American Health Advantage of Tennessee

American Health Advantage of Tennessee Provider Directory

This directory provides a list of American Health Advantage of Tennessee HMO-SNP participating network providers and pharmacies (Network Providers). To get detailed information about your health care coverage, please see your Evidence of Coverage.

You will have to choose one of our Network Providers who are listed in this directory to be your Primary Care Provider (PCP). The term “PCP” will be used throughout this directory. Generally, you must get your health care services from your PCP. American Health Advantage of Tennessee HMO-SNP is an Institutional-eligible Health Maintenance Organization (HMO) Special Needs Plan (SNP). Since we are an HMO, it is necessary for you to select a PCP to utilize while on the plan. We do not guarantee that each provider is still accepting new members.

The “Network Providers” listed in this directory have agreed to provide you with your health care. You may go to any of our Network Providers listed in this directory. However, some services may require a referral. If you have been going to one Network Provider, you are not required to continue to go to that same Network Provider. In some cases, you may get covered services from non-network providers. If you get a bill from a non-network provider, please submit it to American Health Advantage of Tennessee HMO-SNP for processing. We can help determine how much you are responsible for paying, if any.

Emergency care can always be obtained in or out of the service area from the nearest available provider. When in the service area you must use Network Providers for urgent care. When out of the service area, urgent care may be obtained from the first available provider. In addition, when out of the service area, you can obtain dialysis treatment from any Medicare certified dialysis provider. You must use American Health Advantage of Tennessee Network Providers except in emergency or urgent care situations. If you obtain routine care from non-network providers neither Medicare nor American Health Advantage of Tennessee HMO-SNP will be responsible for the costs.

What is the service area for American Health Advantage of Tennessee?

The counties in our Tennessee service area are Anderson, Blount, Carroll, Carter, Chester, Davidson, Decatur, Dyer, Gibson, Giles, Hamilton, Hancock, Hawkins, Haywood, Henderson, Knox, Lewis, Madison, Marion, Maury, McNairy, Meigs, Montgomery, Obion, Rhea, Rutherford, Shelby, Sullivan, Washington and Wilson.

How do you find American Health Advantage of Tennessee Network Providers in your area?

This is a searchable online document and is updated at least monthly. You can enter areas in the fields to narrow down your search. For example, if you enter “Tennessee” in the state field, and “Wilson” in the county field, the search engine will generate a list of all providers, hospitals and pharmacies in Wilson County, Tennessee. You can also search by provider name, city, or specialty.

If you have questions about American Health Advantage of Tennessee HMO-SNP or require assistance in selecting a PCP, please call our Member Service Department at 1-844-321-1763, from 8 a.m. to 8 p.m. seven (7) days a week October 1 through March 31 and Monday to Friday April 1 through September 30. TTY/TDD users should call 711 or visit tn.amhealthplans.com.

American Health Advantage of Tennessee HMO-SNP, offered by American Health Plans, Inc., is a Health Plan with a Medicare contract, Enrollment in American Health Advantage of Tennessee HMO-SNP depends on contract renewal. This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.

The formulary, pharmacy network, or provider network may change at any time. You will receive notice when necessary.