See your Tennessee health insurance coverage options.

To qualify for health coverage through the Tennessee Marketplace, you must:⁶

• Live in Tennessee
• Be lawfully present in the United States
• Not be incarcerated
• Not be enrolled in Medicare

Eligibility for financial assistance (premium subsidies and cost-sharing reductions) depends on your income. In addition, to qualify for financial assistance with your Marketplace plan you must:

• Not have access to affordable employer-sponsored health insurance. If your employer offers coverage but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• Not be eligible for Medicaid or CHIP.
• Not be eligible for premium-free Medicare Part A.⁷

In Tennessee, the open enrollment period for individual/family health coverage runs from November 1 to January 15.⁸ 

If you need your coverage to start on January 1, you must apply by December 15. If you apply between December 16 and January 15, your coverage will begin on February 1.⁹ 

Outside of open enrollment, a qualifying life event is necessary to enroll or make changes to your coverage. If you have questions about open enrollment, you can learn more in our comprehensive guide to open enrollment. We also have a comprehensive guide to special enrollment periods.

To enroll in an ACA Marketplace plan in Tennessee, you can: 

• Visit HealthCare.gov to access Tennessee’s health insurance marketplace. Here you will find an online platform to shop, compare, and choose the best health plans. 

• Purchase individual and family health coverage with the help of an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity.¹⁰

You can also call HealthCare.gov’s contact center by dialing 1-800-318-2596 (TTY: 1-855-889-4325). The call center is available 24 hours a day, seven days a week, but it’s closed on holidays.

Tennessee uses the federally run exchange for individual market plans, so residents who buy their own health insurance enroll through HealthCare.gov.

For residents who purchased health plans through the Tennessee Marketplace, about nine out of ten eligible enrollees saved money on premium payments in 2023, which amounted to an average savings of $572/month and reduced the average enrollee’s premium to about $72/month.¹¹

The Affordable Care Act provides income-based advance premium tax credits (subsidies) that offset your premium payments to help keep your expenses down. People with household incomes of no more than 250% of the federal poverty level also qualify for cost-sharing reductions (CSR) that will result in lower deductibles and out-of-pocket expenses for Silver plans (these cost-sharing reductions are not available on plans at other metal levels). Between the premium subsidies and cost-sharing reductions, you may find that an ACA health insurance plan provides the best value.

Source: CMS.gov¹¹

Tennessee has a coverage gap because the state has refused to expand Medicaid under the Affordable Care Act. Childless adults without disabilities are ineligible for Tennessee Medicaid regardless of how low their income is. Because the ACA’s premium tax credits (subsidies) aren’t available to applicants with income below the poverty level (because the law called for them to have expanded Medicaid instead), these applicants fall into what’s come to be known as a coverage gap. They are ineligible for Medicaid and also ineligible for premium tax credits to make private coverage more affordable.

There are an estimated 124,000 Tennessee residents in the coverage gap.¹²

For 2024 coverage, six insurers are continuing to offer health plans through the exchange/Marketplace in Tennessee:¹³

All areas of Tennessee have at least three participating exchange-based health insurers offering plans for 2024.¹⁴

For 2024, the following average rate changes were approved for Tennessee’s individual/family insurers (before subsidies are applied):¹³ 

Source: HealthCare.gov¹³

These rate changes represent an average increase of about 4.8% for 2024, according to ACASignups.net.¹⁵ This is before any subsidies are applied, and the majority of Tennessee’s Marketplace enrollees do receive subsidies, as described above. 

For perspective, here’s an overview of how full-price (unsubsidized) average premiums have changed in Tennessee over the years:

• 2015: Average increase of 9%.¹⁶
• 2016: Average increase of 28.2%.¹⁷
• 2017: Average increase of 56%.¹⁸
• 2018: Average increase of 28.5%.¹⁹
• 2019: Average decrease of 12.4%.²⁰
• 2020: Average decrease of 1.1%.²¹
• 2021: Average increase of 8.2%²²
• 2022: Average increase of 4.4%.²³
• 2023: Average increase of 8.5%.²⁴

A record-high of more than 340,000 people enrolled in private health coverage through the Tennessee exchange during the open enrollment period for 2023 coverage.²⁵ And that came on the heels of a previous record high in 2022.²⁶

The surge in enrollment during these years was due in part to the American Rescue Plan (ARP) making ACA’s premium subsidies more substantial. Under the ARP’s subsidy enhancement rules – now extended through 2025 by the Inflation Reduction Act – subsidies are larger and more widely available than they used to be.²⁵

Source: 2014,²⁷ 2015,²⁸ 2016,²⁹ 2017,³⁰ 2018,³¹ 2019,³² 2020,³³ 2021,³⁴ 2022,³⁵ 2023¹¹

HealthCare.gov
800-318-2596

State Exchange Profile: Tennessee
The Henry J. Kaiser Family Foundation overview of Tennessee’s progress toward creating a state health insurance exchange.