Russell (zimzat) wrote,

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Busting a TennCare Myth, and (hopefully) getting reimbursed for it

I signed up for TennCare at the end of February. When I did so I asked my case worker about vision and dental coverage, and was told that since I'm over 18 I wouldn't be covered. Ok, fine, if I end up in the hospital I'll at least be covered for that.

Well, fast forward to June and I decided it was time to get new glasses. My old ones were over three years old and getting a little outdated. Since I had just gotten my initial check I went ahead and paid for an exam and new glasses out of pocket.

Fast forward again to today. I got a courtesy call from TennCare asking if I would like them to schedule a physical for me. During the conversation the lady mentioned I also have vision and dental coverage through TennCare. Wait, hold up a second, what? Yes, that's right, vision and dental. I then asked her if "vision" entailed regular eye exams and glasses, and she said I would have to call my specific insurance provider and gave me the number for them. I called them and they said it does cover regular eye exams and glasses, but they don't do vision themselves as TennCare covers that directly. I asked about reimbursement specifically and they said I would have to talk to TennCare about that. I then called the "TennCare Solutions" (appeals) number and talked to the lady about that. She then walked me through filing an appeal for reimbursement and said I would need to fax in a copy of the receipts.

And that's where I'm at right now. Our fax machine doesn't send correctly anymore so I'm scanning the receipts and going to try sending it through one of those online fax senders. I'll test it first by sending it to our number to see what it looks like. If it looks right then I'll send it on to the TennCare fax number I was given.
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