YOUR HEALTH

Everything to keep you and your family healthy. From head to toe.

We've pulled together a lot of useful information right here. All to make it easier for you to stay on top of your health.

Quick links:

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Mother and daughter having fun in the park Mother and daughter having fun in the park
HEALTH HISTORY AND NEEDS SURVEY

Tell us about your health history and needs

To help get you the right care, we need to know more about your health history and what’s important to you. We require this info once a year from all our members.
You can get us that info by:

  • Calling us at 1-888-416-30251-888-416-3025.
  • Or you can download, print and mail your health history and needs survey:

Are you a CoverKids member? Here’s your survey.

Well-care visits, screenings and immunizations

You can stay healthy by going to scheduled well-care checkups. Preventive care can catch potential issues early on. Plus, they’re covered. You don’t have to pay for them.

Select your age range and gender to see which well-care checkups and screenings you may need to schedule for yourself or your child.

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Children

Babies and Toddlers

BlueCare and TennCareSelect plans include TennCare Kids, a program that provides free checkups through age 21. CoverKids members receive free well-baby visits through age 18. The American Academy of Pediatrics recommends 12 well-care checkups from birth through age 2 ½.

Age Checkups needed
Birth–1 Before your baby leaves the hospital, your baby’s first week at home, every 1 to 3 months after that
1–2 12 months, 15 months, 18 months
2–3 24 months, 30 months

Here’s what’s included in a well-care visit:

  • Health history
  • Complete unclothed physical exam
  • Lab tests, as needed
  • Vaccinations, as needed (for the latest guidance from experts visit here)
  • Vision and hearing screenings
  • Developmental and behavioral screenings (as needed)
  • Advice on how to keep your child healthy

Sometimes providers or teachers notice a change in your child’s health or behavior. They can refer your child for a screening or checkup, even if it’s not time for an annual well-child exam. You may need to travel away from your local area to get the care your child needs. You may need help getting there, paying for meals, a place to stay or even someone to go with your child. If you have any questions, just give us a call.

Children and Teens

BlueCare and TennCareSelect plans include TennCare Kids, a program that provides free checkups through age 21. CoverKids members receive free well-child visits through age 18.The American Academy of Pediatrics recommends yearly well-care checkups from ages 3 through 20.

Here’s what’s included in a well-care visit:

  • Health history
  • Complete unclothed physical exam
  • Lab tests, as needed
  • Vaccinations, as needed (for the latest guidance from experts visit here)
  • Vision and hearing screenings
  • Developmental and behavioral screenings (as needed)
  • Advice on how to keep your child healthy

Sometimes providers or teachers notice a change in your child’s health or behavior. They can refer your child for a screening or checkup, even if it’s not time for an annual well-child exam. You may need to travel away from your local area to get the care your child needs. You may need help getting there, paying for meals, a place to stay or even someone to go with your child. If you have any questions, just give us a call.

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Women

Select your age range to see which screenings you may need to schedule.Information icon

Ages 18–39

Screening/Test When it's needed
Blood pressure test Every 2 years if your blood pressure is less than 120/80.
Every year if it's between 120/80 and 139/89.
More often if it measures 140/90 or higher.
Your provider will discuss a schedule with you.
Breast cancer screening
(Mammogram)
1 time between ages 35-40 to get a "baseline”— an image they'll use for comparison at your next mammogram. Discuss the best timing with your provider, especially if you have a family history of breast cancer.
Cervical cancer screening
(Pap test)
Every 3 years if you're 21 and up and have a cervix.

Every 5 years you can get a Pap test and an HPV test together if you have a cervix.
Chlamydia test Sexually active women who are not more than 29 years of age and older women with risk factors should get a test every year. Talk with your provider about whether you’re at risk.
Cholesterol test Regularly starting at age 20 if you are at increased risk of heart disease. Talk with your provider about whether you're at risk and how often you need the test.
Diabetes screening Regularly if you're overweight and at increased risk of heart disease. The test will include a screening of blood sugar levels to determine diabetes.
Obesity screening Every year
Ages 40–49

Screening/Test When it's needed
Blood pressure test Every 2 years if your blood pressure is less than 120/80.
Every year if it's between 120/80 and 139/89.
More often if it measures 140/90 or higher.
Your provider will discuss a schedule with you.
Breast cancer screening
(Mammogram)
Every 1 to 2 years at age 40 and over. Discuss this with your provider, especially if you have a family history of breast cancer.
Cervical cancer screening
(Pap test)
Every 5 years, you can get a Pap test and an HPV test together if you have a cervix.
Chlamydia test Women with risk factors should get a test every year. Talk with your provider about whether you’re at risk.
Cholesterol test Regularly if you are at increased risk of heart disease. Talk with your provider about whether you're at risk and how often you should be tested.
Diabetes screening Regularly if you're overweight and at increased risk of heart disease. The test will include a screening of blood sugar levels to determine diabetes.
Obesity screening Every year
Ages 50–64

Screening/Test When it's needed
Blood pressure test Every 2 years if your blood pressure is less than 120/80.
Every year if it's between 120/80 and 139/89.
More often if it measures 140/90 or higher.
Your provider will discuss a schedule with you.
Bone mineral density test Testing is encouraged if you are at risk of osteoporosis. Talk to your provider to see if you are at risk.
Breast cancer screening
(Mammogram)
Annually
Cervical cancer screening
(Pap test)
Every 5 years, you can get a Pap test and an HPV test together if you have a cervix.
Chlamydia test Women with risk factors should get a test every year. Talk with your provider about whether you’re at risk.
Cholesterol test Regularly if you are at increased risk of heart disease. Talk with your provider about whether you're at risk and how often you should be tested.
Colorectal screening Needed regularly. Several types of tests are offered. Talk to your provider about what's right for you and how often you need it.
Diabetes screening Needed if you're overweight and at increased risk of heart disease. The test will include a screening of blood sugar levels to determine diabetes.
Obesity screening Every year
Ages 65 and Up

Screening/Test When it's needed
Blood pressure test Every 2 years if your blood pressure is less than 120/80.
Every year if it's between 120/80 and 139/89.
More often if it measures 140/90 or higher.
Your provider will discuss a schedule with you.
Bone mineral density test 1 time at age 65 and up. Talk to your provider about repeat testing.
Breast cancer screening
(Mammogram)
Annually
Cervical cancer screening
(Pap test)
Ask your provider if you need a Pap test.
Chlamydia test Women with risk factors should get a test every year. Talk with your provider about whether you’re at risk.
Cholesterol test Regularly if you're at increased risk for heart disease. Talk with your provider about whether you're at risk and how often you should be tested.
Colorectal screening Needed regularly. Several types of tests are offered. Talk to your provider about what's right for you and how often you need it.
Diabetes screening Needed if you are overweight and at increased risk of heart disease. The test includes a screening of blood sugar levels to determine diabetes.
Obesity screening Every year
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Men

Select your age range to see which screenings you may need to schedule.Information icon

Ages 18–39

Screening/Test When it's needed
Blood pressure test Every 3 to 5 years if you have no risk factors. Risks may include being African-American, having high readings in the past and/or being overweight. Talk to your provider about what's right for you.
Cholesterol test Regularly at age 20 to 35 if you are at increased risk of heart disease. Talk with your provider about whether you’re at risk. Regularly as your provider advises, starting at age 35.
Diabetes screening Regularly if you're overweight and at increased risk of heart disease. The test will include a screening of blood sugar levels to determine diabetes.
Obesity screening Every year
Ages 40–49

Screening/Test When it's needed
Blood pressure test Every year
Cholesterol test Regular testing as your provider advises
Diabetes screening Regularly if you're overweight and at increased risk of heart disease. The test will include a screening of blood sugar levels to determine diabetes.
Obesity screening Every year
Ages 50–64

Screening/Test When it's needed
Blood pressure test Every year
Cholesterol test Regular testing as your provider advises
Colorectal cancer screening Needed regularly. Several types of tests are offered. Talk to your provider about what's right for you and how often you need it.
Diabetes screening Regularly if you're overweight and at increased risk of heart disease. The test will include a screening of blood sugar levels to determine diabetes.
Obesity screening Every year
Ages 65 and Up

Screening/Test When it's needed
Abdominal aortic
aneurysm screening
1 time if you are age 65 to 75 and have ever smoked
Blood pressure test Every year
Cholesterol test Regular testing as your provider advises
Colorectal cancer screening Needed regularly. Several types of tests are offered. Talk to your provider about what's right for you and how often you need it.
Diabetes screening Regularly if you're overweight and at increased risk of heart disease. The test will include a screening of blood sugar levels to determine diabetes.
Obesity screening Every year
Mom holding newborn baby at home Mom holding newborn baby at home

Services that require an OK

Your benefits cover the most common types of care. Other health care services may require a referral from your PCP and an OK from us. An OK is called a prior authorization. And your provider has to request it. Most providers know what services need an OK from us and call before providing care. But you can ask them just to be sure.

You’ll get approval notices in your online account. Just log in to check. But we’ll send you a letter if your request is denied.

And if you have any questions, you can contact us us.

What’s a referral?

Think of a referral as an official request for health care services. For example, you may need to see a specialist who treats a certain disease or part of the body. Your PCP may make that request. You can check here to make sure your specialist is in network.

Do all health care services require a referral?

No referral is needed to:

  • See a women’s health provider for well-woman checkups
  • Get treatment for mental health or substance use disorders, but they do sometimes require a prior authorization.

What health care services need an OK?Information icon

  • Inpatient hospital admissions and services
  • Outpatient hospital services, tests and procedures
  • Services from a health care provider not in our network
  • Mental health and substance use disorder treatment
  • Bariatric surgeries for weight loss
  • Chiropractic services for children (available only for members under 21)
  • Durable Medical Equipment (purchase or rental of more than $500)
  • Hospice Care, inpatient and outpatient
  • Imaging services including MRIs, PET Scans and Nuclear Cardiology
  • Orthotics (purchase amount/allowed amount of more than $200)
  • Outpatient Therapy (Physical, Occupational & Speech)
  • Plastic Surgery
  • Pregnancy care
  • Prosthetics (purchase amount/allowed amount of more than $200)
  • Skilled Nursing Facility
  • Transplants and related services
  • Wheelchairs (any cost or rental fee)

What about medicine?

Some pharmacy medicine also needs an OK. These may include certain shots or medicine given by IV. Your provider will have to get an OK from the TennCare Pharmacy Program before prescribing them. Ask your provider to help you make sure all your medicine is covered by your plan.

Does behavioral health treatment require an OK?

Some mental health and substance use disorder treatments may also need an OK. Ask the provider to get an OK from us before you get this kind of treatment.

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Need to switch your PCP or see a specialist?

Use our Find Care tool to make sure they are in your network and accept your insurance plan.

UNDERSTANDING AND MANAGING YOUR HEALTH
Find health information and check for symptoms

We provide extra resources to help you manage your health. Like information on health topics and conditions. Plus an interactive symptom checker.