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The Challenges of TennCare Coverage for Pregnant Women: Sierra's Story

Updated: Oct 16, 2023

Sierra Clark lives in Millington, Tennessee with her husband and five children. She is a stay-at-home mother and her husband works. Sierra and her husband have been on her husband’s employer insurance since he switched jobs in September of 2019 and her five children are on TennCare. Mrs. Clark has become eligible for TennCare during each of her pregnancies in the pregnant woman category. Her husband used to be self-employed and she worked, so Mrs. Clark was eligible for TennCare in the pregnancy category during her pregnancies, but was over income for the parent/caretaker relative category. During her first pregnancy, her TennCare terminated about two months after the end of her 60-day eligibility period after giving birth. After her second and third pregnancies, her TennCare was not automatically terminated and she had to call TennCare to prompt them to terminate her. After she gave birth to her fourth child in 2018, she noticed that her TennCare had again not been automatically terminated. She called TennCare to let them know that her TennCare had not been terminated and became very stressed out, worrying that she would get in trouble for having TennCare when she was not eligible. She knew that based on the family’s self-employment income that they had reported to TennCare, she would not be financially eligible for TennCare in the parent/caretaker relative category.

In late 2018/early 2019, while her TennCare from her previous pregnancy had still not been terminated, Sierra became pregnant. This was around the time that TennCare was switching over to its new TEDS system. She sent TennCare her proof of pregnancy to apply for TennCare as a pregnant woman. In the summer of 2019, shortly before she gave birth, Sierra received a notice from TennCare that she had been denied TennCare coverage. TennCare later notified her that she had been approved and offered her a type of extended TennCare that she declined, because she didn’t want to have the problem of having TennCare when she knew she wasn’t eligible again.

This whole process caused Sierra a lot of anxiety which contributed to the anxiety and depression she experienced after giving birth. She firmly believes that post-partum coverage for mothers on TennCare needs to extend further than 60 days after giving birth. A lot of new mothers struggle with mental health after giving birth and Sierra says she would have liked the option to visit a provider and seek help in the months after giving birth, since the two months that are covered go by quickly and problems can arise after that time frame. She has also had C-sections and expressed worry for how she would seek care if an infection or complication occurred after her TennCare coverage ended. Overall, Sierra shared that the new TennCare system works much better than the old system, but highlights the need for TennCare post-partum coverage to extend more than 60 days for pregnant women eligible for coverage.

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