We want you to be treated with respect and in a dignified way and be satisfied with your health plan. You have many rights as a TennCareSM member. You also have responsibilities – what you must do in order to get your health care benefits.
Your Member Rights & Responsibilities can be found in Part 7 of your member handbook.
We obey federal and state civil rights laws. We do not treat people in a different way because of their race, color, birth place, language, age, disability, religion or sex. If you think you were treated differently for any of these reasons, you can file a complaint.
If you're having problems with your health care or TennCare, we want to hear from you. You can call or email us. But you also have the right to file an appeal.
When you appeal, you ask a judge to decide if TennCare made a mistake. It’s called a fair hearing. You have 30 days to appeal once you think there’s a problem.
There are two different kinds of appeals:
1) Administrative Appeals are for problems like getting or keeping TennCare, disagreeing with the kind of TennCare you have, or if you think your income or co-pay amounts are wrong. These appeals are handled by the Eligibility Appeals Unit at TennCare Connect. There are several ways to handle your appeal:
Eligibility Appeals Unit
P.O. Box 23650
Nashville, TN 37202-3650
2) Medical Appeals are for problems with your health care. This is handled by the TennCare Solutions Unit. There are several ways to handle your appeal:
P.O. Box 000593
Nashville, TN 37202-0593
If it’s an emergency – like a risk of serious health problems if you don’t get care – you can ask for a fast answer, an Expedited Appeal. Your health care provider can fill out and sign the appeal form.
More information about appeals can be found in Part 6 and Part 7 of your member handbook. Choose the handbook for your plan.