all expenses exceeding $25,000 until the next plan year begins. Members exceeding the $25,000 annual benefit maximum will continue to receive network discounts on their medical services and prescription drugs when they use network providers and pharmacies.