This guide, including the FAQs below, 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
Five of the six carriers have filed rates and plans for 2025, but one is exiting the market at the end of 2024 (more details below).
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.
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Learn about Tennessee's Medicaid expansion, the state’s Medicaid enrollment and Medicaid eligibility.
Use our guide to learn about Medicare, Medicare Advantage, and Medigap coverage available in Tennessee as well as the state’s Medicare supplement (Medigap) regulations.
Short-term health plans provide temporary health insurance for consumers who may find themselves without comprehensive coverage. Learn more about short-term plan availability in Tennessee.
To qualify for health coverage through the Tennessee Marketplace, you must: 2
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:
In Tennessee, the open enrollment period for individual/family health coverage runs from November 1 to January 15. 7
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. 8
Outside of open enrollment, a special enrollment period (typically triggered by a specific 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 .
To enroll in an ACA Marketplace plan in Tennessee, you can:
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.
Tennessee uses the federally run exchange for individual market plans, so residents who buy their own health insurance enroll through HealthCare.gov.
Ninety-six percent of the people who purchased health plans through the Tennessee Marketplace in 2024 were eligible for advance premium tax credits (APTC), also known as premium subsidies. The APTC amounted to an average savings of $581/month and reduced the average enrollee’s premium to about $66/month. 10
Marketplace enrollees 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). 11 Between the premium subsidies and cost-sharing reductions, you may find that a Tennessee Marketplace 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 95,000 Tennessee residents in the coverage gap. 13
For 2024 coverage, six insurers offer health plans through the exchange/Marketplace in Tennessee, which is unchanged from 2023. 14
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 2024. 15
For 2025, Ascension (US Health & Life) will no longer offer coverage 16 Tennessee residents enrolled in Ascension plans in 2024 will need to pick new coverage during the open enrollment period for 2025, which begins November 1, 2024.
For 2025, the following average rate changes have been proposed by Tennessee’s individual/family insurers (before subsidies are applied): 17
Tennessee no longer has an effective rate review program, so the federal government (CMS) reviews the rates that are filed in Tennessee. 19 Rates will be finalized before open enrollment begins in November 2024.
The average proposed rate changes listed above are calculated before any subsidies are applied The majority of Tennessee’s Marketplace enrollees do receive subsidies, which change each year to keep pace with the cost of the second-lowest-cost Silver plan in each area.
For perspective, here’s an overview of how full-price (unsubsidized) average premiums have changed in Tennessee over the years:
A significant record-high of more than 555,000 people enrolled in private health coverage through the Tennessee exchange during the open enrollment period for 2024 coverage. 30 The previous record high had been fewer than 350,000 people, set the year before . 31 (See chart below for a summary of enrollment by year.)
The surge in enrollment in recent years is 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. 31
The enrollment growth for 2024 was also due in part to the “unwinding” of the COVID-related Medicaid continuous coverage rule (people were not disenrolled from Medicaid for three years during the pandemic, but that ended in the spring of 2023). By April 2024, nearly 124,000 Tennessee residents had transitioned from Medicaid or CHIP to a private Marketplace plan. 32
Source: 2014, 33 2015, 34 2016, 35 2017, 36 2018, 37 2019, 38 2020, 39 2021, 40 2022, 41 2023, 42 2024 43
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.
