Tennessee Health Insurance Guide 2025

Everything you need to know about health coverage in the Volunteer State

Medicaid Expansion
Not Expanded
Exchange Type
Federal (HealthCare.gov)
Open Enrollment
Nov 1 - Jan 15

Health Insurance Overview

Tennessee residents have several pathways to health insurance coverage. While the state has not expanded its Medicaid program (TennCare), many residents can find affordable coverage through the federal marketplace with premium subsidies that significantly reduce costs.

Coverage Gap Alert: Because Tennessee has not expanded TennCare, some adults fall into a "coverage gap" where they earn too much for traditional Medicaid but not enough for marketplace subsidies. If this affects you, contact us to explore alternative options.

TennCare (Medicaid in Tennessee)

TennCare is Tennessee's Medicaid program, providing health coverage since 1994. Without expansion, TennCare primarily covers:

  • Children under 19 (income limits vary by age)
  • Pregnant women with income up to 195% of poverty level
  • Parents/caretakers with very low income
  • Adults age 65 and older who meet income requirements
  • Individuals with qualifying disabilities

How to Apply for TennCare

You can apply for TennCare through:

  • Online: Visit TennCare Connect
  • Phone: Call 1-855-259-0701
  • In Person: Visit your local Department of Human Services office
  • Mail: Download and submit a paper application

CoverKids Program

CoverKids provides health coverage for uninsured children under 19 whose families earn too much for TennCare but still need assistance. Income limits are higher than traditional TennCare.

Health Insurance Marketplace

Tennessee uses the federal Health Insurance Marketplace at HealthCare.gov. You can compare plans from multiple insurers serving your area and see your potential savings before you enroll.

2025 Open Enrollment: November 1, 2024 through January 15, 2025. Enroll by December 15 for coverage starting January 1.

How to Enroll

  1. Visit HealthCare.gov
  2. Create an account and complete your application
  3. Review your eligibility for TennCare or marketplace subsidies
  4. Compare plans and select the best option for your needs
  5. Pay your first premium to activate coverage

Average Costs and Subsidies

Financial assistance is available to help Tennessee residents afford coverage:

  • Premium Tax Credits: Available for income between 100-400% of poverty (with enhanced subsidies potentially available above 400%)
  • Cost-Sharing Reductions: Lower out-of-pocket costs on Silver plans for those under 250% of poverty
  • Zero Premium Options: Some residents qualify for Bronze plans with $0 monthly premium

Frequently Asked Questions

Has Tennessee expanded Medicaid?

No, Tennessee has not expanded Medicaid (TennCare) under the Affordable Care Act. Adults without children generally do not qualify for TennCare regardless of income. However, children, pregnant women, elderly, and disabled individuals may qualify under traditional TennCare rules.

What is TennCare?

TennCare is Tennessee's Medicaid program that provides health coverage to eligible low-income residents. It covers children, pregnant women, parents with very low income, seniors, and people with disabilities. TennCare has been operating since 1994 as a managed care program.

How do I apply for health insurance in Tennessee?

Tennessee uses the federal marketplace at HealthCare.gov for individual and family coverage. You can apply online, by phone at 1-800-318-2596, or with help from a licensed agent. For TennCare, apply through the TennCare Connect portal or call 1-855-259-0701.

Can I get help paying for health insurance in Tennessee?

Yes, if your income is between 100% and 400% of the federal poverty level, you may qualify for premium tax credits through HealthCare.gov. These subsidies can significantly reduce your monthly premium, and many Tennesseans pay less than $100/month for quality coverage.

Need Help Finding Coverage in Tennessee?

Our licensed agents can help you navigate Tennessee's insurance options and find the most affordable coverage for your situation.

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