FACTS ABOUT COVERKIDS

• The program is open to children ages 18 years and under. There are no pre-existing condition exclusions for children with already-diagnosed special needs or medical conditions.
• Applicants to the CoverKids program will first be screened for TennCare eligibility or access to other state-sponsored insurance options.
• CoverKids has no monthly premium for families with household incomes up to 250% of the Federal Poverty Level.. Participants pay a co-pay for certain services; the co-pay amount depends on income.
• Access to other health insurance coverage does NOT affect eligibility (if a family has access to insurance through a parent's job but the coverage is not affordable, the child is eligible for CoverKids).
• Coverage is offered for 12 months. After that, families must re-verify their children's eligibility.
• Children must live in a household with income under 250% of the federal poverty level (example: for a family of four, this would be $51,625). Buy-in is available for children in households with higher income (the buy-in premium is $210 per month per child in 2007).
• Children must be U.S. citizens or qualified aliens and must be Tennessee residents.
• Children must have been without insurance for three months (this is waived for newborns up to four months of age and for children moving to CoverKids from TennCare or from another state's SCHIP program).
• Maternity care (medical treatment or physician visits related to the pregnancy or the health of the unborn child) is available for pregnant women who meet other eligibility criteria, from the date of application until 60 days following the baby's birth.
• CoverKids provides comprehensive health insurance with an emphasis on preventive health services and coverage for physician services, hospitals, prescriptions, mental health/substance abuse, dental, vision and more. CoverKids has an emphasis on services children need most, well-baby and well-child visits, and age-appropriate required immunizations. For mental health, CoverKids offers up to 52 visits per year on an outpatient basis and 30 days of inpatient treatment per year.