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TennCare Medical Appeal
Use this form ONLY to appeal. DO NOT use it to apply for TennCare.
¿Tiene problemas para obtener atención médica en TennCare?
En Español
Important APPEAL information.
Step 1.
Print this form (pdf) .
Step 2.
Fill it out.
Step 3.
Make a copy of the completed
form to keep for your records.
Step 4.
Mail to
TennCare Solutions
PO Box 593, Nashville, TN 37202-0593
OR FAX (toll-free) 1-888-345-5575
Kurdish, Arabic, Somali, Bosnian or Vietnamese (pdf)
QUESTIONS: Telephone (toll-free) 1-800-878-3192
TTY/TDD: 1-800-772-7647 Espanol: 1-800-254-7568
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