Tennessee Health Insurance Guide

Health Insurance Overview in Tennessee

Tennessee has not expanded Medicaid under the ACA, despite discussions and near-expansions. The state uses the federal HealthCare.gov marketplace. Tennessee has seen significant marketplace stability challenges — in 2016-2017, insurer withdrawals left some counties without marketplace coverage, contributing to the national debate about marketplace stability.

Average Health Insurance Costs in Tennessee

Health insurance premiums in Tennessee vary significantly based on age, plan type (Bronze, Silver, Gold, Platinum), insurer, and income-based subsidies. The figures below represent estimated 2026 benchmark premiums before ACA subsidies for a 40-year-old individual and family of four.

Coverage Type	Monthly Premium	Annual Premium
Individual (benchmark Silver)	$462/mo	$5544/yr
Family of Four (benchmark Silver)	$1,322/mo	$15864/yr
Avg. Annual Deductible	$4,900

Premiums shown are before ACA subsidies. Most marketplace enrollees receive premium tax credits that significantly reduce these costs. Use our Health Insurance Calculator to estimate your net premium after subsidies.

Marketplace Enrollment in Tennessee

Tennessee residents can enroll in individual and family health insurance plans through HealthCare.gov (Federal). Open enrollment runs November 1 – January 15 (federal marketplace). Outside of open enrollment, a qualifying life event (job loss, marriage, birth of a child, move to a new state) triggers a Special Enrollment Period during which you can enroll or change plans.

Average Premiums by City in Tennessee

Health insurance premiums vary by location within Tennessee, reflecting local healthcare costs, provider availability, and insurer competition. The following estimated monthly individual premiums are based on a benchmark Silver plan for a 40-year-old non-smoker.

City	Est. Monthly Premium (Silver, age 40)
Memphis	$475/mo
Nashville	$470/mo
Knoxville	$458/mo
Chattanooga	$462/mo
Clarksville	$455/mo
Murfreesboro	$460/mo

Medicaid in Tennessee

Tennessee has not expanded Medicaid (TennCare). TennCare is a managed care Medicaid program covering traditional categories: children, pregnant women, the elderly, and people with disabilities. Adults without children generally do not qualify.

Children's Health Insurance (CHIP) in Tennessee

CoverKids covers children in families with incomes up to 250% of the federal poverty level.

What Makes Tennessee Unique

Tennessee faced one of the most acute marketplace stability crises in the nation in 2016-2017, when major insurers withdrew from the state exchange, leaving some counties temporarily without marketplace options. Tennessee's experience contributed to national policy discussions about marketplace stability and insurer incentives. The state has since seen improved market stability with additional carriers returning.

ACA Subsidies: What Tennessee Residents Should Know

Premium tax credits (subsidies) are available for Tennessee residents who purchase coverage through the marketplace and have incomes between 100% and 400% of the federal poverty level (or higher in states with additional state subsidies). The subsidy amount is based on the cost of the benchmark Silver plan in your area and your income. For 2026, the enhanced subsidies first enacted in the American Rescue Plan have been extended, providing more substantial assistance across a broader income range than before.

Cost-sharing reductions (CSRs) provide additional savings on deductibles and copays for those who enroll in Silver plans with incomes between 100-250% of the federal poverty level. Silver plans with CSRs often provide Gold or Platinum-level value at Silver premiums, making them the best value for eligible enrollees.

Tips for Choosing Health Insurance in Tennessee

Tennessee residents earning 100%+ of the federal poverty level should check HealthCare.gov for subsidy eligibility. CoverKids provides children's coverage. Adults below the poverty level face very limited options due to non-expansion. Nashville and Memphis have better marketplace competition than rural areas.

• Enroll during open enrollment (November 1 – January 15 (federal marketplace)) — missing the deadline means waiting until the next open enrollment unless you have a qualifying life event.
• Check both Medicaid eligibility and marketplace subsidy eligibility — your income determines which program you qualify for.
• Don't just compare premiums — also compare deductibles, out-of-pocket maximums, and whether your doctors are in-network.
• Silver plans with cost-sharing reductions (for incomes 100-250% FPL) typically offer the best overall value despite higher premiums than Bronze plans.
• Use our Health Insurance Calculator to estimate your total annual cost (premium + expected out-of-pocket) for different plan options.

The information on this page is provided for general informational purposes only and reflects estimated industry averages and program eligibility rules as of 2026. Health insurance premiums, Medicaid eligibility thresholds, marketplace options, and program rules change annually. Always verify current eligibility and enrollment options at the official HealthCare.gov (Federal) or by contacting a certified navigator or broker. Premium figures shown are approximations before subsidies — actual net premiums depend on individual income, household size, and plan selection.