The General Assembly has appropriated $13 million in funds for premium assistance to make monthly premiums more affordable for low-income participants.
The AccessTN Board has determined that premium assistance:
| • |
Will be available for applicants up to 350% of federal poverty level, up to an annual household income of $75,000. |
| • |
Is limited to available funding; not all of those meeting eligibility criteria will necessarily qualify. |
| • |
Will range from 20% of premium to 60% of premium based on household income. |
| • |
Will only be available for Plan One, which has the lowest deductible and highest premiums. |
Rates below reflect 2009 FPL effective 3/1/09.
| Income Guidelines for Premium Assistance |
| Persons in Household |
Up to 200% FPL |
Up to 250% FPL |
Up to 350% FPL |
| 1 |
$21,660 |
$27,075 |
$37,905 |
| 2 |
$29,140 |
$36,425 |
$50,995 |
| 3 |
$36,620 |
$45,775 |
$64,085 |
| 4 |
$44,100 |
$55,125 |
up to $75,000 |
| 5 |
$51,580 |
$64,475 |
up to $75,000 |
| 6 |
$59,060 |
$73,825 |
up to $75,000 |
| 7 |
$66,540 |
up to $75,000 |
up to $75,000 |
| 8 |
$74,020 |
up to $75,000 |
up to $75,000 |
| State Premium Assistance Pays |
60% |
40% |
20% |
| Member Share of Premium |
40%
see table D below |
60%
see table C below |
80%
see table B below |
Important: You DO NOT have to figure your premium to apply for AccessTN!
We will figure it for you when your coverage is approved, and if you request premium assistance, your proof of income has been reviewed. |
B) 20% State Premium Assistance - Member Pays 80%
PLAN 1000*: $1,000 deductible |
| |
Target Weight or Below |
Above Target Weight |
| Age |
Non Tobacco User |
Tobacco User |
Non Tobacco User |
Tobacco User |
| <19 |
$328 |
$328 |
$328 |
$328 |
| 19-29 |
$328 |
$378 |
$365 |
$419 |
| 30-39 |
$382 |
$438 |
$424 |
$486 |
| 40-49 |
$463 |
$533 |
$514 |
$592 |
| 50-59 |
$550 |
$634 |
$612 |
$704 |
| 60-64 |
$650 |
$747 |
$722 |
$830 |
| 65+ |
$766 |
$882 |
$852 |
$980 |
C) 40% State Premium Assistance - Member Pays 60%
PLAN 1000*: $1,000 deductible |
| |
Target Weight or Below |
Above Target Weight |
| Age |
Non Tobacco User |
Tobacco User |
Non Tobacco User |
Tobacco User |
| <19 |
$246 |
$246 |
$246 |
$246 |
| 19-29 |
$246 |
$283 |
$274 |
$314 |
| 30-39 |
$286 |
$329 |
$318 |
$365 |
| 40-49 |
$347 |
$400 |
$386 |
$444 |
| 50-59 |
$413 |
$475 |
$459 |
$528 |
| 60-64 |
$487 |
$560 |
$541 |
$623 |
| 65+ |
$575 |
$661 |
$639 |
$735 |
D) 60% State Premium Assistance - Member Pays 40%
PLAN 1000*: $1,000 deductible |
| |
Target Weight or Below |
Above Target Weight |
| Age |
Non Tobacco User |
Tobacco User |
Non Tobacco User |
Tobacco User |
| <19 |
$164 |
$164 |
$164 |
$164 |
| 19-29 |
$164 |
$189 |
$182 |
$210 |
| 30-39 |
$191 |
$219 |
$212 |
$243 |
| 40-49 |
$232 |
$266 |
$257 |
$296 |
| 50-59 |
$275 |
$317 |
$306 |
$352 |
| 60-64 |
$325 |
$374 |
$361 |
$415 |
| 65+ |
$383 |
$441 |
$426 |
$490 |
*Premiums will be slightly higher for Portability eligibility enrolling directly from COBRA, TennCare or other qualifying coverage.
