Tennessee Health Insurance

You can choose from five health insurance companies in The Volunteer State to access affordable individual and family coverage.

Tennessee Health Insurance Overview

Fewer Tennessee residents are uninsured since the Affordable Care Act (or Obamacare) took effect in 2013. Approximately 883,000 lacked coverage in 2013 compared to about 670,000 as of 2018. This drop means roughly 213,000 more residents gained health insurance.¹

Among Tennessee’s 6.5 million residents, about 1 in 5 have coverage through programs for low-income earners. These are Medicaid and the Children’s Health Insurance Program (CHIP).² Those who have private health insurance under Obamacare make up roughly 3.1% of the population.³

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

You can enroll in Obamacare to access private health insurance for yourself or you and your family. If you’re self-employed and have no employees, you have the same options as individuals and families. People who enroll in Obamacare are generally under 65. Those who are 65 or older 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. 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, but cost the most per month and are rarely offered.

Enrolling in Tennessee Health Insurance

Tennessee residents use the federal Marketplace at Heathcare.gov to enroll in Obamacare plans. More than 200,000 residents signed up during the 2020 open enrollment period (OEP),⁴ which was extended to December 18, 2019.⁵ The OEP usually runs from November 1 to December 15 each year. Outside of the OEP, you can only get Obamacare if you have a qualifying life event.

Who Offers Health Insurance in Tennessee?

Five Tennessee health insurance companies offer Obamacare plans for 2020. All provide bronze, silver, and gold plans. 

1. Blue Cross Blue Shield: Offers plans statewide
2. Bright Health: Serves Knoxville, Nashville, and Memphis
3. Ambetter: Serves Knoxville, Nashville, Memphis, and Chattanooga 
4. Cigna: Serves Knoxville, Nashville, Memphis, Chattanooga, and Tri-Cities
5. Oscar: Serves Nashville and Memphis 

How Much Does Tennessee Health Insurance Cost?

Tennessee health insurance premiums have declined over the past two years. Below are the average lowest premiums for plans sold in the Marketplace from 2018 to 2020.

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.⁶ 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 determined when you apply for coverage through Healthcare.gov. The average subsidy received in 2019 among Tennessee Marketplace enrollees was $609 per month.⁷

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

A 25-year-old in Nashville, Tenn., earning $28,000 a year, could get a silver plan for $172 per month with subsidies or $384 without them —a savings of $212.

A family of four in Memphis, Tenn., making $45,000 a year, could get a silver plan for $198 per month with subsidies. That policy would cost $1,322 per month without subsidies, which a savings of $1,123.

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 nearly 1.4 million residents⁸, which includes 1 in 7 adults under 65 and 3 in 5 children.

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.

Each group must meet certain income limits to qualify. For instance, eligible single parents can earn up to 95% of the federal poverty level (FPL), or $12,122 a year. Meanwhile, a single pregnant woman can make up to 200% of the FPL (or $25,520).

Tennessee is one of 14 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 TennCare. Nearly 53,000 people enrolled as of October 2019.¹⁰

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 in 2020.¹¹

Tennessee Medicare For Seniors and Adults Under 65 With Disabilities 

Medicare is a federal government program generally for seniors. About 81% of Tennessee residents qualify once they turn 65. Others qualify as younger adults due to disabilities.¹²

More than 1.3 million Tennessee residents have Medicare. About 3 out of 5 get benefits through Original Medicare from the government, which includes Part A hospital and Part B medical insurance. Approximately 1 in 4 beneficiaries get Part A and B through Medicare Advantage plans sold by private insurance companies.¹³ These plans often include Medicare Part D prescription drug coverage.

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. More than 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.