Nearly 600,000 Tennesseans lacked health coverage as recently as 2023, according to Kaiser Family Foundation estimates — a number that reflects the state’s decision not to expand Medicaid under the Affordable Care Act. Finding affordable health insurance in Tennessee requires navigating a marketplace that varies significantly by region, with some rural counties offering just one or two carriers. Still, premium tax credits and the state’s CoverKids program provide meaningful help for hundreds of thousands of residents.
This guide breaks down Tennessee’s marketplace landscape, average costs, plan options, and enrollment steps so you can make a well-informed decision. For broader context on how state and federal policies shape insurance access, see our healthcare policy guide.
Tennessee’s Health Insurance Marketplace
Tennessee relies on the federal Health Insurance Marketplace at HealthCare.gov for individual and family plan enrollment. The state does not operate its own exchange. Residents in Nashville, Memphis, Knoxville, and Chattanooga typically have more carrier choices than those in rural East or West Tennessee.
Key insurers on the Tennessee marketplace include BlueCross BlueShield of Tennessee, Ambetter from TennCare Select, Cigna, Oscar Health, and Bright Health in select markets. BlueCross BlueShield of Tennessee is the most widely available carrier, offering plans in all 95 counties.
Competition among insurers has improved in recent years, which has helped moderate premium increases. However, plan networks vary considerably. Some of the lowest-premium options use narrow networks that restrict your choice of hospitals and specialists, so checking provider directories before enrolling is essential.
Plan Types and Metal Tiers Available
Marketplace plans in Tennessee follow the standard ACA metal tier structure. Each tier reflects how costs are split between you and the insurer.
- Bronze: Lowest premiums, highest out-of-pocket costs. The insurer covers about 60% of average expenses. Deductibles often exceed $7,000.
- Silver: Moderate premiums with roughly 70% cost coverage. Silver plans are the gateway to cost-sharing reductions for lower-income enrollees.
- Gold: Higher premiums but lower deductibles and copays. The insurer covers about 80% of costs.
- Platinum: Highest premiums, lowest out-of-pocket expenses, covering approximately 90% of costs.
Catastrophic plans remain available for those under 30 or with hardship exemptions, offering very low premiums paired with high deductibles.
Average Premiums and Costs
A benchmark Silver plan in Tennessee costs approximately $480 to $560 per month for a 40-year-old before subsidies, based on KFF data. After premium tax credits, many enrollees pay considerably less. In Davidson County (Nashville), subsidized Silver plans can drop below $75 per month for individuals earning around 200% of the federal poverty level.
Bronze plans typically run $340 to $430 monthly before subsidies, making them attractive for younger, healthier individuals who want protection against catastrophic expenses without high monthly costs. Gold plans range from $540 to $650 before subsidies.
Deductibles in Tennessee track national averages. Individual Bronze plan deductibles commonly fall between $6,500 and $9,100, while Silver plans range from $3,000 to $6,000. The 2026 federal out-of-pocket maximum is $9,450 for individuals and $18,900 for families.
TennCare and the Medicaid Coverage Gap
Tennessee has not expanded Medicaid under the ACA. The state’s Medicaid program, TennCare, covers specific categories of low-income residents: children, pregnant women, parents or caretakers with very low incomes, seniors, and individuals with disabilities. Childless adults generally do not qualify regardless of income.
This creates what is known as the coverage gap. Adults earning below 100% of the federal poverty level — about $15,060 per year for an individual — often earn too much for TennCare but too little to qualify for marketplace subsidies, which begin at 100% of the poverty level. An estimated 100,000 or more Tennesseans fall into this gap.
Several legislative proposals have attempted to address this issue over the years, including block grant approaches, but none have resulted in full expansion as of 2026. If you fall into the coverage gap, community health centers and charity care programs at hospitals may be your primary options for affordable care.
CoverKids: Tennessee’s CHIP Program
CoverKids is Tennessee’s Children’s Health Insurance Program, providing health insurance for children and pregnant women in families that earn too much for TennCare but cannot afford private coverage. Children in families with household incomes up to 250% of the federal poverty level may qualify.
CoverKids provides comprehensive benefits including doctor visits, immunizations, dental care, vision services, hospital stays, mental health treatment, and prescription medications. Monthly premiums are modest — typically $0 to $50 depending on family income — and copays are minimal.
Enrollment is open year-round. Applications can be submitted through TennCare’s CoverKids page or by calling the CoverKids hotline. Processing usually takes 30 to 45 days.
Subsidies and Financial Assistance
Premium tax credits are available to Tennessee residents purchasing marketplace plans with household incomes between 100% and 400% of the federal poverty level. Enhanced subsidies, extended by recent federal legislation, also cap premiums at 8.5% of household income for those above 400% of the poverty level.
Cost-sharing reductions further reduce out-of-pocket costs for Silver plan enrollees earning between 100% and 250% of the poverty level. These reductions lower deductibles, copays, and maximum out-of-pocket limits without increasing your premium.
For a single adult in 2026, 100% of the federal poverty level is approximately $15,060, and 400% is about $60,240. A family of four qualifies for subsidies with income below roughly $124,800. Use the HealthCare.gov subsidy calculator to estimate your specific credit amount. You can also learn more about how insurance costs add up across different plan types in our healthcare costs guide.
How to Enroll in Health Insurance in Tennessee
Open enrollment for 2026 plans runs from November 1, 2025, through January 15, 2026. Selecting a plan by December 15 ensures coverage starts January 1. Plans chosen between December 16 and January 15 take effect February 1.
To enroll, visit HealthCare.gov and create or log into your account. You will need documentation including Social Security numbers for household members, income verification (W-2s, pay stubs, or tax returns), and current insurance information if applicable.
Special Enrollment Periods allow enrollment outside the standard window if you experience qualifying events:
- Loss of employer-sponsored or government coverage
- Marriage, divorce, or legal separation
- Birth or adoption of a child
- Permanent move to a new coverage area
- Change in immigration status
Tennessee has a network of certified navigators and insurance agents who offer free enrollment assistance. Organizations like the Tennessee Department of Health can help connect you with local resources. Community health centers across the state also provide application support.
Employer-Sponsored and Short-Term Plans
Most insured Tennesseans get coverage through an employer. If your employer offers a plan that covers at least 60% of costs and costs you no more than about 8.39% of household income for self-only coverage, it is considered affordable under ACA rules, and you will not qualify for marketplace subsidies.
Short-term health insurance is available in Tennessee for up to 12 months, with the possibility of renewal. These plans skip many ACA requirements — they can deny coverage for pre-existing conditions and exclude essential health benefits like maternity care or mental health treatment. Premiums are lower, but the coverage is thinner. Understanding the different types of health insurance helps clarify whether a short-term plan fits your situation.
Frequently Asked Questions
Has Tennessee expanded Medicaid?
No. Tennessee has not expanded Medicaid under the ACA. TennCare covers children, pregnant women, certain parents, seniors, and people with disabilities, but childless adults generally do not qualify. This leaves a coverage gap for some low-income residents.
How much does health insurance cost in Tennessee?
Before subsidies, a benchmark Silver plan for a 40-year-old costs roughly $480 to $560 per month. With premium tax credits, many enrollees pay less than $100 monthly. Costs vary by county, age, and household income.
What is CoverKids in Tennessee?
CoverKids is Tennessee’s CHIP program providing health coverage for uninsured children and pregnant women in families with incomes up to 250% of the federal poverty level. It covers medical, dental, vision, and mental health services at low or no cost.
Can I buy health insurance outside of open enrollment in Tennessee?
Only if you qualify for a Special Enrollment Period due to a life event like losing coverage, getting married, having a baby, or moving. TennCare and CoverKids accept applications year-round.
Which insurance companies offer marketplace plans in Tennessee?
BlueCross BlueShield of Tennessee is available statewide. Other carriers include Ambetter, Cigna, Oscar Health, and Bright Health, though availability varies by county. Metropolitan areas typically have more options.
The Bottom Line
Navigating health insurance in Tennessee takes more effort than in states with expanded Medicaid or state-run exchanges, but affordable options exist for most residents. Premium tax credits make marketplace plans accessible for middle-income households, and CoverKids fills a critical gap for families with children. If your income falls into the coverage gap, community health centers and hospital financial assistance programs may provide a safety net.
Compare plans carefully during open enrollment, paying attention not just to premiums but to deductibles, provider networks, and prescription drug coverage. A plan that saves $50 per month in premiums but excludes your doctors or medications may end up costing far more over the course of a year.