Farm Bureau Health Plans in Tennessee and Indiana: How They Compare
Farm Bureau health plans in Tennessee and Indiana are medically underwritten, non-ACA-compliant benefit plans available to Farm Bureau members that typically cost 25% to 50% less than unsubsidized ACA Marketplace plans, but they can deny applicants based on health history, apply pre-existing condition waiting periods, and do not have to cover the ACA’s ten essential health benefits.
These plans are among the most discussed and least carefully explained alternatives to ACA insurance in either state. Tennessee’s version has operated continuously since 1947, making it the oldest ongoing alternative to regulated health insurance in the country. Indiana’s version launched in 2020 and has already enrolled more than 11,000 Hoosiers, growing rapidly as ACA premiums increased. Both plans now operate in a 2026 environment where unsubsidized ACA premiums have risen sharply, making the cost difference between a Farm Bureau plan and a full-price ACA plan larger than at any previous point. This post explains how each plan works, how they differ from each other and from ACA insurance, and who they actually fit.
What is a Farm Bureau health plan, and how is it different from insurance?
A Farm Bureau health plan is a benefit plan offered through a state Farm Bureau, a membership organization that advocates for agricultural and rural interests. In most states that permit them, anyone can join the Farm Bureau for an annual membership fee of $25 to $50, with no requirement to be a farmer or have any connection to agriculture, according to KFF Health News’ April 2026 analysis of Farm Bureau plans. Membership opens the option to apply for the Farm Bureau’s health benefit plan.
The critical distinction is regulatory: Farm Bureau health plans are not classified as insurance in the states that permit them. In Tennessee, the plan is regulated as a “not-for-profit membership services organization” under a state law passed in 1993, which exempts it from state insurance laws and, by extension, ACA requirements, according to the Georgetown Center on Health Insurance Reforms’ foundational policy analysis. The SHADAC analysis of individual market alternatives confirms the same classification: “Tennessee’s Farm Bureau Health Plans are regulated by the state as a ‘not-for-profit membership organization’ and are explicitly considered ‘not insurance.'”
This classification is what allows Farm Bureau plans to use medical underwriting, a practice ACA-compliant insurers are prohibited from using in the individual market. Applicants are screened for health history before enrollment, and applicants with certain pre-existing conditions may be denied coverage or offered coverage with exclusions or waiting periods.
What has Tennessee Farm Bureau Health Plans offered since 1947?
Tennessee Farm Bureau Health Plans has operated continuously since 1947, making it the oldest and largest state Farm Bureau health benefit operation in the country. Today it administers plans in 10 of the 14 states that permit Farm Bureau health coverage, according to KFF Health News, and approximately 73,000 Tennesseans are enrolled in its individual plans, according to SHADAC’s analysis.
The plan is medically underwritten at application, with a six- to twelve-month pre-existing condition waiting period and a nine-month maternity waiting period for multi-person family plans. Maternity benefits are not available under single coverage plans, according to SHADAC. Despite the underwriting at application, Jason Beard, general counsel and chief compliance officer at Tennessee Farm Bureau Health Plans, confirmed directly to KFF Health News that once a member is enrolled, they cannot be dropped or charged a higher rate based on individual health experience: “We do not contractually have the right to raise premiums or cancel plans based on [an individual’s] health experience.” This is a meaningful distinction from short-term health plans, which can cancel coverage or exclude conditions that develop after enrollment.
Plan benefits look structurally similar to traditional health insurance, with deductibles, copayments, and a broad provider network. The plans do not have to meet ACA essential health benefit requirements, so coverage of services like mental health, substance use treatment, and preventive care may differ from ACA-compliant plans. Year-round enrollment is available, with no annual open enrollment window required, which is one of the most practical advantages for anyone between jobs or who missed the Marketplace enrollment period.
What has Indiana Farm Bureau Health Plans offered since 2020?
Indiana Farm Bureau Health Plans is a newer entrant, founded in 2020 specifically to address the cost concerns of Indiana’s self-employed and agricultural community that had been squeezed by rising ACA premiums, according to Indiana Farm Bureau’s announcement of the program. As of October 2025, INFB Health Plans had enrolled more than 7,800 plans covering more than 11,000 Hoosiers, according to the same announcement, which noted the plans provide average savings of 25% to 50% compared to unsubsidized ACA Marketplace plans.
Indiana’s program has a distinctive structural feature that sets it apart from Tennessee’s: the plans are backed by UnitedHealthcare. According to INFB Health Plans’ own website, Indiana Farm Bureau has partnered with United Health Services (UMR) as a third-party administrator, and the traditional health plans utilize the UnitedHealthcare Choice Plus network of providers, one of the broadest commercial provider networks in the country. Coverage is statewide and portable anywhere a member lives in Indiana with no defined service area.
Indiana’s plans include several options: the Classic Choice plan (individual only, with preventive health, dental and vision benefits), the Advanced Choice plan (individual or family, with limited dental and vision and two deductible options), a Major Medical plan (lower premium, catastrophic protection with physician, hospital, and prescription coverage), and several High-Deductible Health Plan (HDHP) options that meet federal requirements to pair with a Health Savings Account. The HDHP option is notable because it allows Indiana Farm Bureau members to pair their plan with an HSA, a benefit not available on most non-ACA alternative plans.
Membership is required before applying, and individuals must be members for at least 30 days before applying for a traditional health or dental/vision plan, according to INFB Health Plans. The annual Indiana Farm Bureau membership costs approximately $50 and is open to anyone, not just farmers, according to Washington Post reporting on the growth of state Farm Bureau plans.
How do the two plans compare directly?
Tennessee and Indiana Farm Bureau plans share the same fundamental regulatory structure (non-insurance benefit plans exempt from ACA requirements) and the same core trade-off (lower premiums through medical underwriting). But they differ in meaningful ways that matter to prospective members.
| Feature | Tennessee Farm Bureau | Indiana Farm Bureau |
|---|---|---|
| Founded | 1947 | 2020 |
| Current enrollment | ~73,000 individuals | ~11,000+ (7,800+ plans) |
| Provider network | Broad statewide network | UnitedHealthcare Choice Plus (nationwide) |
| Plans administered by | Tennessee Farm Bureau Health Plans | INFB Health Plans / UMR (UnitedHealthcare) |
| States administered | 10 of 14 Farm Bureau plan states | Indiana only |
| HSA-eligible option | Not confirmed | Yes (HDHP options available) |
| Maternity (single coverage) | Not available | Check individual plan documents |
| Pre-existing condition | 6-12 month waiting period | Individually rated at application |
| Enrollment | Year-round | Year-round (30-day membership wait) |
| ACA-compliant | No | No |
| Minimum essential coverage | No | No |
| Membership fee | ~$25/year | ~$50/year |
Source: SHADAC, INFB Health Plans, KFF Health News, Georgetown CHIR. Details subject to change; always verify directly with the organization before enrolling.
Who do Farm Bureau plans actually fit?
KFF Health News’ April 2026 investigation is direct about what the plans do and don’t work for. According to that reporting, approximately nine out of ten applicants in Tennessee receive coverage, which means roughly one in ten is denied based on health history. The population that cannot get a Farm Bureau plan is the same population that most needs guaranteed-issue ACA coverage: people with significant pre-existing conditions, active health needs, or conditions that would be applied a waiting period or exclusion.
For a healthy individual or family above the ACA subsidy cliff who cannot get a meaningful premium tax credit and is paying full, unsubsidized price for ACA coverage, a Farm Bureau plan warrants a genuine side-by-side comparison. The 25% to 50% savings Indiana Farm Bureau cites for unsubsidized buyers reflects a real cost difference, not a marketing claim, and the UnitedHealthcare Choice Plus network behind Indiana’s plans provides a level of provider access that is comparable to many ACA plans rather than a bare-bones coverage product.
Farm Bureau plans are a poor fit for anyone who has a pre-existing condition that would result in denial or exclusion, anyone who needs guaranteed maternity coverage from day one, anyone who expects to need mental health or substance use treatment (since these are not required benefits), and anyone who qualifies for a meaningful ACA subsidy below 400% FPL, since the subsidy makes the ACA option more competitive than any unsubsidized alternative.
What are the most important things to know before applying?
The most important thing is to read the actual plan document before applying, not just the enrollment website. The plan document specifies exactly which conditions result in denial, which trigger waiting periods, and which benefits are excluded. According to Anna Howard of the American Cancer Society Cancer Action Network, quoted in KFF Health News, the plans “can be really confusing to people because the plans look like insurance products, but they don’t have the same protections.” That confusion operates in both directions: people sometimes assume they have less protection than they do (the no-drop-after-enrollment provision is real) and sometimes assume more (the pre-enrollment underwriting is also real).
Second, confirm that your existing providers are in the network. Indiana’s UnitedHealthcare Choice Plus network is broad and can often be verified directly on United’s provider directory. Tennessee’s network should be confirmed specific to your county before enrolling.
Third, understand how the plan interacts with the ACA Marketplace. A Farm Bureau plan does not count as minimum essential coverage and does not satisfy any federal coverage requirement. Leaving a Farm Bureau plan does not generally trigger an ACA Marketplace Special Enrollment Period, since Farm Bureau plans are not qualifying coverage under ACA rules. If you join a Farm Bureau plan and later want to return to ACA coverage, you will generally need to wait for open enrollment (November 1 through December 15) unless a separate qualifying life event occurs in the interim.
Frequently Asked Questions
Do you have to be a farmer to join the Tennessee or Indiana Farm Bureau? No. In both states, Farm Bureau membership is open to anyone. Tennessee Farm Bureau annual membership costs approximately $25, and Indiana Farm Bureau membership costs approximately $50. Neither state requires any connection to farming or agriculture to join, and membership is the only prerequisite for applying for the health benefit plan.
Can a Farm Bureau plan deny me coverage because of a pre-existing condition? Yes, at the time of application. Both Tennessee and Indiana Farm Bureau plans use medical underwriting, meaning your health history is reviewed before enrollment. Applicants with certain conditions may be denied coverage entirely or offered coverage with waiting periods or exclusions for specific conditions. According to INFB’s own FAQ, approximately nine out of ten Tennessee applicants receive coverage, meaning approximately one in ten is denied.
Once I’m enrolled, can the Farm Bureau cancel my coverage or raise my rates because I get sick? According to Jason Beard, Tennessee Farm Bureau Health Plans’ general counsel, quoted directly in KFF Health News: “We do not contractually have the right to raise premiums or cancel plans based on [an individual’s] health experience.” This protection applies in Tennessee and the nine other states where Tennessee administers the plans, including Indiana. This is a meaningful protection that distinguishes Farm Bureau plans from short-term health insurance, which can cancel coverage mid-term for conditions that develop after enrollment.
Does a Farm Bureau plan count as minimum essential coverage? No. Farm Bureau health plans in both Tennessee and Indiana are explicitly classified as not insurance and do not qualify as minimum essential coverage under federal law. This means the plans do not satisfy any federal coverage requirement, and members who have no other qualifying coverage may be subject to state individual mandate penalties where applicable. It also means Farm Bureau plan members are not eligible for ACA Marketplace Special Enrollment Periods based solely on their Farm Bureau membership.
Can I use an HSA with a Farm Bureau plan? In Indiana, yes, if you select one of the HDHP options that INFB Health Plans specifically identifies as meeting federal requirements for HSA pairing. The availability of an HSA-eligible option is one of Indiana’s distinctive advantages over most non-ACA alternatives. In Tennessee, HSA pairing depends on the specific plan selected and should be confirmed with the plan administrator before opening or contributing to an HSA alongside Farm Bureau coverage.
What happens to my Farm Bureau coverage if I develop a serious illness while enrolled? Based on Jason Beard’s confirmed statement to KFF Health News, you cannot be dropped or charged a higher individual rate based on health experience once enrolled. However, benefits for a serious illness will be subject to the plan’s specific coverage terms, any applicable waiting periods that were applied at enrollment, and any condition exclusions that were specified in your plan document. A condition excluded at enrollment may not be covered even after it becomes a serious medical need, which is why reviewing the plan document before applying, not after a diagnosis, is essential.
This article is for general informational purposes only and is not insurance, legal, or financial advice. Farm Bureau health plan details, benefits, network access, and eligibility rules described here are based on publicly available sources including KFF Health News, SHADAC, the Georgetown Center on Health Insurance Reforms, Indiana Farm Bureau’s official announcements, and INFB Health Plans’ published plan information, current as of 2026. Always request and review the specific plan document and confirm provider network access directly with the Tennessee Farm Bureau Health Plans or Indiana Farm Bureau Health Plans before enrolling. ACA-compliant coverage remains available through HealthCare.gov.
By the Modern Healthcare Works team