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 ($15,960 for a single person for 2027 coverage), 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 heading into 2027.
Marketplace costs in 2027
Tennessee marketplace premiums saw some of the largest increases in the country for 2026, when BlueCross BlueShield of Tennessee, the state's dominant carrier, raised rates by an average of 42%. Prices are up again for 2027. KFF puts Tennessee's average benchmark Silver premium for a 40-year-old at $796 a month for 2027, up from $711 in 2026 (about 12% higher).
The reason for the 2026 jump: 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 translate to higher premiums. The enhanced subsidies were not extended for 2027.
For subsidized enrollees under 400% FPL, the tax credit absorbs much of the increase. But there is no tax credit above 400% FPL (about $63,840 for a single person or $86,560 for a household of two), and for anyone above that cliff the sticker shock is real.
Open Enrollment for 2027 coverage runs from November 1, 2026, through January 15, 2027, on HealthCare.gov. Enroll by December 15 for coverage that starts January 1.
Carriers in Tennessee (2027)
Five insurers sell 2027 marketplace plans in Tennessee. Cigna left the marketplace for 2027, and Molina is not on the 2027 list.
- 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 for 2026, 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, Memphis, and Knoxville markets.
- UnitedHealthcare offers plans in the major metros, including Nashville, Memphis, Knoxville, and Chattanooga.
- Alliant Health Plans offers plans in parts of the state, including Hamilton County (Chattanooga).
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
One of the most competitive markets in the state. BCBS, Ambetter, Oscar, and UnitedHealthcare 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 UnitedHealthcare compete in Shelby County. Methodist Le Bonheur and Baptist Memorial are the major hospital systems.
Knoxville
BCBS is the primary carrier in Knox County. Ambetter, Oscar, and UnitedHealthcare also sell 2027 plans here. UT Medical Center and Covenant Health are the big systems.
Chattanooga
BCBS, Ambetter, UnitedHealthcare, and Alliant Health Plans sell 2027 plans in Hamilton County. CHI Memorial and Erlanger are the main hospitals.
Estimate your subsidy
Subsidy Estimator
Enter your info below to get a rough estimate of your monthly premium tax credit for a 2027 marketplace plan.
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