Information about Medicare Advantage Plans in Tennessee

Quick links:

• Average 2019 Costs
• Eligibility & Enrollment
• Finding Top-Rated Plans
• List of Plans Available
  • Plans by Carrier
  • Plans by County
  • Plans by Type
• Local Resources

38 percent of Medicare beneficiaries in Tennessee were enrolled in a Medicare Advantage (Medicare Part C) plan in 2019.¹

There are 1,485 different Tennessee Medicare Advantage plans in 2019.¹ Plan availability can vary from one county to another, so be sure to find out which plans are offered where you live.

Call to speak with a licensed insurance agent who can help you compare Medicare Advantage plans in your area of Tennessee.

You can also learn more about other types of Medicare plans:

• Tennessee Medicare Supplement Plans
• Tennessee Medicare Part D Plans

Average costs of Medicare Advantage in Tennessee

Tennessee had relatively low Medicare Advantage premium costs in 2019, with the average premium being $7 per month.

There were 749 available plans in Tennessee that featured $0 monthly premiums in 2019.

• Average monthly premium cost in 2019 (weighted): $7
• Average in-network out-of-pocket spending limit: $5,764
• Average deductible in 2019 (weighted): $75.80¹

The premiums, deductibles and out-of-pocket costs can vary depending on where you live and the plan you have.

Further below in this guide, we detail the average premiums and enrollment information for Tennessee Medicare Advantage plans in 2019 listed by county.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

TN Medicare Eligibility & Enrollment

Enrolling in a Medicare Advantage plan in the state of Tennessee requires first belonging to Original Medicare (Part A and Part B).

In order to sign up for Original Medicare at age 65, you must meet the following requirements:

• You must be a U.S. citizen or permanent legal resident who has lived in the U.S. for five continuous years.
  
  
• You or your spouse must have worked long enough to be eligible for Social Security or Railroad Retirement benefits.
  
  
• You or your spouse must be government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

You may also be eligible to enroll in Medicare before age 65 if:

• You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.
  
  
• You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).
  
  
• You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

If you have ESRD, you may be able to enroll in a Tennessee Medicare Special Needs Plan (SNP) that is specifically designed to help meet your health care needs.

How to sign up for a Medicare Advantage Plan in Tennessee

The first time you may be able to enroll in a Tennessee Medicare Part C plan is during your Medicare Initial Enrollment Period (IEP).

Your Medicare IEP begins three months before your 65th birthday, includes the month of your birthday and continues on for three more months.

If you do not enroll during this time, you may have to wait for one of the following Medicare enrollment periods:

Medicare Advantage Open Enrollment Period: January 1 – March 31

You can switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare during this period, which lasts from Jan. 1 to March 31 each year.

You can join a Medicare standalone prescription drug plan (Medicare Part D) during this period if you disenroll from a Medicare Advantage plan to return to Original Medicare.

Medicare Annual Enrollment Period (AEP): October 15 – December 7

You can enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another during Medicare AEP.

You may also drop your existing Medicare Advantage plan and return to Original Medicare.

You can also join, leave or make changes to a Medicare Part D plan during AEP.

Medicare Special Enrollment Periods (SEP)

If you qualify for a Medicare Special Enrollment Period (SEP), you may potentially be able to make switch Medicare Advantage plans or sign up for a Medicare Advantage plan.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Top-rated Medicare Advantage Plans in Tennessee 2020

The Centers for Medicare & Medicaid Services (CMS) publishes star ratings for all Medicare Advantage plans each year, using system of one to five stars to rate how plans perform across a range of metrics.²

A Medicare Advantage plan must have four or more stars out of five stars to be considered a top-rated plan.

There are 1,053 top-rated 2019 Medicare Advantage plans in Tennessee that are rated four stars or higher. That equals 83 percent of all MA plans in Tennessee in 2019.

Medicare Advantage plans are rated in the following five categories:

• Preventive care and health maintenance (screenings, tests, vaccines, etc.)
• Management of chronic conditions
• Member experiences and ratings of the plan
• Member complaints, problems receiving services and member retention
• Customer service

The information for the star ratings is gathered from information that is submitted to Medicare, Medicare’s regular monitoring activities and member surveys.

List of Medicare Advantage Plans Available in Tennessee in 2020

To view a list of plans offered in your area of Tennessee, use our plan comparison tool.

Or call 1-800-557-6059 1-800-557-6059 TTY Users: 711 24/7 to speak with a licensed insurance agent.

Private insurance companies offer Medicare Advantage plans in Tennessee

Several companies may offer Medicare Advantage plans in Tennessee, but your selection of plan carriers may depend on where you live.

Private insurance companies may offer Medicare Advantage plans are be unique to the plan area they serve.

You may find the following information to be helpful as you’re shopping for Medicare Advantage plans in Tennessee:

• The Medicare Star Ratings can give you an idea of a plan’s overall quality.
  
  
• Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.
  
  
• Websites such as the Better Business Bureau and Consumer Reports can teach you about a company’s reputation among its customers.
  
  
• You can read through Medicare Advantage plan reviews and testimonials from customers.

You can also call to speak with a licensed insurance agent who can help you compare the Medicare Advantage plans that are sold by insurance companies in your area.

Tennessee Medicare Advantage plans by county

The chart below provides some more information about 2019 Tennessee Medicare Advantage plans by county.¹

• Bradley County, Sequatchie County and Hamilton County had the most top-rated Medicare Advantage plans in 2019, each with 16 plans that were rated four stars or higher.
  
  
• Davidson County and Williamson County each had 14 $0 premium plans available in 2019, which was the most of any county in Tennessee.

TN Medicare Advantage enrollees by plan type

The chart below illustrates the percentage of 2019 Tennessee Medicare Advantage enrollees that are enrolled in each primary type of Medicare Advantage plan.¹

The major types of Medicare Advantage plans include:

• HMO
  With a Health Maintenance Organization (HMO) you're typically required to get a referral from your primary care physician (PCP) in order to visit a specialist.
  
  You are also typically required to seek medical care from providers, hospitals and pharmacies that are in your plan network.
  
  
• PPO
  If you have a Medicare Preferred Provider Organization (PPO) plan, you may be able to see providers outside of your plan’s network, though it's often at a higher cost.
  
  You will typically pay less out of pocket if you visit in-network providers and facilities.
  
  PPO plans typically do not require you to get a referral before visiting with a specialist.
  
  
• PFFS
  A Private Fee-For-Service (PFFS) plan determines how much you will pay for approved services at the point of receiving care.
  
  With a PFFS plan, you can typically receive care from any doctor, hospital or health care provider that accepts both Medicare and your plan terms. Not all providers will accept your plan terms.
  
  
• SNP
  A Special Needs Plan (SNP) is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics, such as being dual eligible for Medicare and Medicaid.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2019 Tennessee Medicare Advantage plans that are available where you live.

Local health insurance resources in Tennessee

• Tennessee’s State Health Insurance Assistance Program is part of the nationwide SHIP program offering free benefits counseling to Medicare beneficiaries.
  
  Tennessee’s SHIP aims to help the state’s seniors better understand and utilize their Medicare coverage. The program may be reached at 877-801-0044.  
  
  
• You can also explore more information about the insurance industry in Tennessee by visiting the state’s Department of Insurance website.
  
  
• Tennessee Prescription Drug Assistance Programs
  The state of Tennessee has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.