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

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).

Average Premiums by City in Tennessee

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

The enhanced subsidies first enacted in the American Rescue Plan expired at the end of 2025. For 2026, premium tax credits follow the original ACA rules: there is no credit above 400% (the “subsidy cliff”), and enrollees are expected to pay up to 9.96% of income toward the benchmark Silver plan. House in January 2026 but has not become law, so 2027 plans are being priced and subsidized under the same rules unless Congress acts.

Cigna Leaves Tennessee’s Marketplace for 2027

Six insurers sold Tennessee marketplace plans for 2026; Cigna exits at the end of 2026, leaving Blue Cross Blue Shield of Tennessee, Oscar, Ambetter (Celtic), UnitedHealthcare, and Alliant Health Plans for 2027. Proposed full-price changes vary widely by insurer:

Because your credit is tied to the benchmark Silver plan in your county, a large increase from one insurer doesn’t necessarily raise your net cost — but staying put without comparing often does. Cigna enrollees must pick a new plan.

What Tennesseans Actually Paid in 2026

About 569,000 Tennesseans enrolled for 2026. Roughly 90% received premium tax credits averaging about $772 a month, for an average net premium of about $141 a month, and 36% paid under $10 a month. Tennessee does not run its own rate review program; federal CMS reviews proposed rates.

Open enrollment for 2027 runs November 1, 2026 through January 15, 2027 on HealthCare.gov; enroll by December 15 for January 1 coverage.

TennCare and the Coverage Gap

Tennessee has not expanded Medicaid, leaving an estimated 89,000 adults in the coverage gap — earning too little for marketplace credits (which start at 100% FPL) and not qualifying for TennCare. TennCare has extended eligibility for parents of minor children up to the poverty level, but adults without dependent children generally remain ineligible. Tennessee has also moved toward work requirements for low-income parents in TennCare, with exemptions for parents of young children; check current rules with TennCare before assuming eligibility.

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.
• Tennessee has not expanded Medicaid, so if your income falls below the federal poverty level you may fall into the coverage gap — a community health center or sliding-scale clinic can serve as a bridge until your income qualifies for marketplace subsidies.

Frequently Asked Questions

Which insurers are leaving the Tennessee marketplace for 2027?

Cigna is exiting at the end of 2026. Blue Cross Blue Shield of Tennessee, Oscar, Ambetter (Celtic), UnitedHealthcare, and Alliant Health Plans continue, with proposed 2027 changes from about 10% to 29% before subsidies.

How much do Tennesseans pay for marketplace insurance after subsidies?

In 2026 about 90% of Tennessee enrollees received premium tax credits, and the average net premium was about $141 a month; 36% paid under $10 a month.

Has Tennessee expanded Medicaid?

No. An estimated 89,000 Tennessee adults fall in the coverage gap. TennCare covers parents of minor children up to the poverty level, but adults without dependent children generally do not qualify.

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.