State Readies for Fifth Round of Standard Spend Down

The TennCare Standard Spend Down program will again offer open enrollment opportunities to new applicants on Thursday, Sept. 13, 2012 beginning at 6 p.m. CST.

Standard Spend Down is available through a waiver to the Medicaid program for a limited number of qualified low-income individuals, or those with high, unpaid medical bills who are aged, blind, disabled, or the caretaker relative of a Medicaid eligible child. Eligible individuals must have enough unpaid medical bills to meet the "spend down" threshold to qualify for coverage.

"We are pleased to once again open enrollment in the Standard Spend Down program to Tennesseans who need additional assistance," said Department of Human Services Commissioner Raquel Hatter. "This service certainly benefits people with high medical bills who are not already receiving TennCare benefits."

A special call-in phone line through DHS has been set up for interested applicants. The only way to request an application is by calling the toll-free number -- 1-866-358-3230 -- which will be open between 6:00 p.m. and 8:30 p.m. CST on Sept. 13. Operators will close the phone line once 2,500 applicants call in. In previous open enrollment periods, 2,500 calls had been taken within one hour. If 2,500 calls are not received on Sept. 13, the phone lines will be open from 6:00 p.m. to 8:30 p.m. on subsequent weekdays until 2,500 interested applicants call in.

Prospective applicants are encouraged to check eligibility qualifications before calling in. More information on the Standard Spend Down program and more detailed eligibility criteria are available here.

The toll-free number system is used to ensure equal access to Tennessee citizens interested in this program. DHS will send applications to all callers who are not already on TennCare and will review their eligibility for any open Medicaid categories and the newly opened Standard Spend Down category. Advanced notifications will be made to the public and other stakeholders prior to subsequent openings of the application request line.

Standard Spend Down Eligibility:
•In addition to being aged (65 or older), blind*, disabled,* or a caretaker relative,

•An individual must meet certain income restrictions, or be able to "spend down" qualifying unpaid medical bills to that limit. (*To be considered blind or disabled, an individual must meet standards set by the Social Security Administration.)

The following shows the income limits:
Household Size 1 (Monthly Income $241)
Household Size 2 ( Monthly Income $258)
Household Size 3 (Monthly Income $317)
Household Size 4 (Monthly Income $325)
Household Size 5 (Monthly Income $392)
Household Size 6 (Monthly Income $408)

Applicants also must not have resources that:
•Exceed $2,000 for a family of one and $3,000 for a family of two with an additional $100 added per additional individual in the family.

•A person's unpaid medical bill must have been accrued within the past 90 days. Medical bills paid by the applicant within the past 30 days may count towards meeting an applicant's spend down requirement.

Pregnant women and children still are eligible for the Medically Needy Spend Down program.

The ONLY way to request an application for the TennCare Standard Spend Down Program is through the toll free number 1-866-358-3230. Individuals interested in accessing the Standard Spend Down call-in line who are deaf/hard of hearing/speech impaired and using a TTY (text telephone) device should first call the Tennessee Relay Service at 1-800-848-0298. They will be prompted to enter the number they are trying to reach (the call-in line #) and a communications assistant will act as the go-between. Those wishing to apply for other TennCare categories should contact their local DHS county office, call the Family Assistance Service Center at 1-866-311-4287 during normal business hours, or visit www.tennessee.gov/humanserv/.

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