Non-ACA Health Insurance Options in Tennessee (2026)
Not everyone in Tennessee is best served by a Marketplace plan. Here are the non-ACA options available here, with an honest look at what they do and don’t cover.
Non-ACA options in Tennessee
Tennessee has a long-running non-ACA option: Farm Bureau Health Plans. Under a 1993 state law, its underwritten plans are treated as a membership organization product rather than insurance, so they skip ACA rules. You must join the Farm Bureau and answer health questions, and you can be declined or charged more for health conditions.
Health care sharing ministries are also active here. A 2024 Tennessee law says they are not subject to the state insurance code. Members share medical bills based on shared religious or ethical beliefs, but there is no guarantee a bill will be paid, and many limit sharing for pre-existing conditions.
The trade-off is the same for both: lower prices for people who pass health screening, but fewer protections if you get sick. If you qualify for a marketplace tax credit, an ACA plan may cost less than you expect and covers pre-existing conditions.
Health care sharing ministries
Tennessee passed a health care sharing ministry safe harbor law (enacted in 2024), which says these ministries are not subject to the state insurance code. Sharing ministries are not insurance, and they do not guarantee that your medical bills will be paid.
Farm Bureau health plans
Farm Bureau Health Plans has sold coverage in Tennessee for decades, and under a 1993 state law its underwritten plans are treated as a membership organization product rather than insurance, so they do not have to follow the ACA's rules. Applicants must join the Farm Bureau and answer health questions, and people with health conditions can be turned down or charged more.
Other options
Farm Bureau's current lineup for people under 65 includes plans such as Core Choice, Enhanced Choice, high-deductible, major medical and short-term options, and the plan materials should tell you whether a given plan is medically underwritten.
The trade-offs to understand
Health sharing programs are not insurance. Members share medical bills under the program’s guidelines, and payment isn’t guaranteed. Most limit or exclude pre-existing conditions for a period, and they don’t qualify for premium tax credits.
Fixed indemnity and similar plans pay set dollar amounts for specific events rather than covering your bills, so they work best as a supplement. Before choosing any non-ACA option, compare it against what you would actually pay for a Marketplace plan after subsidies.
Tennessee questions
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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.
Sources
Reviewed October 2026. Rules and prices change every year; a licensed agent will confirm what applies to you.
