The state that flirted with bankruptcy under TennCare is now proving that limited benefits insurance can work. The cost $150 per month – split evenly among the individual, the employer and the state. Beneficiaries get up to 12 primary care visits, limited hospital stays, generic-only prescriptions and a maximum overall benefit of $25,000. The new program, called CoverTN, is challenging three conventional assumptions:
- That catastrophic insurance is socially more important than noncatastrophic coverage.
- That people can manage small medical expenses better than large ones.
- That limited benefit insurance has little social value.
"What we're finding is that even in health care, when people know that there are limits, they work to manage their costs."
- Of 15,000 enrollees, only four exceeded the $25,000 spending limit and only three (2/100ths of 1%!) exceeded the hospital inpatient limits.
- Although 4% exceeded their quarterly pharmacy limits, they can cut their personal, out-of-pocket costs in half by paying for drugs at CoverTN prices.
Full story is here.