Tennessee Health Insurance

Six health insurance companies offer individual and family coverage through the federal Marketplace, though not all companies offer coverage in all counties of the Volunteer State.¹ The Tennessee Farm Bureau also offers access to health insurance. Some of the organization’s plans have coverage elements similar to those found in the Affordable Care Act (or Obamacare), while its other plans do not.²

Tennessee Health Insurance Overview

More Tennessee residents have become insured since the health insurance exchanges began operating in October 2013 and allowed consumers to shop for health insurance plans that began as soon as January 1, 2014. About 10% of Tennessee’s residents lacked coverage in 2019 compared with about 14% in 2013.³ Based on a data analysis that the Kaiser Family Foundation released in October 2019, Medicaid covered about one out of seven adults (age 19-64) and two out of five children statewide.⁴

Buying Tennessee Health Insurance for Individuals, Families, and Self-Employed Professionals

You can enroll in Obamacare to access private health insurance for yourself or for you and your family, including if you’re self-employed and have no employees. People who enroll in Obamacare are generally under 65. Those who are 65 or older generally have access to coverage through Medicare.

Obamacare plans cannot deny you coverage based on your medical status, exclude coverage for preexisting conditions, or charge you more because of your health. Plans include essential health benefits, such as hospitalization, mental healthcare, and free preventive services. If you’re covering dependent children, the plan must offer them dental and vision benefits.

Obamacare plans come in different metal levels: bronze, silver, gold, and platinum. The federal Marketplace also offers catastrophic health plans—but they are available only to people under 30 years of age or people of any age who qualify via a hardship exemption or an affordability exemption, based on Marketplace or job-based insurance being unaffordable.

Each plan covers a certain percentage of your costs. For example, bronze ones pay for 60% of your eligible costs and usually have the cheapest monthly premiums. Platinum plans, on the other hand, cover 90% of covered expenses.

Enrolling in Tennessee Health Insurance

Tennessee residents use the federal Marketplace at Heathcare.gov to enroll in Obamacare plans. Nearly 200,500 residents signed up during the 2020 Open Enrollment Period (OEP),⁵ which was extended to December 18, 2019. For the past few years, the OEP ran from November 1 to December 15. Outside of the OEP, you can only get Obamacare if you have a qualifying life event.

Who Offers Health Insurance in Tennessee?

Six health insurance companies offer Obamacare plans for 2021 through the federal Marketplace. All provide bronze, silver, and gold plans. 

1. Blue Cross Blue Shield
2. Bright Health
3. Celtic/Ambetter Insurance
4. Cigna
5. Oscar Health
6. UnitedHealthcare

UnitedHealthcare also offers plans outside of Obamacare via the Tennessee Farm Bureau.

How Much Does Tennessee Obamacare Health Insurance Cost?

Tennessee health insurance premiums for Obamacare plan have declined over the past four years. Below are the average lowest premiums for plans sold in the Marketplace from 2019 to 2021, for a 40-year-old in each county and weighted by county plan selections.

Can I Get Financial Help to Lower My Tennessee Health Insurance Premium?

The federal government offers financial help for Obamacare plans. You qualify if you make between 100% and 400% of the federal poverty level,  or $12,760 to $51,040 per year, for one person,⁶ and if you do not already have access to a qualified plan through your employer or your spouse’s employer (income guidelines in Alaska and Hawaii differ). If eligible, you can get premium tax credits (called subsidies) on any metal plan you buy through the Marketplace.

The amount of assistance you get is based on your modified adjusted gross income and estimated when you apply for coverage through Healthcare.gov. The average subsidy received in 2020 among Tennessee Marketplace enrollees was $578 per month.⁷

Here are some examples of how much you could save with subsidies:

A 25-year-old non-smoker in Nashville with an income of $28,000 in 2021 could get a silver plan for about $65 per month with subsidies or about $351 without them—a savings of about $287.

A young family of four non-smokers in Memphis with an income of $45,000 in 2021 could get a silver plan for about $33 per month with subsidies. That policy would cost about $1,214 per month without subsidies, a savings of about $1,181.

Can I Get Medicaid in Tennessee if My Income is Low? 

Medicaid is a public health insurance program funded by the state and federal government. Only certain groups of people qualify for Medicaid in Tennessee, which is called TennCare. It covers 1.4 million of Tennessee’s approximately 6.8 million residents.⁸

TennCare is available to low-income children under 21, parents or caretakers of minor children, seniors 65 and older, pregnant women, and people with disabilities, among others.

Each group must meet certain income limits to qualify. For instance, a single pregnant woman with no children can make up to 195% of the FPL (or $25,116, based on 2021 federal poverty guidelines).

Tennessee is one of 12 states that has not expanded Medicaid. So childless adults under 65, regardless of income, don’t qualify. As a result, 113,000 residents (as of October 2019) who would otherwise qualify for Medicaid don’t have health coverage.⁹

Tennessee Health Insurance for Children and Pregnant Women

Tennessee’s Children’s Health Insurance Program (CHIP) is called CoverKids. It’s available to children under 19 and pregnant women who don’t qualify for or are not enrolled in TennCare. Nearly 128,685 people enrolled as of September 2020.¹⁰

Eligible children need to be U.S. citizens or qualified non-citizens. Pregnant women can apply regardless of immigration status. Households can qualify if they earn up to 250% of the FPL, or $31,900 for an individual, according to TennCare’s January 2021 eligibility reference guide.¹¹

Tennessee Medicare For Seniors and Adults Under 65 With Disabilities 

Medicare is a federal government program generally for seniors. About 82% of Tennessee residents qualify by age once they turn 65, according to 2019 data. The remaining 18% as younger adults due to disabilities.¹² Open enrollment for Medicare is Oct. 15 to Dec. 7 every year.

Close to 1.4 million Tennessee residents have Medicare. In 2020, about 803,000 of those people get benefits through Original Medicare from the government, which includes Part A hospital and Part B medical insurance. Approximately 573,000 beneficiaries got Part A and B through Medicare Advantage plans sold by private insurance companies.¹³ These plans often include Medicare Part D prescription drug coverage.¹⁴

Private insurers also offer individual Part D drug plans and Medicare Supplement plans, known as Medigap. Because Original Medicare doesn’t cover most prescription drugs, many residents add a Part D plan. About half a million Tennessee beneficiaries have a separate Part D drug plan.¹⁴

Medicare Supplement is also paired with Original Medicare. Tennessee insurers offer 10 standard plans, which cover some to all of your Part A and B out-of-pocket expenses. These include coinsurance, copayments, and deductibles.

Tennessee Short-Term Health Insurance 

Tennessee doesn’t have specific rules on how long you can have a short-term health plan. Instead, the state follows federal guidelines that allow you to get coverage for up to 364 days. You can renew it for up to 36 months.

When to Get Short-Term Health Insurance 

You may consider short-term health insurance if you need temporary coverage. For example: 

• You missed the enrollment period to get Obamacare
• You’re in-between jobs
• You’re waiting for coverage to start at a new job
• You aged off your parent’s health plan because you turned 26

Tennessee’s short-term plans offer basic benefits like emergency care and doctor visits. But they aren’t the same as Obamacare plans that provide comprehensive coverage. Short-term plans can also deny you coverage based on your health status or a preexisting condition.

Short-term health insurance plans typically have lower monthly premiums than Obamacare. But you may end up paying more for care because short-term policies are less comprehensive.

You should carefully assess your needs and budget to decide which type of health insurance is right for you.