Medicare & Medicaid Changes
Effective June 1st 2027
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Tennessee Residents on a Medicare DSNP & Medicaid who are FBDE (QMB+ SLMB+ and other Full Benefits Dual Eligible) are affected by these changes, and will be receiving letters from their Medicaid and Medicare plans, as well as from TennCare. You will need to align your Medicare D-SNP provider with your Medicaid MCO insurance provider. Resident have from June 1st through October 31’st to change their TennCare MCO, and until January 1st of 2027 to align their coverage, or they will be disenrolled from their Medicare Plan
Please see Link to Government Website: https://www.tn.gov/tenncare/long-term-services-supports/dual-eligible-special-needs-plan--d-snp-.html
EXAMPLE: You cannot have a D-SNP Medicare Plan With Anthem Wellpoint and have your Medicaid through United Healthcare, you will need to change either your MCO or Medicare DSNP company or risk being disenrolled
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There are two ways to make this change, update your Medicare D-SNP plan to match your TennCare Medicaid plan OR update your TennCare Medicaid plan to match your Medicare D-SNP plan.
NOTE: If you are affected and do not make these changes by January 1st 2027 you will lose your Medicare D-SNP program.
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TennCare Special Enrollment Period: Because of the changes that will take place beginning January 1, 2027, TennCare will open another enrollment period, which will be from June 1, 2026, through October 31, 2026, to allow you more time to change your TennCare health plan to match your D-SNP.
To change your TennCare health planduring the special open enrollment period there are three (3) ways to request a change:
Call: You can call TennCare Medical Appeals for free at 1-800-878-3192.
Fax: You can fax your health plan change request to 1-888-345-5575.
Mail: You can mail your health plan change request to:
TennCare Member Medical Appeals
P.O. Box 000593
Nashville, TN 37202-0593
To Fax or Mail in your TennCare health plan change request, complete this TennCare Medical Appeal Form on TennCare’s website.
EXAMPLE: if you have a Medicare D-SNP with Blue Cross and your MCO is with Anthem, if you would like to keep your Blue Cross SNP Medicare plan you must contact Tenncare and request a change in your Medicare Provider to match your Medicare D-SNP
NOTE- Just changing your MCO will not fully integrate your Medicare D-SNP and Medicaid MCO. Aligning your plans with the same Insurance Carrier will now allow you to move into a FIDE (Fully Integrated D-SNP) program where you will receive 1 card for both your Medicare and TennCare, All Full Benefits Medicare and Medicaid (TennCare) recipients must be in a fully integrated program by 2030.
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If you have a Medicare D-SNP that is not aligned with your TennCare MCO, you will be automatically disenrolled from your Medicare D-SNP Program January 1st of 2027. In order to avoid this you must align your D-SNP with your current TennCare MCO; managed by either United Healthcare, Blue Care, or Anthem Wellpoint. In order to change your D-SNP you can call or message us locally and we will be happy to assist. Or you can call 1800-MEDICARE and they will be happy to assist you as well.
EXAMPLE: If you have United Healthcare as your TennCare MCO but Humana for your Medicare DSNP, you would either need to call a local agent that works with United Health, 1800-MEDICARE or call into the company directly, and they will assist you in moving into A Fully Integrated D-SNP with United Healthcare
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Here at Helms Dougherty Insurance Agency we can assist you in aligning your MCO and Medicare DSNP with either: United Healthcare, Anthem Wellpoint, or Blue Cross Blue Care, to ensure you do not lose your Medicare D-SNP Coverage. Once aligned, you may qualify for more benefits then your current un-aligned D-SNP through a Fully Integrated D-SNP offered to you, once your Medicare plan and Tenncare plans are aligned. You can also call 1-800 MEDICARE and they can assist you directly as well.
NOTE: If you need help or have questions navigating these changes You can Call or Text questions to 423-307-7712,
You can also Message us on Facebook or right here on our Website
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Link to the new Medicare & Medicaid Law Changes Effective June 1st 2026
Your D-SNP options in Tennessee
Access to DSNP comparison between Medicare Health Plans