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Tennessee Health Insurance Consumer Guide
This guide was developed to assist you in choosing the right Tennessee health insurance plan for you and your family. The options found in Tennessee’s ACA Marketplace may be a good choice for many consumers, and we will guide you through the options below.
Tennessee uses the federally run health insurance exchange (Marketplace), HealthCare.gov, for residents to purchase its ACA Marketplace plans. The Tennessee Marketplace provides access to health insurance products from six private insurers, although plan availability varies from one area of the state to another.1
When you enroll in a plan through the Marketplace, you may find that you’re eligible for financial assistance that reduces the monthly cost of your coverage (premium subsidies), and possibly also your out-of-pocket expenses (cost-sharing reductions, or CSR). These are federal subsidy programs created by the Affordable Care Act, and eligibility depends on your income and circumstances.
Dental coverage in Tennessee
Looking to improve your smile? Dental insurance may be a smart addition to your health coverage. Our guide explores dental coverage options in Tennessee.
Tennessee’s Medicaid program
Tennessee has not expanded Medicaid eligibility as allowed under the Affordable Care Act, which means that there are an estimated 118,000 residents in the coverage gap in Tennessee.2 Tennessee's current total Medicaid enrollment has grown to more than 1.5 million people.3
Medicare coverage and enrollment in Tennessee
As of May 2023, there were 4,441,441 Tennesseeans enrolled in Medicare plans.4 Our guide will help you confidently understand Medicare Parts A, B, C and D plans – as well as Medicare supplement (Medigap) plans available in Tennessee.
Short-term coverage in Tennessee
As of 2023, there were at least eight insurers selling short-term health insurance plans in Tennessee.5
Frequently asked questions about health insurance in Tennessee
Who can buy Marketplace health insurance?
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
When can I enroll in an ACA-compliant plan in Tennessee?
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.
How do I enroll in a Tennessee Marketplace plan?
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.
How can I find affordable health insurance in Tennessee?
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.
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
How many insurers offer Marketplace coverage in Tennessee?
Are Marketplace health insurance premiums increasing in Tennessee?
For 2024, the following average rate changes were approved for Tennessee’s individual/family insurers (before subsidies are applied):13
Tennessee’s ACA Marketplace Plan 2024 Approved Rate Increases by Insurance Company
|Blue Cross Blue Shield of Tennessee||2.7%|
|US Health and Life||12.07%|
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
How many people are insured through Tennessee’s Marketplace?
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
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
- TDCI Offers Consumer Insurance Tips for 2024 ACA Open Enrollment. Tennessee Department of Commerce and Insurance. October 31, 2023.
- ”How Many Uninsured Are in the Coverage Gap and How Many Could be Eligible if All States Adopted the Medicaid Expansion?” KFF.org, March 31,2023
- “April 2023 Medicaid & CHIP Enrollment Data Highlights” Medicaid.gov, April 28, 2023
- “Medicare Monthly Enrollment” CMS.gov, May 2023.
- “Availability of short-term health insurance in Tennessee” healthinsurance.org, March 6, 2023
- ”A quick guide to the Health Insurance Marketplace” HealthCare.gov
- Medicare and the Marketplace, Master FAQ. Centers for Medicare and Medicaid Services. Accessed November 2023.
- “When can you get health insurance?” HealthCare.gov, 2023
- “A quick guide to the Health Insurance Marketplace®” HealthCare.gov, Accessed August, 2023
- “Entities Approved to Use Enhanced Direct Enrollment” CMS.gov, April 28, 2023
- “2023 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2023
- How Many Uninsured Are in the Coverage Gap and How Many Could be Eligible if All States Adopted the Medicaid Expansion? KFF. March 2023.
- ”Tennessee Rate Review Submissions” HealthCare.gov, 2023
- Plan Year 2024 Qualified Health Plan Choice and Premiums in HealthCare.gov Marketplaces. Centers for Medicare and Medicaid Services. October 25, 2023.
- Tennessee: *Final* Avg. Unsubsidized 2024 #ACA Rate Changes: +4.8%. ACA Signups. September 2023.
- Analysis Finds No Nationwide Increase in Health Insurance Marketplace Premiums. The Commonwealth Fund. December 2014.
- FINAL PROJECTION: 2016 Weighted Avg. Rate Increases: 12-13% Nationally* ACA Signups. October 2015.
- 2017 Rate Project State Roundup: IN, IA, ME, MA, MT, ND, SD, TN. ACA Signups. September 2016.
- 2018 Rate Hikes. ACA Signups. October 2017.
- Tennessee: Correction Re. Final 2019 #ACA Rate Changes: 12.4% DROP (Vs. ~22% Drop W/Out #ACASabotage). ACA Signups. October 2018.
- Tennessee: APPROVED Avg. 2020 #ACA Premiums: 1.1% DECREASE; 3 Carriers Expanding Coverage. ACA Signups. August 2019.
- Weighted average calculated by healthinsurance.org, using these sources: TDCI Approves Health Insurance Carriers’ Rates on the Federally Facilitated Marketplace for 2021. Tennessee Department of Commerce and Insurance. September 2020. And Tennessee: Preliminary Avg. 2021 #ACA Premiums: +5.0% Indy Market, +5.5% Sm. Group. ACA Signups. July 2020.
- Tennessee: Approved Avg. 2022 #ACA Rate Changes: +4.4% Indy Market; +8.9% Sm. Group (Updated). ACA Signups. October 2021.
- Tennessee: Final Avg. Unsubsidized 2023 #ACA Rate Changes: +8.5%. ACA Signups. October 2022.
- “Health Insurance Marketplaces 2023 Open Enrollment Report” CMS.gov, 2023
- “2022 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2022
- “ASPE Issue Brief (2014)” ASPE, 2015
- “Health Insurance Marketplaces 2015 Open Enrollment Period: March Enrollment Report” HHS.gov, 2015
- “Health Insurance Marketplaces 2016 Open Enrollment Period: Final Enrollment Report” HHS.gov, 2016
- “2017 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2017
- “2018 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2018
- “2019 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2019
- “2020 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2020
- “2021 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2021
- “2022 Marketplace Open Enrollment Period Public Use Files” CMS.gov, 2022