Tennessee Health Insurance: 2021 Coverage Guide

Fran
Fran Majidi
August 21, 2020

Tennessee Affordable Healthcare Insurance

The residents of Tennessee have some options for health insurance plans and they should compare these options carefully to make sure they are buying the right plan that fits their needs. If you’re buying individual coverage or insurance for your family, you can get the coverage you need at the best prices by comparing your options with SmartFinancial. You may only enroll in a health plan during open enrollment, unless you are eligible for the Special Enrollment Period due to a qualifying event.

When Is Open Enrollment in Tennessee?

November 1, 2020 - December 15, 2020. Coverage begins January 1, 2021.

How to Get Health Insurance in Tennessee

It’s easy to create a projection of healthcare costs for the following year. You can estimate what that will be based on the previous year’s health visits and bills. You’ll need this information to decide which type of coverage is right for you, and which level tier will be most economical. Sometimes, higher premiums end up saving you money if you frequently visit care providers in a given year.

To get the lowest rates for the coverage you need, compare health insurance companies and health insurance quotes. After you submit the form you’ll get several competing health insurance rates to choose from, and we’ll connect you with an agent in your area so you can buy the coverage or ask questions about the plan you’re considering.

What Types of Health Insurance Are Available in Tennessee?

HMOs, EPOs, PPOs and POS plans are the most common types of health plans available in Tennessee. You can buy different levels of coverage too. In Tennessee, there are catastrophic, bronze, silver, gold and platinum plans to choose from. A gold plan in Tennessee covers about 80% of all costs but costs double what a bronze plan closets. However, a bronze plan only covers 60% of costs. Catastrophic plans offer the least coverage.

Does Health Insurance Cover Pre-existing Conditions?

The Affordable Care Act made it illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

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Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

  • If you lost a job, changed jobs or even started your own business.
  • If you turned 26 and can no longer be on your parents’ health insurance plan, you can enroll in an individual health plan.
  • You may have had a health plan that was only valid in one region or state but you moved to another state outside the enrollment period. You can sign up for a new health plan.
  • If you extended your healthcare with Cobra but it expired, you can enroll in a new health plan.
  • Divorce. If you were married and shared a health plan coverage with your spouse but divorced, you still have time to enroll in a new health plan.
  • Marriage. If you recently married, you may be able to get added onto your spouse’s policy or start an entirely new one together.
  • If your baby was born outside the open enrollment date, you can still buy health insurance for that child.
  • If you were covered under your spouse or partner’s health plan but that person passed away, you can take advantage of the special qualifying events exception to enroll in an individual plan.
  • Spouse of partner loses coverage. If you previously had health insurance through a partner or spouse who lost his/her coverage for any qualifying reason, you are eligible to buy an individual plan or buy coverage with that spouse/partner again.

Is Health Insurance Required in Tennessee?

No, only California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC still require health insurance. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.

How Much Is Health Insurance in Tennessee?

The average cost of health insurance in Tennessee for a 40 year old is about $491 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.

How to Save on Health Insurance in Tennessee

The best way to save on health insurance in Tennessee is to compare rates based on the tier system. Beforehand, you’ll want to estimate your medical costs.


Medicare in Tennessee

Medicare is health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental and prescription drug coverage.

How Many People Are on Medicare in Tennessee?

20% of the people in Tennessee are on Medicare.

How Much Is Medicare in Tennessee?

If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020, or even higher depending on income.

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Tennessee

If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

To qualify for Medicare you must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Tennessee?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.


Tennessee State Health System Ranking

Ever wonder how your state stacks up when it comes to quality healthcare? The Commonwealth Fund published a report in 2019 on State Health System Performance. They took into consideration the access to quality care, health outcomes, and disparities in all 50 states. The scores for the Tennessee Health System is listed below:

  • Tennessee: Overall State Ranking: 38 of 50
  • Tennessee: Overall Performance: Below Average
  • Tennessee: Access & Affordability: 38
  • Tennessee: Prevention & Treatment: 27
  • Tennessee: Avoidable Hospital Use & Cost: 29
  • Tennessee: Healthy Lives: 44
  • Tennessee: Health Care Disparities: 39
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Tennessee Health Insurance Coverage

The people of Tennessee have different kinds of health insurance while some Tennessee residents are not insured at all. See the breakdown below:

  • Private coverage: 41.3%
  • Medicaid: 32%
  • Medicare: 20%
  • Uninsured: 6.7%

Report: America's Health Insurance Plans

Tennessee Health Insurance Companies

The following carriers offer health insurance and/or medicare in Tennessee.

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