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Tennessee CoverKids Plan - Lookup Tools

Find A Provider

We have contracted with many physicians, hospitals and specialists to help meet referral needs. With this tool, you can search our network of health care providers for specialists, hospitals, laboratories, X-ray centers and more.

If you are looking for a provider(s) in your area, a Member Service Representative can assist you in finding the provider(s) that you need.

Remember, your primary care doctor will make the referral to other health care providers for you. It is important that your primary care doctor notify us of referrals as necessary. Only by doing so can he or she take total responsibility for your care. Also, when visiting a specialist, always identify yourself as a member and present your CoverKids ID card.

Search for a Provider

Medicaid

Links and Resources

LabCorp Laboratories

Find A Drug

The Preferred Drug List (PDL) is a list of prescription drugs. It is used for the UnitedHealthcare Community Plan and UnitedHealthcare government-paid health plans.

View the Preferred Drug List (PDL). 

Behavioral health care (mental health, alcohol or drug abuse services)

You do not need to see your PCP before getting behavioral health services. But, you will need to get your care from someone who is in our network. If you’re getting care now, ask your provider if they take CoverKids.

A Community Mental Health Agency (CMHA) is one place you can go for mental, alcohol or drug abuse services. Most CMHAs take CoverKids.

You can get help for a mental health, alcohol or drug abuse emergency anytime even if you are away from home. And you don’t have to get an OK from anyone before you get emergency care.

If you have a mental health, alcohol or drug abuse emergency, go to the nearest mental health crisis walk in center or ER right away.

What if you don’t know where your closest mental health crisis walk in center is? Call Mental Health Crisis Services at: 855-CRISIS-1 (or 855-274-7471) right away. These calls are free. Or, you can call your provider. Your provider can help you get emergency care if you need it. CoverKids pays for mental health, alcohol or drug abuse emergencies even if the doctor or hospital isn’t in the Provider Network. 

Children under age 18 

If you are under 18 years-old or your child is under age 18 and has a behavioral health (mental health, alcohol or drug abuse) emergency:

  • Go to the nearest ER, or
  • Call 911, or

Call the statewide crisis line or the regional phone number in your area. Your call will be routed to a crisis specialist for help — 24/7 statewide crisis line: 855-274-7471 (855-CRISIS-1).

To reach an agency directly:

Youth Villages

866-791-9221 — North Middle TN

866-791-9222 — South Middle TN

866-791-9227 — Rural West TN

866-791-9226 — Memphis Region

866-791-9224 — East Region

866-791-9225 — South East Region

Mental Health Cooperative

615-726-0125 — Davidson County

Frontier Health

877-928-9062 — Upper East TN

Helen Ross McNabb

865-539-2409 — East TN

Youth Villages, Frontier Health, Helen Ross McNabb, and Mental Health Co-Operative offer statewide crisis services for children under age 18. If you go to the ER, someone from one of these agencies in your area may come help evaluate your child’s need for care. If you have problems reaching someone at the number listed for your area, call 1-866-600-4985,

TTY/TDD 711. We will help you. You can also call 911. These calls are free.

Always carry your CoverKids card with you. In case of an emergency, doctors will know that you have CoverKids.

Dental care for children (for teeth)

If you are a child under the age of 19, you also have a dental plan for your teeth called DentaQuest.

Their phone number is 1-888-291-3766. You can call DentaQuest to find a dentist. Or, if you have questions about caring for your child’s teeth, you can call them. It’s a free call.

Children’s teeth need special care. Children under age 19 should have a checkup and cleaning every six months. Children need to start seeing a dentist by age 3 or even earlier for some children.

CoverKids will pay for other dental care if it is medically necessary. Braces are covered only if they are medically necessary.

You do not need to see your PCP before you go to a dentist. But, you will need to go to a DentaQuest dentist.

This dental care is only for children under age 19. CoverKids does not pay for any routine dental care for pregnant women 19 and older

Vision Care

Members age 18 and younger receive: an exam and glaucoma testing) per calendar year, one set of lenses (including bi-focal, tri-focal, etc.) per calendar year; and one set of eyeglass frames every 2 calendar years.

For pregnant women age 19 and older, vision services are limited to medical evaluation and management of abnormal conditions and disorders of the eye. The first pair of cataract glasses or contact lens/lenses after cataract surgery are covered.


TN Disclaimer
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If you think you have been treated differently for any of these reasons: Race, Color, National Origin, Disability, Age, Sex, Religion or Any other Status/Group protected by Law, you can file a free online complaint by following the link: https://www.tn.gov/tenncare/members-applicants/civil-rights-compliance.html

Last Updated: 09.19.2024 at 11:35 PM CDT

Disclaimer information
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Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® (Medicare-Medicaid plan)

UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook. 

UnitedHealthcare Senior Care Options (HMO SNP) plan

UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 / TTY 711, or use your preferred relay service.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.