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Tennessee Health Insurance Consumer Guide
This guide was developed to assist you in choosing the right 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 HealthCare.gov for residents to purchase its ACA Marketplace plans. The Marketplace provides access to health insurance products from private insurers.
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.
Explore our other comprehensive guides to coverage in Tennessee
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.1 Tennessee's current total Medicaid enrollment has grown to more than 1.5 million people.2
Medicare coverage and enrollment in Tennessee
As of May 2023, there were 4,441,441 Tennesseeans enrolled in Medicare plans.3 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.4
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:5
- 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 and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. In addition, to qualify for financial assistance with your Marketplace plan you must:
- Not have access to affordable health coverage through your employer. 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.
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 15.6
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 1.7
Outside of open enrollment, a qualifying 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.8
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 which amounted to an average savings of $572/month and reduced the average enrollee’s premium to about $72/month.9
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 below 250% of the federal poverty level also qualify for cost-sharing reductions (CSR) that may reduce your deductibles and out-of-pocket expenses when you buy a Silver plan. Between the premium subsidies and cost-sharing reductions, you may find that an ACA plan is the cheapest health insurance option for you.
Source: CMS.gov10
How many insurers offer Marketplace coverage in Tennessee?
For 2023 coverage, six insurers offer exchange-based health plans in Tennessee, including one newcomer:11
- Ascension Personalized Care/US Health and Life (New for 2023; plans available in central Tennessee)
- Blue Cross Blue Shield of Tennessee
- Celtic/Ambetter
- Cigna
- Oscar
- United Healthcare
All areas of Tennessee have at least three participating exchange-based health insurers offering plans for 2023.12
Are Marketplace health insurance premiums increasing in Tennessee?
For 2024, Colorado’s individual/family insurers have proposed the following average rate changes:11
Tennessee’s ACA Marketplace Plan 2024 Proposed Rate Increases by Insurance Company |
|
---|---|
Issuer | Percent Increase |
Blue Cross Blue Shield of Tennessee | 2.7% |
Cigna | 2.59% |
Oscar | -0.32% |
Celtic/Ambetter | 6.73% |
UnitedHealthcare | 1.88% |
US Health and Life | 12.05% |
Source: HealthCare.gov11
These proposed rate changes represent an average increase of about 4.8% for 2024, according to ACASignups.net.13
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.14
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 – now extended by the Inflation Reduction Act – subsidies are more significant and accessible through the end of 2025.14
Source: 2014,152015,16 2016,17 2017,18 2018,19 2019,20 2020,21 2021,22 2022,23 2023,9 202424
What health insurance resources are available to Tennessee residents?
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.
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.
Footnotes
- ”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 ⤶
- “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 ⤶ ⤶
- “2024 Marketplace Open Enrollment Period Public Use Files” CMS.gov, March 2024 ⤶
- ”Tennessee Rate Review Submissions” HealthCare.gov, 2023 ⤶ ⤶ ⤶
- “Health Insurance Information”, [email protected] ⤶
- “Tennessee: Preliminary Avg. Unsubsidized 2024 #ACA Rate Changes: +4.8%” ACASignups.net ⤶
- “Health Insurance Marketplaces 2023 Open Enrollment Report” CMS.gov, 2023 ⤶ ⤶
- “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 ⤶
- “HEALTH INSURANCE MARKETPLACES 2024 OPEN ENROLLMENT REPORT” CMS.gov, 2024 ⤶