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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:

Small kid playing with bubbles at the park with his mother

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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:

Members 16 and older

Members 15 and younger

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

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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.

Children
Women
Men

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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
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

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Women

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

Ages 18–39

Screening/Test	When it's needed
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
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
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
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.

Ages 18–39

Screening/Test	When it's needed
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
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
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
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

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Your primary care provider

Your PCP has all your records and can point you toward other help if you need it. We may have already assigned you a PCP – check your ID card or the welcome text we sent you.

We want you to be happy with your PCP. So if you want to make a change at any time, we’re here to help. Just call us or log into your online account.

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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?

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.