Margaret Huntley Last Updated On: August 14, 2023

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What You Need to Know About Health Insurance in Tennessee

Whether you prefer sightseeing at the Great Smoky Mountains National Park, watching a Tennessee Titans football game, or attending an event at the Grand Ole Opry, Tennessee is a state with plenty to see and do. But Tennessee also has great health insurance that protects you as you explore all the riches the state has to offer!

You’re never bored in Tennessee, with so much to choose from. In the same vein, residents also have a variety of health insurance options to choose from, whether that’s employer-sponsored health insurance to ACA marketplace plans.

So, if you’re in the market for health insurance in Tennessee, we’ll discuss everything you need to know about finding the best health care for you.

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Table of Contents

Options for Health Insurance Plans in Tennessee

Every American wants the freedom to choose the best health insurance that fits their lifestyle and budget; fortunately, Tennessee offers many different types of health insurance.

Medicaid

If health insurance is out of reach for you, you should consider applying for Medicaid. This is one of the best options for low cost health insurance in Tennessee for those living below the federal poverty line. Although Medicaid differs by state, Tennessee’s program is called TennCare Medicaid or Medicaid Standard, which provides low-cost or no-cost health insurance plans to qualifying individuals and their families.

To qualify for TennCare Medicaid, here are the requirements:

  • You cannot receive TennCare if you’re not disabled or not a pregnant adult without dependent children, regardless of income.
  • Adults with children earning a household income below 95% of the poverty line.
  • Pregnant women with infants under the age of one with a household income below 200% of the poverty line.
  • Children from 1-5 years of age with a household income below 147% and children from 8-18 with a household income below 138% of the poverty line.
  • CHIP, also called Cover Kids, is offered to households that are ineligible for Medicaid because they earn above the poverty line, for up to 255%.

It’s relatively simple to apply for Medicaid in Tennessee. Here’s how:

  • Apply year-round, which means you don’t have to wait for open enrollment
  • Enroll via HealthCare.org virtually or by phone
  • Enroll online via TennCare
  • Go to a Tennessee Department of Human Services to enroll in person

What services does TennCare cover?

  • Specialist appointments
  • Transportation to your appointments
  • Wellness and preventative care, e.g., hospital or primary care provider 
  • Dental services, including for children
  • Pregnant and postpartum dental care
  • Mental health services

Medicare

If you’re approaching your Golden Years or for qualifying individuals under the age of 65, there is Medicare, a federally-funded health insurance program. Medicare is sold in units called parts. Qualifying individuals can buy into an Original Medicare plan that bundles Part A and Part B, or they can purchase Medicare Advantage (Part C) through private insurance that bundles Part A, Part B, and other supplemental coverage (e.g., Part D). 

  • Part A: Plan A covers hospital visits. Typically hospital visits are free unless you’re new to Medicare.
  • Part B: Part B covers medical services such as primary care provider visits.
  • Part C: Part C or “Medicare Advantage”, bundles Part A, Part B and supplemental coverage, like dental, eye care, or prescription medication. Medicare Advantage is a popular choice, only offered through independent insurance companies.
  • Part D: Part D is optional coverage for prescription medication.

Note, Medicare is just for individual health insurance in Tennessee, it doesn’t provide family coverage.

Individual Health Insurance

The beauty of individual health insurance in Tennessee is that it’s straightforward, so residents can effortlessly browse their choices—sold in metallic tiers—until they find the best health insurance for their needs.

There are four metallic tiers offered by individual health insurance in Tennessee:

  • Catastrophic: Catastrophic coverage was designed for individuals who are healthy and under the age of 30 or those who cannot afford higher premiums (note, you’ll need a financial hardship to qualify). Here are some policy highlights:
    • Low monthly premiums
    • High deductibles
    • Has high out-of-pocket maximums
    • It protects you from the essential health benefits (10 listed in ACA) and some preventative services
    • Not eligible for premium tax credits for cheaper rates
    • Only for healthy, young individuals that don’t need routine medical treatment or for those who can’t afford health insurance
  • Bronze: Bronze is the most affordable metallic tier health insurance, as long as you don’t need regular medical care. With bronze health insurance, you’ll get these features:
    • Low monthly premiums, but more than Catastrophic
    • High deductibles but less than Catastrophic
    • High out-of-pocket expenses if you need medical treatment
    • Bronze coverage is excellent for healthy individuals that don’t require routine medical care
  • Silver: Silver policies are among the most popular health insurances sold on the state exchange offering mid-level protection. Silver plans are so popular because they are the only tier eligible for premium tax credits, which in turn, decreases the cost of your health insurance premiums.
    • Moderate monthly premiums
    • Lower deductibles than bronze plans
    • Eligible to apply for low-income subsidies or “cost-sharing” with silver plans for more affordable rates
    • Policies pay 70% of your medical treatment costs, but with tax credits for qualifying low-income individuals, the figure can jump to up to 94% coverage
  • Gold: Gold health insurance plans are ideal for policyholders that require routine medical treatment, as the higher monthly premiums result in lower deductibles and net expenses.
    • Higher monthly premiums
    • Lower deductible amounts

When Is Tennessee’s Open Enrollment?

Health insurance season, or “open enrollment,” is when Americans can shop for or change their health insurance.

For Tennesseeans, open enrollment runs from November 1 to January 15. 

Note, you may be able to change your plan at other times of the year if you’ve had a qualifying life event, like a divorce, job loss, marriage, birth, etc.

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How Much Is Individual Health Insurance in Tennessee?

he average cost of health insurance in Tennessee for a 40-year-old man is $478. However, since 2022, health insurance costs have risen by an average of 4%.

The cost of health insurance in Tennessee depends on the metallic tier you purchase. Here’s the cost breakdown by age and metallic tier, but keep in mind that health insurance costs, like a fine wine, increase with age.

Metallic TierCost for a 21 Year OldCost for a 40 Year Old
Catastrophic $258$330
Bronze$336$430
Silver$417$533
Gold$485$620

 

If you’re shopping for health insurance for your family, we haven’t forgotten about you; here are the premiums you can expect to pay per tier.

Please note that your premiums will inevitably increase when you add more individuals to a policy! Children under 15 years of age pay a lower flat rate than a spouse, but children over 15 will slowly cost more in premiums as they age.

*This chart assumes an adult is 40 years old.

Family SizeMonthly Premiums
Adult + Child$853
Couple $1,067
Couple + Child$1,386
Couple + 2 Children$1,705
Couple + 3 Children$2,205

Skip the guesswork by getting access to free quotes here, so you can get a sense of how much you can expect to pay for your exact circumstances.

How Health Insurance Rates in Tennessee Are Calculated

As much as we would all love a universal clothing size so that we never have to speculate whether our usual size fits from brand to brand, it’s just not the case! Unfortunately, this same logic applies to health insurance as every insurer uses different factors to set your premiums, so your rates will vary across providers. Your health insurance rates are calculated using these factors:
  • Factors such as age and health that every insurer uses to set premiums
  • The state’s health insurance regulations
  • The plan you choose
  • Where you live
  • How many people you’re insuring
Costs can vary significantly from person to person and plan to plan. This is why it’s so important to do your due diligence and shop around before settling on a plan.

The Best Health Insurance Companies in Tennessee

When shopping for anything from a new phone to new health insurance, we all want the best, so if you’re looking for the most affordable rates and good customer service, you cannot go wrong with any of these insurers: 
  • US Health and Life Insurance Company
  • UnitedHealthcare Insurance Company
  • Oscar Insurance Company
  • Cigna Health and Life Insurance Company
  • BlueCross BlueShield of Tennessee
  • Ambetter of Tennessee
These companies are great starting points to find health insurance that fits the bill. Short-Term Health Insurance If you’ve recently lost your health insurance for any reason, there’s short-term health insurance to help fill the gaps until you can find the right insurance plan for you.  Here are some key features Tennesseeans should know about short-term health insurance:
  • You can take out a short-term plan anytime, even outside the open enrollment window.
  • Short-term plans don’t cover everything traditional health insurance plans do. Some of the services that are often not covered by short-term plans include:
    • Pregnancy care
    • Mental health services
    • Prescription medications
  • Short-term term lengths are for 12 months but can be renewed up to 36 months.
Short-term health insurance can get you through a tough time, but it’s not designed to last you for long. And if you’re looking for the cheapest health insurance in Tennessee, short-term plans aren’t it. They often end up being more expensive than standard health insurance, and you may not qualify if you have a pre-existing condition. Luckily, you have so many options for health insurance available to you in the state of Tennessee, so you won’t need to rely on short-term health insurance for long.  

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Final Thoughts on Health Insurance in Tennessee

Tennessee has so much for residents to see and do. Whether you’re visiting Elvis Presley’s home, Graceland or traversing the breathtaking Great Smoky Mountains National Park, it’s important that you’ve got the right health insurance should anything happen during your day to day. 

Now keep in mind that locking down the best health insurance in Tennessee will require some research and shopping around. To help you find the best health insurance plan, here are a few questions you should ask yourself:

  • Budget: How much can you afford to spend on health insurance monthly? Annually?
    • Household Income: How much is your household net worth; will you qualify for Medicaid or low-income subsidies off a Silver plan?
  • Household Size: How many people are in your household? The cost for a family will be more than for an individual. 
  • Age: How old are you? If you’re 65 or older, then you qualify for Medicare. 
  • Medical History: Do you or any household members require routine medical treatment for a chronic health condition or otherwise? If yes, consider taking out a Gold plan.

Once you have a reasonably good idea of which plan you’re interested in, make sure you shop around, as every insurance company uses different calculations to set your rates, meaning the same premiums will cost varying amounts across multiple insurers. So, if you want affordable rates, get a handful of quotes before choosing the best policy for you. 

Get started quote shopping now with access to free quotes here. Great health insurance awaits!

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Margaret Huntley Margaret Huntley is a creative writing and philosophy student at Western University. She has been working as a freelance writer for over two years and has written about everything from insurance, to poker, to health and wellness for international businesses.

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