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TennCare, Pregnancy & Immigration

Last week, I learned about TennCare and immigration. A woman called American Exchange saying that  TennCare denied her coverage, but her husband and two kids received coverage through the state’s Medicaid entity. As I probed more and more, I found out that she recently emigrated from Asia to live with her husband—a United States citizen. Furthermore, she is pregnant with her third child and needs help with the labor and delivery costs. Naturally, she wanted to explore her options.

chinese woman pregnantShe was confused. All of the representatives told her that the woman was ineligible for Medicaid because she was an “ineligible immigrant.” However, when asked what constitutes an ineligible immigrant, the representatives could not elaborate.

The birth of a child is a HUGE life change, and financial concerns must be addressed . The woman wanted to make certain she was ineligible for TennCare coverage, and if this was the case, the woman wanted to learn about other financial aid options. In a 20 minute call, we both learned that immigrants face long wait times in becoming eligible for TennCare coverage. Other options exist in Tennessee helping with the labor and delivery costs of pregnancy.

TennCare’s Five Year Wait Times

Immigrants must first establish that they are “lawfully present” in the United States to brothersapply for TennCare. What this means is that someone living in the United States is a qualified non-citizen, or it means that someone is legally living in the United States due to humanitarian reasons or other special circumstances. After this, qualified non-citizens must wait five years before they can apply. Generally, these are the conditions that immigrants must meet in order to qualify for TennCare, but there are always exceptions to the rule.

The following groups may apply for TennCare with no delay:

  • Immigrants who served in the U.S. military and their families
  • Refugees and asylees
  • Some Afghani and Iraqi immigrants
  • Victims of Human Trafficking
  • Battered immigrants and children

The woman calling in was inquiring about getting health coverage for her impending labor and delivery. In researching the eligibility requirements for TennCare for Tennessee’s immigrant population, I was able to find alternative methods to aid with the costs of labor and delivery.

CoverKids–CHIP Insurance through TennCare

Look to CoverKids for help with labor and delivery costs! CoverKids is Tennessee’s administrator of the CHIP program, and the agency’s website states that pregnant women are eligible for coverage if they meet the following criteria. The pregnant women have to be residents of Tennessee, they are generally not eligible or enrolled in TennCare, and the women’s household income must be at or below 250% of the Federal Poverty Level. Our female caller definitely fits two of the criteria in order to receive aid from CoverKids, but I cannot say if she met the income requirements.

In any case, it would be in her best interest to call CoverKids at 1-866-620-8864 to inquirebaby about aid. Plenty of data exists stating the costs of labor and delivery across the United States. The website nerdwallet.com cites a study stating that the range of costs of an uncomplicated vaginal birth range from $3,296 to $37,227 in the State of California. In 2010, the average charge for a C-Section pregnancy with complications was $18,079 in Tennessee. The bottom line is that one can expect charges in the thousands of dollars for labor and delivery costs. CoverKids offers monetary aid to families in need, so ask!

Philip Strang is a Certified Agent/Broker with American Exchange. Contact him by telephone at 1-888-995-1674 or by email at p.strang@americanexchange.com.

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