Tennessee Plan Benefit Materials
This booklet gives you a summary of costs and coverage in your plan. Please select the document for your plan and county:
For HMO Members:
Plan Name | CMS # | County | Summary of Benefits |
---|---|---|---|
Ascension Complete Saint Thomas Reward (HMO) | H2853- 001 | Cannon, Cheatham, Davidson, Robertson, Rutherford, Smith, Sumner, Trousdale. Williamson and Wilson counties |
|
Ascension Complete Saint Thomas Secure (HMO) | H2853- 002 | Cannon, Cheatham, Davidson, Robertson, Rutherford, Smith, Sumner, Trousdale. Williamson and Wilson counties |
|
For PPO Members:
Plan Name
CMS #
County
Summary of Benefits
Ascension Complete Saint Thomas Access Plus (PPO)
H8121- 001
Cannon, Cheatham, Davidson, Robertson, Rutherford, Smith, Sumner, Trousdale, Williamson, Wilson
Ascension Complete Saint Thomas Access (PPO)
H8121- 002
Cannon, Cheatham, Davidson, Robertson, Rutherford, Smith, Sumner, Trousdale, Williamson, Wilson
This booklet gives you a complete list of services, limitations and exclusions for your plan coverage. Please select the document for your plan and county:
For HMO Members:
Plan Name | CMS # | County | Evidence of Coverage (EOC) |
---|---|---|---|
Ascension Complete Saint Thomas Reward (HMO) | H2853- 001 | Cannon, Cheatham, Davidson, Robertson, Rutherford, Smith, Sumner, Trousdale. Williamson and Wilson counties |
|
Ascension Complete Saint Thomas Secure (HMO) | H2853- 002 | Cannon, Cheatham, Davidson, Robertson, Rutherford, Smith, Sumner, Trousdale. Williamson and Wilson counties |
|
For PPO Members:
Plan Name
CMS #
County
Evidence of Coverage (EOC)
Ascension Complete Saint Thomas Access Plus (PPO)
H8121- 001
Cannon, Cheatham, Davidson, Robertson, Rutherford, Smith, Sumner, Trousdale, Williamson, Wilson
Ascension Complete Saint Thomas Access (PPO)
H8121- 002
Cannon, Cheatham, Davidson, Robertson, Rutherford, Smith, Sumner, Trousdale, Williamson, Wilson
If you were enrolled in Ascension Complete last year, this booklet will tell you about changes to your plan’s costs and benefits for the coming year. Please select the document for your plan and county:
For HMO Members:
Plan Name | CMS # | County | Annual Notice of Changes (ANOC) |
---|---|---|---|
Ascension Complete Saint Thomas Reward (HMO) | H2853- 001 | Cannon, Cheatham, Davidson, Robertson, Rutherford, Smith, Sumner, Trousdale. Williamson and Wilson counties | |
Ascension Complete Saint Thomas Secure (HMO) | H2853- 002 | Cannon, Cheatham, Davidson, Robertson, Rutherford, Smith, Sumner, Trousdale. Williamson and Wilson counties |
If you have questions please, contact Member Services.