Health Insurance in Tennessee

The TennCare and coverage gap situation

Tennessee's Medicaid program is called TennCare. It covers children, pregnant women, and adults with disabilities or very low incomes. But childless adults without a disability are not eligible, period, regardless of how little they earn.

This means about 82,000 Tennesseans fall into the coverage gap: they earn less than 100% FPL ($15,650 for a single person), which is below the threshold for marketplace subsidies, but they don't fit TennCare's narrow categories. There is no good option for this group right now.

Tennessee does have a few smaller programs. CoverRx provides prescription drug assistance for uninsured adults. Community health centers offer sliding-fee-scale care. But these are not substitutes for comprehensive health insurance.

Several attempts to expand TennCare have failed in the state legislature. The most recent proposal, Insure Tennessee, was blocked in committee. There is no active expansion effort as of 2026.

Marketplace costs in 2026

Tennessee marketplace premiums saw some of the largest increases in the country for 2026. BlueCross BlueShield of Tennessee, the state's dominant carrier, raised rates by an average of 42%. Other carriers followed with similar increases.

The reason: when enhanced subsidies expired, insurers expected a sicker and smaller enrollee pool (healthy people above 400% FPL are more likely to drop coverage when it becomes unaffordable). Higher expected claims per member translates to higher premiums.

For subsidized enrollees under 400% FPL, the tax credit absorbs much of the increase. People under 200% FPL can still find $0-premium Bronze plans in most counties. But for anyone above the cliff, the sticker shock is real.

Carriers in Tennessee (2026)

• BlueCross BlueShield of Tennessee is the largest carrier and is available in every county. It has the broadest network, including Vanderbilt, UT Medical Center, and most community hospitals. Despite the 42% rate increase, it remains the default choice in many areas.
• Ambetter (Centene/TennCare Select) offers lower premiums in several counties, especially in the Nashville, Memphis, and Knoxville metros. Networks are narrower.
• Oscar Health is available in the Nashville and Memphis markets.
• Cigna offers plans in select counties, focused on Middle Tennessee.
• Molina Healthcare operates in certain counties, mostly in the Memphis area.

Rural East Tennessee and parts of Middle Tennessee may only have one or two carriers. Carrier availability varies significantly by county, so check your specific ZIP code.

Key cities

Nashville

The most competitive market in the state. BCBS, Ambetter, Oscar, and Cigna all offer plans in Davidson County. Vanderbilt University Medical Center is a key network consideration. BCBS plans generally include Vanderbilt; check other carriers carefully.

Memphis

BCBS, Ambetter, Oscar, and Molina compete in Shelby County. Methodist Le Bonheur and Baptist Memorial are the major hospital systems. Plan options are decent, though not as broad as Nashville.

Knoxville

BCBS is the primary carrier in Knox County, with Ambetter as an alternative. UT Medical Center and Covenant Health are the big systems. Fewer options than Nashville or Memphis.

Chattanooga

Limited carrier options, typically BCBS and one other. CHI Memorial and Erlanger are the main hospitals.

Estimate your subsidy

Resources

• HealthCare.gov for marketplace enrollment
• TennCare for Medicaid eligibility and enrollment
• Tennessee Justice Center for free enrollment assistance
• Community health centers: find one at findahealthcenter.hrsa.gov