Mental Health Safety Net
Frequently Asked Questions

Mental Health Safety Net Covered Services

QUESTION: Currently people with no insurance who are admitted to a Regional Mental Health Institute (RMHI) have been eligible to use TennCare transportation at no charge. Will this be the case for the disenrolled safety net population?

ANSWER: Persons who are admitted to a RMHI with no insurance are known as “state onlys.” Coverage for state onlys will be handled the same as it has always been until further notice. Transportation is not a covered service under the mental health safety net for persons disenrolled from TennCare.

Eligibility

QUESTION: Are persons with Severe and Persistent Mental Illness (SPMI) who have Medicare and are losing TennCare Standard eligible for safety net services?

ANSWER: Persons who are SPMI and have Medicare and are losing their TennCare Standard are eligible for safety net services assuming they meet all other eligibility requirements. Medicare will be the primary payor and then safety net services can be rendered in accordance to the contract for services not covered by Medicare.

QUESTION: Is an individual who has been identified as eligible for safety net services still eligible for safety net services even if they are now covered through their spouse’s group health insurance?

ANSWER: Private insurance will be the primary payor and then safety net services can be rendered in accordance to the contract for services not covered by private insurance.

QUESTION: Does Safety Net coverage preclude Medicare eligibility?

ANSWER: No, the safety net was designed to allow dual eligibles who are disenrolled to have medication coverage until Medicare Part D goes into effect January 1, 2006.

Registration

QUESTION: Do consumers who are registering for safety net services have to register with the CMHA in their county or can they choose one in another county?

ANSWER: They can sign up with any participating Community Mental Health Agency (CMHA) and be seen at any satellite of the CMHA. However, the consumer must stay with that CMHA unless they move out of their CMHA’s service area.

Reimbursement

QUESTION: What is the impact of revenue from Medicare or private insurance on the TDMHDD reimbursement of safety net services?

ANSWER: Medicare or private insurance will be the primary payor and then safety net services can be rendered in accordance to the contract for services not covered by Medicare or private insurance.