For people over age 65 and adults with disabilities or certain health conditions, Medicare in Tennessee can provide comprehensive health insurance coverage.
By considering the options available, you can get the health coverage — from original Medicare to Medicare Advantage plans — that works best for you in 2020.
You have several options for Medicare in Tennessee. Depending on your needs, you may choose original Medicare with or without additional supplements, such as drug coverage (part D) or Medicare Advantage (Part C) plans.
Most people are automatically enrolled in original Medicare once they turn 65 years old. Original Medicare is provided through the federal government and is made up of Part A and Part B. It provides coverage for all your basic healthcare needs, including:
- Hospital care. Part A covers inpatient hospital care, short-term nursing facility care, and home health care.
- Medical care. Part B covers annual physical examination, lab tests like blood work or X-rays, equipment like wheelchairs or walkers, and emergency ambulance services.
If you have original Medicare, you can also purchase supplemental drug coverage, also known as Part D. Part D can help reduce your out-of-pocket expenses for medications.
If you’d like more coverage or to bundle all your coverage into one plan, you may decide to purchase a Medicare Advantage (Part C) plan instead. These are insurance plans bought from private health insurance carriers.
Part C plans provide all the basic coverage offered by original Medicare Tennessee, as well as drug coverage. Some plans will also offer more extensive coverage, including services such as hearing tests, dental care, or even wellness programs.
Finally, Medicare special needs plans provide comprehensive coverage for adults with disabilities or chronic health conditions, such as end stage renal disease, chronic lung disorders, or autoimmune disorders.
Medicare Advantage and Medicare Part D prescription drug plans are subject to change every year. Updated plan information for 2021 should become available on October 1, in advance of Medicare’s Annual Election Period beginning October 15. Healthline.com will provide updated 2021 plan information once it is announced by the Centers for Medicare & Medicaid Services (CMS).
Medicare Advantage plans in Tennessee are offered by private health insurance carriers that vary by county. The following providers offer Medicare Advantage plans in Tennessee:
- BlueCross BlueShield of Tennessee
- Cariten Health Plan
- HealthSpring Life and Health Insurance
- Volunteer State Health Plan
- Sierra Health and Life
- Harmony Health Plan
- Highmark Senior Health
- NHC Advantage
- American Health Plan
- United Mine Workers of America
- Alexian Brothers Community Services
Each of these carriers offers several plans with varying premiums and coverage options that work with a different network of doctors and pharmacies.
When searching for plans, use your ZIP code to make sure the plans you’re comparing are all available in your county.
To be eligible for Medicare in Tennessee, you must be:
- a resident of Tennessee
- a U.S. citizen or permanent resident
- over age 65, or have a disability or chronic illness
You’ll automatically be enrolled in original Medicare Tennessee when you turn 65 years old if you’re receiving benefits from the Social Security Administration or the Railroad Retirement Board.
If you paid Medicare taxes while you were employed, you most likely qualify to get Part A coverage without any monthly premiums. Keep in mind, though, that premium payments will still likely be required for Part B, Part D, and Advantage plans.
There are two annual enrollment periods for Medicare plans in Tennessee: general enrollment and open enrollment.
The Medicare general enrollment period is from January 1 through March 31. The Medicare open enrollment period stretches from October 15 through December 7. During both, you can enroll in original Medicare in Tennessee, add drug coverage, or even switch to an Advantage plan.
Around the time of your 65th birthday, you’ll become eligible and can enroll in Medicare Tennessee. This initial enrollment period starts 3 months before your birth month and ends 3 months after, giving you time to research coverage options and find a plan that matches your needs.
If you chose not to access Medicare when you turned 65 years old because you still had employer insurance, you will qualify for a special enrollment period. This period will begin when you lose employer coverage.
You’ll also qualify for special enrollment if you’ve recently been diagnosed with a chronic disability or illness.
With so many options to choose from, finding the right plan will take some time and research. When choosing from among original Medicare, Medicare Advantage, or Medicare supplement (Medigap) plans, think about each of the following:
- Coverage needs. When comparing plans, stay focused on your coverage needs. Make a list of all the health services you access, such as home healthcare, doctor’s visits, hospital care, or hearing screenings. Then, make a list of additional services you’d like, such as dental coverage or transportation assistance. Look for plans that match your healthcare needs and provide adequate coverage.
- Preferred physician. Are you happy with the care provided by your preferred physician? Medicare Advantage plans in Tennessee work only with network-approved doctors, so call your physician to find out which insurance carriers they accept.
- Medications. One of the biggest out-of-pocket expenses you have is for prescription medications. If you’re planning to enroll in original Medicare, adding Part D could help reduce some of your medication costs. If you’re planning to enroll in an Advantage plan, read about the drug coverage offered and make sure your prescriptions will be covered.
- Star rating. If you haven’t been able to narrow down your search based on the considerations above, you can consult the CMS star ratings. This system ranks Medicare plans on a scale from 1 to 5. Plans that score a 4 or 5 provide quality care and excellent support to insured members.
For more information about Medicare Tennessee, including original Medicare, drug coverage, or Medicare Advantage plans, you can contact the following organizations:
- Medicare. You can contact Medicare directly at 800-633-4227 or online to ask about coverage, specific plans, or assistance with enrolling in Medicare.
- Tennessee SHIP. The State Health Insurance Assistance Program (SHIP) can be reached at 877-801-0044 and provides free, confidential Medicare information and counseling. They can also provide resources on preventing Medicare fraud.
- Tennessee Commission on Aging & Disability. The Commission on Aging & Disability, at 615-741-2056, provides information about Medicare, the SHIP program, stopping elder abuse, and long-term care concerns.
If you’re considering Medicare Advantage, once you’ve settled on your top three to five plans, carefully compare them:
- Determine which plan provides the best coverage for lowering your out-of-pocket costs and makes it easy for you to access quality care.
- Determine which plan has the best premiums for the coverage being offered.
- Call SHIP for advice, or call the Advantage plan providers directly to start the application process.
Original Medicare provides basic coverage, and Medicare Advantage plans in Tennessee offer additional coverage to meet your healthcare needs. Whether you rely on original Medicare with supplemental drug coverage or opt for a comprehensive Advantage plan, Medicare Tennessee gives you many coverage options.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.