What Is the Average Cost of Health Insurance in Tennessee?

Understanding health insurance costs in Tennessee is important for residents to manage their financial well-being and access medical care. Health coverage expenses vary substantially, influenced by personal and plan-related details. Gaining clarity on these factors and available coverage options helps individuals and families make informed decisions and budget effectively for their medical needs.

Average Health Insurance Costs

The average monthly premium for individual health insurance in Tennessee for 2025 is approximately $558 for a 40-year-old on a Silver plan. Actual costs are subject to individual circumstances. For a 30-year-old, a Bronze plan costs around $398 per month, while a Silver plan averages about $492 monthly. Gold plans for this age group have an average monthly premium of $509.

Premiums also vary for younger adults, with a 27-year-old paying about $367 per month for a Bronze plan. Family coverage incurs higher costs than individual plans. For instance, a couple aged 40 can expect an average monthly premium of approximately $1,077. A family of four (two 40-year-old adults and two children under 15 on a Silver plan) might see average monthly costs ranging from $1,116 to $1,784.

Key Factors Affecting Costs

Several factors influence health insurance premiums in Tennessee. Age is a primary determinant, with premiums increasing as individuals get older; a 60-year-old pays more than double what a 21-year-old would for similar coverage. While Bronze plan premiums rise incrementally by about $5 per year between ages 21 and 30, the rate of increase accelerates for those in their 40s and 50s. Federal regulations cap the maximum premium for older adults at no more than three times the rate for a 21-year-old.

Geographic location within Tennessee affects premium costs. For a 30-year-old on a Bronze plan, monthly premiums range from approximately $363 to $434 across different counties. Rural areas, such as Anderson, Union, and Sevier counties, have lower average premiums, while urban areas like Coffee, Maury, and Wayne counties see higher costs. Tobacco use also increases premiums, with individuals who use tobacco paying up to twice as much as non-smokers.

The type of health plan chosen, often categorized by “metallic tiers” (Bronze, Silver, Gold, Platinum), directly impacts premiums and out-of-pocket expenses. Bronze plans feature the lowest monthly premiums but require individuals to pay a larger share of medical costs, covering approximately 60% of care. Silver plans offer a balance, covering about 70% of medical costs. Gold and Platinum plans have higher premiums but cover 80% to 90% of costs, resulting in lower out-of-pocket expenses when care is needed.

The overall cost of a health plan extends beyond the premium to include deductibles, copayments, coinsurance, and annual out-of-pocket maximums. These collectively determine the total financial responsibility.

The number of individuals covered under a plan, whether individual or family, significantly influences the total premium. Family plans cost more overall but often less per person than purchasing multiple individual plans.

How to Obtain Health Insurance

Individuals and families in Tennessee have several pathways to secure health insurance. The primary avenue for those without employer-sponsored benefits is the Health Insurance Marketplace, accessible through HealthCare.gov. This platform allows consumers to compare plans and enroll during the annual Open Enrollment Period, which runs from November 1 to January 15 for the upcoming year’s coverage. Outside this period, a Special Enrollment Period is available for individuals experiencing qualifying life events such as marriage, birth of a child, loss of previous coverage, or a change in residence.

Many Tennesseans obtain health insurance through employer-sponsored plans. Employers contribute a portion of the premium costs for these plans, making them a cost-effective option for many. Plans can also be purchased outside the Marketplace directly from various health insurance companies operating in Tennessee.

Government programs provide avenues for specific populations. Medicare offers health coverage for individuals aged 65 or older, and certain younger people with disabilities. TennCare, Tennessee’s Medicaid program, serves low-income individuals, including children, pregnant women, and people with disabilities, based on income and eligibility criteria. CoverKids, the state’s Children’s Health Insurance Program (CHIP), provides free or low-cost health coverage for eligible children under 19 and pregnant women who do not qualify for TennCare.

Reducing Health Insurance Costs

Several programs and strategies help eligible individuals in Tennessee reduce health insurance expenses. Premium Tax Credits, often called subsidies, are available through the Health Insurance Marketplace and can lower monthly premiums. The credit amount is determined by household income and family size, with eligibility temporarily expanded through 2025 to cap premiums at 8.5% of income for a benchmark plan. To qualify, household income must be above 100% of the federal poverty level.

Beyond premium assistance, Cost-Sharing Reductions help lower out-of-pocket expenses such as deductibles, copayments, and coinsurance for eligible individuals. These reductions are available to those who enroll in Silver plans through the Health Insurance Marketplace and meet certain income requirements.

For those with very limited incomes, TennCare and CoverKids offer free or low-cost health coverage. TennCare, the state’s Medicaid program, provides comprehensive benefits to qualifying low-income individuals, families, and children. CoverKids extends similar free or low-cost coverage to children under 19 and pregnant women whose household income is at or below 250% of the federal poverty level and who are not eligible for TennCare. Enrollment for both TennCare and CoverKids is open year-round, allowing eligible individuals to apply at any time.