Tennessee health insurance questions, answered.
Answers from licensed agents about buying your own coverage in Tennessee, organized by topic.
Getting started
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Open enrollment on HealthCare.gov runs from November 1, 2026 to January 15, 2027. To have coverage start January 1, 2027, you need to enroll by December 15, 2026. Outside that window you need a qualifying life event, such as losing other coverage.
No. Tennessee uses the federal marketplace, HealthCare.gov. You can apply there yourself, by phone at 1-800-318-2596, or with help from a licensed agent.
Yes, if your household income is between 100% and 400% of the federal poverty level. The enhanced credits that removed the upper income limit expired after 2025, so above 400% you pay full price. Tennessee does not add its own state subsidy.
Leaving a job
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Possibly. Federal COBRA covers employers with 20 or more workers, but Tennessee's continuation law covers insured group plans of any size. It lets you keep coverage for the rest of the month it ends plus 3 more months, if you were covered for at least 3 months and pay the full premium in advance.
Often, especially if your income dropped. COBRA charges the full group premium plus up to 2%, while marketplace tax credits are based on your expected income for the year. Losing job coverage gives you 60 days to enroll on HealthCare.gov.
Only if you fit a covered group, such as a parent of a minor child, a pregnant woman or a person with a disability. Tennessee has not expanded Medicaid, so most adults without children do not qualify at any income.
Early retirement
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For most people it is a marketplace plan bought through HealthCare.gov. Retiring and losing job coverage opens a special enrollment period. Your premium help depends on your household income, so plan withdrawals and other income with that in mind.
In 2026 you lose all premium tax credits once household income passes 400% of the federal poverty level. KFF found that people just above that line made up a large share of the drop in 2026 sign-ups. Keeping income under the line can save thousands of dollars a year.
Usually not, unless you have a disability or a minor child at home. Tennessee is one of the states that has not expanded Medicaid. If your income falls below the poverty line, you may also lose marketplace credits, so plan to report at least 100% of the poverty level.
Self-employed
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Use your expected net self-employment income for the year plus any other household income. If your income ends up higher than you estimated, you may have to pay back some of the credit at tax time. You can update your estimate on HealthCare.gov during the year.
No. Tennessee does not have its own individual mandate, so there is no state tax penalty for going without coverage. The bigger risk is being uninsured when you need care.
They can be cheaper if you are healthy and pass their health questions. They are not ACA plans, so you can be declined or face limits for pre-existing conditions. Compare them with a marketplace plan, especially if you qualify for a tax credit.
Short-term plans
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Tennessee follows federal rules. The federal agencies said in August 2025 they would not prioritize enforcing the 4-month cap from 2024, and insurers here now offer plans from 6 months up to 36 months including renewals.
Usually not. Short-term plans can ask health questions, decline you, and exclude conditions you already have. They also do not have to cover all essential health benefits.
First check whether you qualify for a special enrollment period, such as after losing job coverage. If you do, an ACA plan protects you better. A short-term plan is mainly for healthy people with a short gap.
Non-ACA options
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It is a long-standing Tennessee option sold to Farm Bureau members. Under a 1993 state law, its underwritten plans are treated as a membership organization product rather than insurance, so they do not follow ACA rules and require health screening.
Yes. A Tennessee law enacted in 2024 says sharing ministries are not subject to the state insurance code. They are not insurance and do not guarantee payment of your bills.
Yes. Farm Bureau's underwritten plans screen applicants for health conditions, and sharing ministries often limit sharing for pre-existing conditions. Marketplace plans cannot deny you or charge more because of your health.
Insurers
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Six: BlueCross BlueShield of Tennessee, Cigna, Ambetter (Celtic), Oscar, UnitedHealthcare and Alliant Health Plans. Not every insurer sells in every county, so your choices depend on where you live.
Cigna is leaving the ACA individual market after 2026, so your plan ends December 31, 2026. Pick a new plan during open enrollment, by December 15 for January 1 coverage. If you do nothing, the marketplace may move you into another plan that could cost more or use different doctors.
Full-price premiums rose an average of 37.5% for 2026, according to healthinsurance.org's summary of rate filings. KFF puts the 2026 benchmark Silver premium for a 40-year-old at $711 a month before subsidies, up from $516 in 2025. Insurers proposed an average increase of about 12.7% for 2027.
Sources
Reviewed October 2026. Rules and prices change every year; a licensed agent will confirm what applies to you.
- HealthCare.gov: Dates and deadlines for 2027 health insurance
- healthinsurance.org: Tennessee ACA marketplace guide (updated September 2026)
- KFF: What we know so far about 2026 ACA marketplace enrollment, premiums and deductibles
- KFF: State-based efforts will provide limited relief from enhanced tax credit expiration
- KFF: How many uninsured are in the coverage gap
- KFF State Health Facts: Poor uninsured adults in the ACA coverage gap
- J.J. Keller: Continuation of benefits coverage (COBRA), Tennessee
- U.S. Department of Labor: COBRA continuation coverage
- HealthCare.gov: Special Enrollment Period
- U.S. Department of Labor: Statement on short-term, limited-duration insurance (August 7, 2025)
- healthinsurance.org: Short-term health insurance in Tennessee
- Tennessee General Assembly: SB 0862 / HB 1163 (health care sharing ministries)
- WKRN: Tennessee passes Healthcare Sharing Ministries Freedom to Share Act
- Georgetown CHIR: What's going on in Tennessee? (Farm Bureau Health Plans)
- Farm Bureau Health Plans: Plan options
- KFF State Health Facts: Marketplace average benchmark premiums
- HealthCare Insider: Cigna is leaving the ACA marketplace in 2027
See what you'd actually pay.
A licensed agent will compare plans from every insurer in your Tennessee county, check your subsidy, and walk you through the options. No cost, no obligation.