Tennessee Health Insurance Exchange: A Comprehensive Guide to Enrollment and Plans

Tennessee's health insurance exchange is a marketplace where individuals and families can shop for and enroll in health insurance plans. The exchange is open to residents of Tennessee who are not covered by an employer or another source.

To enroll in a plan through the Tennessee health insurance exchange, you'll need to create an account and provide some basic information, such as your name, date of birth, and social security number. You can do this online, by phone, or in person.

There are four main types of health insurance plans available through the Tennessee exchange: bronze, silver, gold, and platinum. Bronze plans have the lowest premiums but the highest out-of-pocket costs, while platinum plans have the highest premiums but the lowest out-of-pocket costs.

The enrollment period for the Tennessee health insurance exchange typically runs from November to December, but special enrollment periods may be available for certain life events, such as losing job-based coverage or getting married.

The Tennessee Health Insurance Exchange is a platform that allows residents to access health insurance plans and potentially receive tax subsidies to help make coverage more affordable. The Exchange will be operated through a federally-run health insurance exchange, also known as the Health Insurance Marketplace.

Eligible individuals and families can access tax subsidies, capping their premium costs at between 2% to 9.5% of their income. This means that if you're eligible, you might be able to get health insurance for a lower cost than you would without the subsidy.

The Exchange will also screen for Medicaid and public assistance programs, so you can see if you qualify for those benefits as well. A significant number of Tennesseans, approximately 889,000, are currently uninsured, and many of them may qualify for tax subsidies or Medicaid.

Here are the three options Tennessee had for its health insurance exchange:

Tennessee chose to default to a federally-facilitated health insurance exchange, which means that the Exchange will be run by the federal government.

The Tennessee Health Insurance Exchange is a federally-run health insurance exchange, also known as the Health Insurance Marketplace. This means that Tennessee residents will be able to access information about all the plans available through the Exchange starting in October 2013.

Tennessee residents who are uninsured may be eligible for tax subsidies to purchase coverage in the Marketplace. According to an estimate by healthcare.gov, approximately 889,000 or 16% of Tennessee's non-elderly residents are uninsured.

Eligibility for these tax subsidies is based on household size and income, and it's estimated that 94% of these uninsured residents may qualify for either tax subsidies or Medicaid. The Exchange will also screen for Medicaid and public assistance programs.

The Exchange will be open for enrollment on October 1, 2013, with coverage starting January 1, 2014.

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Tennessee created an Insurance Exchange Planning Initiative in 2010 to review its options for a state health insurance exchange and advise state decision-makers.

The initiative met with various stakeholders, including small businesses, agents and brokers, health care providers, insurers, and consumer advocates, to discuss the state's options.

Governor Haslam announced on December 10, 2012, that Tennessee would not operate a state-based exchange.

As a result, Tennessee defaulted to the federally-run health insurance exchange.

To enroll in a Tennessee Marketplace plan, you can visit HealthCare.gov, which offers an online platform to shop, compare, and choose the best health plans.

You can also get help from an insurance agent or broker, a Navigator or certified application counselor, or an approved enhanced direct enrollment entity to purchase individual and family health coverage.

For assistance, you can call HealthCare.gov's contact center at 1-800-318-2596 (TTY: 1-855-889-4325), which is available 24 hours a day, seven days a week, but closed on holidays.

If you need expert guidance on ACA Marketplace plans, consider reaching out to GetCoveredTenn, which offers in-person or phone appointments with a team member to help you determine the best plan for your needs.

To learn more about Medicare coverage and enrollment in Tennessee, you can use a guide provided by a trusted source.

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To buy health insurance through the Marketplace, you must meet certain basic requirements. You must live in Tennessee.

To qualify for financial assistance, your income is a key factor. Your income will determine if you're eligible for premium subsidies and cost-sharing reductions.

You must not have access to affordable employer-sponsored health insurance. If your employer offers coverage but you think it's too expensive, you can use the Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace.

You must not be eligible for Medicaid or CHIP. These programs provide health insurance to low-income individuals and families.

You must not be eligible for premium-free Medicare Part A. This is a type of Medicare coverage for people who are 65 or older, or have certain disabilities.

You must not be able to be claimed by someone else as a tax dependent. This means you must be considered an independent individual.

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If you're married, you must file a joint tax return with your spouse. This is usually the case, but there may be some exceptions.

Here are the basic requirements to buy health insurance through the Marketplace:

In Tennessee, you can enroll in an ACA-compliant plan during the open enrollment period, which runs from November 1 to January 15.

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.

You can also enroll outside of open enrollment by triggering a special enrollment period, which is typically necessary after a specific qualifying life event.

To enroll in an ACA Marketplace plan, you can visit HealthCare.gov to access Tennessee's health insurance marketplace.

You can also 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.

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If you need help navigating the process, you can call HealthCare.gov's contact center at 1-800-318-2596 (TTY: 1-855-889-4325), which is available 24 hours a day, seven days a week.

Here are the ways to enroll in a Tennessee Marketplace plan:

GetCoveredTenn is also available to provide expert guidance on ACA Marketplace plans, making the process easier and more user-friendly.

You can contact GetCoveredTenn to learn more about the process of finding and signing up for a health insurance plan that meets your needs.

In Tennessee, you have multiple options for health insurance through the exchange. Six insurers offer individual/family health plans through the exchange/Marketplace in Tennessee for 2025 coverage.

The number of participating insurers is unchanged from 2024, but one new insurer, Alliant Health Plans, is joining the market, while another, Ascension/US Health & Life, is exiting at the end of 2024. This means that residents enrolled in Ascension plans in 2024 will need to pick new coverage during the open enrollment period for 2025.

Plan availability varies from one part of the state to another, but all areas of Tennessee have at least three participating exchange-based health insurers offering plans for 2025. This ensures that residents can find a plan that suits their needs, regardless of where they live.

The Tennessee Health Insurance Exchange will offer plans that meet the ACA definition of a Qualified Health Plan (QHP). These plans will be offered by level of coverage for essential health benefits, allowing consumers to compare plans on an "apples to apples" basis.

The four "metal" levels are: Bronze (plan pays 60%), Silver (plan pays 70%), Gold (plan pays 80%), and Platinum (plan pays 90%). This gives consumers a clear idea of what to expect from each plan.

The following insurance companies will be offering individual health insurance plans through Tennessee’s Exchange: BlueCross BlueShield of Tennessee, Community Health Alliance, Humana Insurance Company, and Cigna Health and Life Insurance Company.

In Tennessee, the average health insurance premiums have been fluctuating over the years. For 2025, the average rate changes for individual/family insurers in Tennessee range from a -1.26% decrease to a 3.86% increase.

The majority of Tennessee's Marketplace enrollees receive subsidies, which change each year to keep pace with the cost of the second-lowest-cost Silver plan in each area. New federal health insurance tax subsidies will cap the cost of health insurance at 2% - 9.5% of household income, if household income is up to 400% above the federal poverty line (FPL).

Here's a brief overview of the average full-price (unsubsidized) premium changes in Tennessee over the years:

Tennessee's individual/family insurers have approved rate changes for 2025, and some are actually decreasing.

Blue Cross Blue Shield of Tennessee's rate is decreasing by -0.98%, and UnitedHealthcare's rate is decreasing by -1.26%. On the other hand, Cigna's rate is increasing by 2.99%, and Oscar's rate is increasing by 3.86%.

The average approved rate changes listed above are calculated before any subsidies are applied, and the majority of Tennessee's Marketplace enrollees do receive subsidies.

Here's a brief look at how full-price (unsubsidized) average premiums have changed in Tennessee over the years:

The federal government reviews the rates that are filed in Tennessee, as the state no longer has an effective rate review program.

Federal Premium Subsidies can significantly reduce the cost of health insurance for eligible residents. The subsidies are based on household income, and Tennessee residents may be eligible if their household income is up to 400% above the federal poverty line (FPL).

The actual amount you'll pay for health insurance depends on your household income, and subsidies will cap the cost at 2% - 9.5% of your household income. This means that even with the subsidies, your health insurance costs will still be a manageable percentage of your income.

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Individual plan rates can be a mystery, but let's break it down. In Tennessee, the average rate changes for individual/family insurers in 2025 are already approved, with some issuers even decreasing their rates.

Blue Cross Blue Shield of Tennessee is decreasing its rates by 0.98%, while Cigna is increasing its rates by 2.99%. Oscar is increasing its rates by 3.86%, and Celtic/Ambetter is increasing its rates by 2.3%. UnitedHealthcare is also decreasing its rates by 1.26%.

The majority of Tennessee's Marketplace enrollees receive subsidies, which change each year to keep pace with the cost of the second-lowest-cost Silver plan in each area. To give you a sense of how full-price (unsubsidized) average premiums have changed in Tennessee over the years, here's a quick rundown:

If you're looking for a more detailed breakdown of how rates can vary, here's a table showing the average rates for different age groups and family sizes in Tennessee, as of 2023:

Medicare coverage and enrollment in Tennessee is a bit more complicated than other states due to the state's Medicare supplement (Medigap) regulations.

Tennessee has a unique set of rules governing Medigap plans, which can affect your coverage options.

To enroll in Medicare in Tennessee, you must be 65 or older, or have a disability, or have end-stage renal disease.

Medicare Advantage plans in Tennessee offer additional benefits not covered by Original Medicare, such as vision, dental, and hearing coverage.

Medigap plans in Tennessee can help cover out-of-pocket costs not covered by Medicare, such as copays and deductibles.

The Medicare Annual Enrollment Period (AEP) in Tennessee allows you to change or enroll in a Medicare plan from October 15 to December 7 each year.

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Insurance professionals can register with the Tennessee Health Insurance Exchange and receive commissions directly from carriers using their Exchange ID number and NPN.

You can also work with an insurance agent or broker to purchase individual and family health coverage. They can guide you through the process and help you choose the best plan.

To enroll in an ACA Marketplace plan in Tennessee, you can visit HealthCare.gov, which is available 24/7, or call the contact center at 1-800-318-2596 (TTY: 1-855-889-4325).

The Tennessee Health Insurance Exchange navigator program will assist consumers in making choices about their health care options and accessing their new health care coverage.

Here's a brief overview of your options for getting help with the enrollment process:

You can also reach out to GetCoveredTenn, a program that aims to simplify the process of understanding and comparing health insurance options in Tennessee.

You can enroll in a Tennessee Health Insurance Exchange plan during the annual Open Enrollment Period, which typically runs from November to December.

The Open Enrollment Period is the only time of the year when you can enroll in a plan without a qualifying event.

You can also enroll in a plan if you have a qualifying event, such as losing your job or getting married.

Qualifying events allow you to enroll in a plan outside of the Open Enrollment Period.

Tennessee Health Insurance Exchange plans are required to cover essential health benefits, including doctor visits, hospital stays, and prescription medication.

You can choose from a range of plan options, including Bronze, Silver, Gold, and Platinum plans.

The Bronze plan has the lowest premium but also has the highest deductible.

The Platinum plan has the highest premium but also has the lowest deductible.

You can also choose from a range of network options, including HMO and PPO plans.

HMO plans require you to choose a primary care physician, while PPO plans allow you to see any doctor without a referral.