Experts At Abusing The TennCare System

Sunday, July 17, 2005

While I realize that there are a lot of people who could not do without TennCare benefits, I also know first hand of numerous "needy" people who have become experts at abusing the system. I have worked in several physicians' offices and seen my share of patients who have TennCare benefits. I have seen the elderly patient who would not have prescription coverage without TennCare, I have seen the child with so many medical issues that TennCare is the only way the parents have to try and help their child.

On the other hand, I have seen the patient who comes in for an initial visit to a specialist, then has disability paperwork ready for the physician to sign after only one evaluation. I have worked with co-workers who were paid under the table in order not to lose their precious TennCare (while the physican did not offer any kind of insurance coverage to those of us who actually were being a responsible taxpayer.)

I have also seen several patients who have private insurance coverage through their spouse, who in turn sign up under TennCare using their maiden name as to avoid a 10 or 20 dollar copay and to receive free prescriptions. These patients have actually stated to TennCare that they have no other coverage and will actually ask us at the physician's office to not file their primary so that TennCare will not terminate them.

Having just left a physician's office that offers no insurance benefits whatsoever, I would be more than happy with a $20 co-pay instead of the $90-$150 up front fee I am forced to pay when going for an office visit.

We wonder why the system is in such dire straits. Maybe they need to review who really needs TennCare and who is just abusing the system with "my" and "your" hard-earned tax dollars.

Theresa C.

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