TJC Story Blog
Lou Ellen (LuLu) Hearn is a 67-year-old woman living in Jackson, Tennessee. She describes her experience working with TennCare as “a nightmare”. She had Medicaid from 2001-2019 along with having Medicare. She was on Social Security Disability and her Medicare premiums were taken out of her Social Security checks. In 2019, she went in for a routine mammogram and was told that she no longer had TennCare. It took her months to figure out why she had lost her TennCare and she was sent around everywhere without getting a clear explanation. She has a three-ring binder with all her notes from the people she talked to. She finally found out that somehow her address in TennCare’s system had been changed from Elmwood Street to Elm Moore. She lost her TennCare because she hadn’t filled out renewal paperwork that TennCare said they sent to her, but she never got the paperwork because TennCare sent it to the wrong address. Ms. Hearn has lived at the same address since 1995 and did not do anything to cause TennCare to incorrectly change her address.
Ms. Hearn kept going to SHIP and other agencies for help and no one would help her. She believes she was transferred from SSDI to normal Social Security retirement benefits which caused her to lose her TennCare. She tried to get a Medicare supplemental policy and around that time was diagnosed with kidney cancer, which has left her ineligible for a supplemental policy for three years. She has a lot of medical bills totaling thousands of dollars from labs and doctors’ appointments. She also has many medications not covered by Medicare that she has had to get special plans for to make sure she is still able to get her necessary medications. She takes one medication for Hepatitis B that costs $1,200 a month. If she does not take this expensive medication, then she is contagious with the virus.
At one point in the summer of 2020, Ms. Hearn was out mowing her lawn and got a call from a judge saying she was having a TennCare hearing. The judge said she should have received a packet and Ms. Hearn said she had not received anything. An attorney on the call finally said that her packet was still on their desk. Ms. Hearn was finally able to get in touch with a high-level person at TennCare who seemed to understand what was going on and provide some answers. He advised that she needed to get a PAE to be evaluated for the CHOICES program. She set up a PAE and when the evaluator arrived, they told her that she failed her PAE because she could lift a spoon to her mouth. She has continued to receive the run-around by those at TennCare which is extremely frustrating. Ms. Hearn is sharing her experiences in the hopes that joining in TJCs advocacy with help make the TennCare process easier for others.