Last verified against primary sources on August 17, 2026.
Tennessee had the worst individual-market rate increase of any state I am
licensed in. The approved average for 2026 was +37.5% — nearly
three times Maryland’s. On top of that, the enhanced federal premium tax credits
expired on December 31, 2025, so the subsidy that was covering
part of your premium shrank or vanished in the same year the premium jumped.
Marketplace enrollment in Tennessee fell from 642,867 to 569,310
between 2025 and 2026 — about 73,500 people, an 11% drop. Six insurers offer
individual plans statewide.
Tennessee is also the only state I work in that did not expand
Medicaid, which creates a problem the other states do not have. That is
covered below, honestly, including the part where the answer is that I cannot help
you.
Before you read further — is this page even for you?
What I sell is likely a fit if:
- You are in reasonably good health
- You are self-employed, 1099, or between jobs with no employer plan
- Your income is high enough that you get little or no premium tax credit
- The unsubsidized marketplace premium is more than you can absorb
It is probably the wrong fit — and I will tell you so on
the first call — if:
- You qualify for a meaningful premium tax credit. Take the subsidy.
- You have a chronic or pre-existing condition. These plans are medically
underwritten and you can be declined or have that condition excluded. - You are pregnant or planning to be. Maternity is generally not covered.
- Your household income is below the federal poverty level. In
Tennessee this is the hardest case in the country, and there is a specific section
on it below.
The Tennessee coverage gap — read this before anything else
Tennessee did not expand Medicaid. Between
82,000 and 95,000 Tennesseans fall into what is called the
coverage gap: they earn too much to qualify for TennCare, and too little to
qualify for a marketplace premium tax credit, which generally starts at 100% of
the federal poverty level.
TennCare covers parents and caretaker relatives up to about 105% of the federal
poverty level, pregnant women and infants up to 200%, and children well above
that. Childless, non-disabled adults are generally ineligible at any
income.
If you are in that gap, I want to be direct with you: nothing I sell
solves your problem. A short-term plan is medically underwritten and still
costs money you do not have. What you should look for instead is a federally
qualified health center or community health center — they are required to charge
on a sliding scale based on your income, and there is likely one near you. Call
2-1-1 and ask.
That is not a sales page paragraph. It is the honest answer for tens of
thousands of people in this state, and you deserve to get it in ten seconds rather
than after a phone call.
Tennessee has no state cap on short-term plans
In August 2025 the federal government announced it would stop
enforcing the 2024 rule that capped short-term plans at four months, pending new
rulemaking. That handed the decision back to each state.
Tennessee never wrote its own duration cap. The state defaults
to the federal standard — which is currently unenforced — so plans with total
durations of up to 36 months including renewals are being sold
here as of 2026. At least six insurers offer them, with maximum durations ranging
from six to 36 months depending on the plan.
That puts Tennessee at the permissive end. In North Carolina
the cap is four months, because that state’s insurance department chose to keep
enforcing the federal standard. In Colorado, no insurer sells
them at all. See the full comparison:
short-term health insurance rules
by state.
One caution specific to a 36-month plan: a longer term is not automatically
better. These policies are not guaranteed renewable, and a three-year term does
not mean three years of guaranteed coverage if your health changes. Read what you
are actually buying.
Farm Bureau health plans — a Tennessee-only wrinkle
Tennessee was the first state in the country, in 1993, to
exempt Farm Bureau-sponsored health plans from state insurance regulation. Only a
handful of states have done this. If you are shopping in Tennessee you will run
into these, so you should understand what they are.
- They are not insurance under Tennessee law, and they are
not regulated by the Department of Commerce and Insurance the way
an insurance policy is. - They are medically underwritten — you can be declined based
on your health history. - They are not ACA-compliant and are not required to cover
essential health benefits. - They require Farm Bureau membership, which does not require you to farm.
For a healthy person who does not qualify for a subsidy, they can be genuinely
competitive, and I would rather tell you they exist than pretend they do not. What
matters is that you know you are not buying a regulated insurance product, and
that the consumer protections you would have with one do not attach.
Your options in Tennessee
1. An ACA marketplace plan through HealthCare.gov
Tennessee uses the federal marketplace at HealthCare.gov.
Despite the rate increases, this remains the right answer for most people and the
first thing I check. It is the only option that is guaranteed issue — no medical
questions, no possibility of being turned down — and the only one that covers
pre-existing conditions from day one.
2. TennCare
Worth checking even though eligibility is narrow, particularly if you have
children. Children are covered well above the adult thresholds, and CoverKids
extends further still.
3. A short-term plan
Fits someone healthy, between coverage, who does not qualify for a subsidy and
is facing an unsubsidized premium they cannot absorb. Not ACA-compliant,
medically underwritten, not guaranteed renewable, and pre-existing
conditions are generally excluded.
4. An employer or spouse’s plan
Almost always cheaper than anything on the individual market. Check first.
Tennessee deadlines
Open enrollment for 2027 coverage runs November 1, 2026 through January
15, 2027. Enroll by December 15, 2026 for coverage that
starts January 1.
A federal rule would have shortened this window to December 15. A court
vacated that rule in June 2026, and CMS confirmed in August 2026 that the
January 15 deadline stands. An appeal was argued in late October 2026. I re-check
this page when that is decided.
Common questions about health insurance in Tennessee
How long can a short-term health plan last in Tennessee?
Tennessee has no state-specific duration cap, so it follows the federal
standard, which has been unenforced since August 2025. Plans with total durations
up to 36 months including renewals are available in 2026, with options ranging from
six to 36 months. Because they are medically underwritten, approval is not
guaranteed.
Did Tennessee expand Medicaid?
No. Tennessee is one of a small number of states that did not expand Medicaid
under the ACA. That leaves an estimated 82,000 to 95,000 people in a coverage gap
— earning too much for TennCare but too little for marketplace subsidies.
Why did Tennessee premiums go up so much for 2026?
Two things at once. The approved average individual-market increase was 37.5%,
the highest among the states I am licensed in, and the enhanced federal premium tax
credits expired December 31, 2025. For many households the subsidy loss mattered
more than the rate increase.
Are Farm Bureau health plans insurance in Tennessee?
No. Since 1993 Tennessee law has exempted them from state insurance regulation.
They are medically underwritten, can decline applicants based on health history,
and are not ACA-compliant. They may still be a reasonable option for a healthy
person who does not qualify for a subsidy, but you should know you are not buying a
regulated insurance product.
Can I be turned down for coverage in Tennessee?
Not for an ACA marketplace plan — those are guaranteed issue regardless of
health history. You can be turned down for a short-term plan or a Farm Bureau plan,
because both are medically underwritten.
What if I cannot afford anything?
Look for a federally qualified health center or community health center. They
are required to charge on a sliding scale based on income. Dial 2-1-1 to find the
nearest one. This is the right answer for anyone in the coverage gap, and it is not
something I am paid for.
Related reading
Health insurance for the self-employed and 1099 workers
Short-term rules by state — how Tennessee compares.
About the agent
Scott Binsack — licensed health insurance agent, National
Producer Number 20492859. Licensed in Tennessee and 30 other
states. You can verify any agent’s licence through the Tennessee Department of
Commerce and Insurance.
I am compensated by the insurance company when you enroll, at no additional cost
to you. I have told you above which options I am not paid for, because you should
hear that from me rather than find it out later.
