WHAT IF MY TENNCARE APPLICATION IS DENIED?
TennCare Advocacy can help. Has your application been denied? Or do you have to pay co-pays and disagree with how much you have to pay? Or do we have your income or family size wrong?
Have you waited for a decision for more than 45 days (or more than 90 days if you applied for long-term care)? You can now ask for a “delay hearing”. To ask for a delay hearing, call us at 1-855-259-0701. OR download TennCare Eligibility Appeal PDF. If you click on the link, fill out the page and follow the instructions. That page tells you how to send it to us by mail or fax.
There are two ways to file a TennCare Eligibility appeal:
Appeal by phone by calling 1-855-259-0701.
OR, appeal in writing. You can download an appeal page PDF. Or, you can write your appeal on plain paper. If you write your appeal on plain paper, be sure you include:
•Your full name (first name, middle initial, last name)
•Your Social Security Number
•The names of anyone else in your household with the same problem
•Your daytime phone number and the best time to call
•The specific mistake you think we made
•Any proof that shows why you think we made that mistake
Mail your appeal to this address:
Tennessee Health Connection
P.O. Box 305240
Nashville, TN 37230-5240
Or fax it toll free to 1-855-315-0669.
Keep a copy of your appeal. Write down the date that you mailed or faxed it to us. If you fax it, keep the page that shows your fax went through.
How long do I have to file an appeal?
New Applicant: A new applicant has up to 40 days from the date of your denial letter to file an appeal.
Reverifying Member: If you're reverifying your TennCare and are told you don't qualify, you have up to 40 days from the date of your termination letter to file an appeal. If you appeal before your TennCare ends, you can keep TennCare during the appeal process
After you file an appeal, it can take up to 90 days for a decision to be made.