Individual health coverage · Tennessee · 2026
Health coverage options in Tennessee —
ACA plans, Health Shares, DPC, and more.
Tennessee uses the federal HealthCare.gov exchange for ACA enrollment. The 2026 benchmark premium for a 40-year-old is $711/month. Tennessee has not expanded Medicaid, creating a coverage gap for residents below 100% FPL. This page covers what each coverage type costs in Tennessee, who qualifies for subsidies, and where the real trade-offs are.
$711
2026 ACA benchmark premium — Tennessee has the highest of the 7 launch states
ACA plans in Tennessee
What ACA plans cost in Tennessee in 2026
Tennessee uses the federal exchange at HealthCare.gov — there is no state-run marketplace. For 2026, multiple insurers participate in the Tennessee marketplace through the federal HealthCare.gov exchange. Check healthcare.gov for current carrier availability in your county.
The 2026 benchmark silver premium for a 40-year-old in Tennessee is $711/month. For households below the 400% FPL subsidy cliff ($62,600 for a single adult), subsidies can significantly reduce this cost. Above the cliff, you pay the full amount.
| Annual income | % of FPL (single) | Full benchmark | Estimated subsidy | Your est. monthly cost |
|---|---|---|---|---|
| $20,000 | 128% FPL | $711/mo | ~$628/mo | ~$33/mo |
| $30,000 | 192% FPL | $711/mo | ~$511/mo | ~$150/mo |
| $40,000 | 256% FPL | $711/mo | ~$395/mo | ~$266/mo |
| $50,000 | 320% FPL | $711/mo | ~$286/mo | ~$375/mo |
| $62,600 | 400% FPL | $711/mo | ~$141/mo | ~$520/mo |
| $63,000+ | Above cliff | $711/mo | $0 | $711/mo |
Estimates for a single adult, age 40. Subsidy calculated using IRS Rev. Proc. 2025-25 applicable percentage table and 2025 HHS poverty guidelines. Actual subsidy depends on exact income, household size, and county. Source: KFF.org · IRS Rev. Proc. 2025-25. Use the comparison tool for your specific ZIP, age, and income.
Tennessee does not have Medicaid expansion
Tennessee has not expanded Medicaid (TennCare). Working-age adults without children generally do not qualify for TennCare regardless of income. Individuals below 100% FPL ($15,650/yr for a single adult) fall into the coverage gap — too low for ACA subsidies, ineligible for TennCare.
Tennessee ACA marketplace — key 2026 facts
Tennessee enrolls through HealthCare.gov only — no state exchange. 16 insurers for 2026 (Aetna exited; Harbor Health joined). HMO and EPO plans only — no PPO available on-exchange. Open enrollment: November 1 – January 15. Coverage begins January 1 for plans selected by December 15, February 1 for plans selected December 16–January 15. Source: healthinsurance.org Tennessee marketplace.
2026 Tennessee benchmark — key numbers
Benchmark premium — age 40, Tennessee
$711/mo
Premium increase vs 2025
Above national avg
Subsidy cliff — single adult
$62,600/yr
No-subsidy-zone below 100% FPL
$15,650/yr
No Medicaid expansion — TennCare limited to specific eligible groups. Source: KFF.org 2026
Subsidy cliff — Tennessee
A single adult earning $62,500 receives a subsidy — at $63,000 the subsidy drops to $0 and the full $711/mo applies. This sharp cliff is why residents above the threshold explore Health Shares and other alternatives. Use the comparison tool to see your numbers.
Alternatives to ACA plans in Tennessee
How Health Shares, DPC, and STM compare in Tennessee
| Coverage type | Typical monthly cost | What it covers | Key limitation | Enrollment |
|---|---|---|---|---|
| ACA plan (unsubsidized) | $711/mo (age 40) | Full ACA coverage — pre-existing, mental health, maternity | No PPO on-exchange · HMO/EPO only · high deductibles | Nov 1–Jan 15 |
| Health Share | $150–$350/mo est. | Major medical after Annual Unshared Amount | Not insurance · pre-existing often excluded · voluntary sharing | Year-round |
| DPC + Health Share | $230–$480/mo est. | Unlimited primary care (DPC) + major medical (Health Share) | Pre-existing often excluded · not regulated as insurance | Year-round |
| Direct primary care only | ~$92/mo avg | Unlimited primary care — no major medical | Must pair with other coverage for hospitalizations | Year-round |
| Short-term medical | $95–$165/mo est. | Major medical for temporary gap — 3–4 month terms | Pre-existing excluded · not MEC · terms limited | Year-round |
Why the Health Share + DPC combination is relevant in Tennessee
Tennessee’s $711 benchmark is the highest of the 7 states on this site. For self-employed Tennesseans above the subsidy cliff, the full benchmark represents over $8,500/year — making Health Share alternatives especially worth evaluating. For Tennessee residents above the 400% FPL subsidy cliff earning above $62,600/year, the gap between what unsubsidized ACA costs ($711/mo) and what a Health Share + DPC combination costs ($230–$480/mo) makes alternatives worth evaluating seriously. The combination does not replace ACA coverage for people with pre-existing conditions or subsidy eligibility — but for healthy residents above the cliff, it is a financially compelling option.
Short-term medical in Tennessee
Yes. Short-term medical insurance is available in Tennessee. Tennessee defaults to federal rules for STM duration. Following the August 2025 federal enforcement suspension, insurers began offering longer-duration plans again — as of early 2026, at least 6 insurers offer STM in Tennessee with maximum total durations ranging from 6 months to 36 months depending on carrier and plan. Tennessee does not impose additional state-level duration restrictions beyond the federal framework. STM excludes pre-existing conditions and does not count as ACA minimum essential coverage. Source: healthinsurance.org Tennessee STM tracker.
Initial term allowed
up to 364 days (federal default)
Maximum total duration
6 to 36 months depending on carrier
ACA marketplace — 2026 carrier & plan guide
Tennessee marketplace carriers, plans, and pricing
The table below shows every carrier offering ACA marketplace plans in Tennessee for 2026, what metal tiers they offer, their network type, and estimated starting premium for a 40-year-old before subsidy. Availability varies by county — verify at healthcare.gov for your specific ZIP code.
Carriers — 2025
7
marketplace insurers
Carriers — 2026
6
▼ 1 fewer than 2025
National average
9.0
insurers per state 2026
2026 notable changes: Aetna exited. 6 carriers. Cigna ⚠ exiting after 2026. TN has the highest benchmark of our 9 states. Source: KFF — Insurer Participation 2026.
Premiums are estimates for a 40-year-old non-smoker before any subsidy. ⚠ carriers are participating in 2026 but have announced exit after the 2026 plan year — 2027 coverage will need to be selected from remaining carriers. Carrier count and county availability vary. Always verify at healthcare.gov for your ZIP code.
See your exact costs for Tennessee — enter your income and ZIP
The comparison tool calculates your ACA subsidy, benchmark premium, and how alternatives compare — for your specific age, income, and Texas ZIP code.
Tennessee health coverage — common questions
Individual health coverage in Tennessee — questions people ask most
Does Tennessee have its own health insurance marketplace?
No. Tennessee uses the federal exchange at HealthCare.gov — there is no state-run marketplace. Texas is one of the largest states to rely entirely on the federal exchange. The Texas Department of Insurance regulates carrier rates and network adequacy, but enrollment runs through CMS-operated HealthCare.gov. 16 insurers participate in the Texas marketplace for 2026, offering HMO and EPO plans only — no PPO plans are available on-exchange.
What is the 2026 ACA benchmark premium in Tennessee?
The 2026 benchmark silver premium for a 40-year-old in Tennessee is $711/month. Premiums are age-rated: younger adults pay less, older adults pay more. For a 60-year-old, the benchmark premium is significantly higher. If your household income is between $15,650 and $62,600 (100%–400% FPL for a single adult), you likely qualify for a premium tax credit that reduces this cost. Use the comparison tool to calculate your specific subsidy. Source: KFF.org 2026.
Does Tennessee have Medicaid expansion?
No. Tennessee has not expanded Medicaid under the ACA. Tennessee has not expanded Medicaid (TennCare). Working-age adults without children generally do not qualify for TennCare regardless of income. Individuals below 100% FPL ($15,650/yr for a single adult) fall into the coverage gap — too low for ACA subsidies, ineligible for TennCare.
Are Health Shares available in Tennessee?
Yes. Health Shares are available to Tennessee residents year-round with no open enrollment requirement. Health Shares are not insurance and are not regulated by the state Department of Insurance — they operate under contract law and are subject to the state Attorney General’s oversight. Pre-existing conditions are typically excluded or subject to waiting periods. See the Health Shares guide for a full explanation.
What are the best health coverage options for self-employed Tennessee residents?
It depends on your income. If your projected MAGI is between $15,650 and $62,600 (single adult, 2026), an ACA plan with a subsidy is almost always the most cost-effective option. If your income exceeds $62,600, you face the full $711/month benchmark premium with no assistance. At that income level, a Health Share paired with a DPC membership is a common alternative — total monthly cost typically $230–$480/month. Note that self-employed residents can deduct health insurance premiums — ACA premiums and Health Share contributions have different tax treatment. Consult a CPA for your specific situation.
Is short-term health insurance available in Tennessee?
Tennessee defaults to federal STM rules. Following the August 2025 federal enforcement suspension, at least 6 insurers offer plans in Tennessee with maximum total durations ranging from 6 to 36 months depending on the carrier and plan. STM excludes pre-existing conditions, does not satisfy ACA minimum essential coverage, and losing it does not trigger an ACA SEP. See the short-term medical guide.