TN Medicaid FAQs
Find answers to some of your frequently asked questions.
Your Health Plan
What is Wellpoint?
Wellpoint is a managed care company chosen by the state of Tennessee as one of the health plans that provides health care coverage to people who qualify for TennCare.
Do I have to choose a health plan when I get TennCare?
No, TennCare will assign a health plan for you. If you’re happy with your plan, you don’t have to do anything.
How can I change my health plan?
Call TennCare at 800-878-3192 to change your plan. If you’re a new TennCare member, you have 45 days to change your plan. After that, you can only change your plan during your “open enrollment” month. Your open enrollment month depends on where you live. You’ll find a complete list on the TennCare website.
Your Primary Care Provider (PCP)
Will I be able to use the same doctor when I join Wellpoint?
If your primary care provider (PCP) is in the Wellpoint plan, you can keep seeing them. If your PCP is not in our network, we can help you select a new one. You can also choose or change your PCP online by logging in to your secure account.
How do I change my PCP?
You can change your PCP at any time. To find a provider in your area, use our Find Care tool. Then, log in to your secure account to change your PCP. You can also call Wellpoint Member Services at 833-731-2153 (TRS 711) for help.
If you change your PCP, we’ll send you an updated ID card. But the change will start right away.
Do I need a referral for specialists?
In most cases, you’ll need a referral or OK from your PCP to visit a specialist. To find out if you need a specialist referral for care or services, please check your Member Handbook.
Your ID Card
When will I get my ID card?
You’ll get your Wellpoint ID card in the mail within 30 days from the date we’re notified of your enrollment in Wellpoint. You can also download a copy of your ID card from your account using the Member ID Card tool on our website, or access your card on the Sydney Health mobile app.
Can I still see a doctor if I don’t have my card yet?
If you go to the doctor’s office without your member ID card, you can tell them you’re with Wellpoint. The doctor’s office will call us to verify your information. You can also find your ID card on the Sydney Health mobile app. Do your best to bring your card with you to every appointment.
How can I get a new ID card or member handbook?
You can get a new member ID card or handbook by calling Wellpoint Member Services at 833-731-2153 (TRS 711). You can also view and download these items on our website:
Your Benefits
Whom do I contact with questions about my health care benefits?
If you’d like more information about your benefits, you can send us a secure message via chat, call Member Services at 833-731-2153 (TRS 711) or review your member handbook.
How do I change my CoverKids provider?
If you’d like to change your PCP, you can search our online directory.
