Assisted living facilities primarily help residents with non-medical needs. Although minor and infrequent medical services, such as first-aid for a wound, can sometimes be met on-site by nurses. These communities may sometimes also be called ALFs, residential care facilities, retirement homes, or long-term care facilities.
The financial options available to help pay for senior care is dependent on, among other things, the type of care that is required. If you are just beginning the research process on how to pay for long-term care, it is helpful to have an idea about the type of care you or your loved one currently requires, as well as to anticipate future needs. In addition, it is important to be familiar with the associated eldercare terminology.
Can using home care technology help your family save money caring for an aging loved one? The answer is most certainly “Yes”. Our goal is not to provide a comprehensive list, but rather to make sense of those that are available on the market today and can reduce the care hours required by elderly persons. As such, they can reduce a family’s out-of-pocket care costs or reduce the hours they spend providing care themselves.
Medicare Advantage (Part C), a privately offered alternative to Original Medicare (Parts A and B), has grown in popularity over the years. Despite the growing popularity of Medicare Advantage, some seniors face obstacles that prevent them from truly understanding how it works and who it benefits. Common mistakes about Medicare Advantage include misunderstanding its differences from Original Medicare, getting it confused with other forms of private Medicare insurance (like Medigap or Part D), or not understanding how to look up or evaluate plans.
Medicare is the government health insurance program for seniors 65 and older and other qualifying Americans. Medicare Advantage, sometimes known as Part C Medicare, provides a bundled package of health care coverage as an alternative to the separate parts of Original Medicare. While regular Medicare is a fee-for-service program managed by the federal government, Medicare Advantage is provided on a state-by-state basis by private insurance companies. Providers charge monthly premiums and set maximum annual out-of-pocket payments, unlike regular Medicare, which has no such expenditure caps.
Part C plans must include much of the same basic coverage as Parts A and B of regular Medicare, namely inpatient and outpatient medical services. Medicare Advantage does not cover hospice care. However, seniors who require such care remain covered by Original Medicare, while their Part C policies cover any other conditions. Medicare Advantage Plans typically offer some prescription drug benefits in lieu of Medicare Part D. They also often cover aspects that aren’t offered by regular Medicare, such as vision and hearing care, dental treatments and subsidized senior wellness services. The Centers for Medicare and Medicaid Services regulate Part C providers.
Tennessee is home to around 7 million people. Adults aged 65 and older, the prime demographic for Medicare and Medicare Advantage enrollment, make up about 17.3% of the population. Between 2022 and 2023, the number of Medicare-eligible individuals in Tennessee increased by 2.3%. In 2022, 681,438 people were enrolled in Medicare Advantage, representing 45% of all eligible individuals. In 2023, this figure increased by 8.36% to 738,373, meaning that 51% of all qualifying people opted for Medicare Advantage. From 2022 to 2023, the number of people enrolled for Part C increased by 5.92%. Currently, enrollment for Medicare Advantage in Tennessee is in line with the nation, with 51% of all Medicare-eligible Americans opting for Part C plans.
Within this guide, you’ll find insights into the coverage provided by Advantage Plans in Tennessee, a breakdown of senior eligibility for these plans and comprehensive information about enrollment timings and locations.
The Top 10 Medicare Advantage Plans in Tennessee
Several Medicare Advantage companies serve Tennessee seniors, with most providers offering multiple plan types. The table underneath indicates the 13 most popular Part C insurers in Tennessee. Enrollment figures combine the number of participants in all plans from each provider. Because of varying policy options, pricing is given as a range rather than an absolute amount. All data is current as of July 2023. Seniors can visit Medicare.gov for more details.
Name
Enrollment
Medicare Star Rating
Monthly Cost Range
Plan Types
Humana
194082
3.5
$0 – $107
PPO, HMO
BlueCross BlueShield of Tennessee
142851
5
$0 – $189
PPO
UnitedHealthcare
103124
3
$0 – $31
PPO, HMO
Cigna
79424
3
$0 – $55
PPO, HMO
AMERIGROUP Community Care
41438
3.5
$0 – $9
HMO
Blue Cross and Blue Shield
18926
3.5
$0 – $15
PPO
Aetna Medicare
16455
2.5
$0 – $17
HMO
Amerigroup
2897
3.5
$0 – $15
HMO
Ascension Complete
1759
N/A
$0 – $0
PPO, HMO
Anthem Blue Cross and Blue Shield
1336
N/A
$0 – $0
PPO
How Medicare Advantage Plans Work in Tennessee
Seniors should educate themselves on how Medicare Advantage differs from Original Medicare before seeking an Advantage Plan. Insurance companies offer different types of Medicare Advantage plans, such as Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. The rules for eligibility, out-of-pocket maximums, coinsurance, in-network vs. out-of-network coverage and specialist referrals all vary by plan. Below is a review of the four primary types of Advantage Plans.
What Medicare Advantage Plans Cover in Tennessee
Medicare Advantage Plans must offer the same level of coverage provided through Original Medicare (Parts A and B). The only exception is hospice care, which remains covered by Medicare Part A. An Advantage Plan will cover annual physicals, preventative care, diagnostic tests, emergency care, inpatient care, outpatient procedures, medical transportation and medical devices and supplies. Providers can offer additional benefits, such as coverage for vision, dental or hearing care and discount programs that allow seniors to access meal programs, gyms and other wellness programs at a reduced price.
Coverage Available With Medicare Parts A & B?
Coverage Available With Medicare Advantage?
Preventive Screenings
Yes
Yes
Hospital Care
Yes
Yes
Durable Medical Equipment
Yes
Yes
Prescription Drugs
No
Yes**
Vision Care
No
Yes*
Dental Care
No
Yes*
Hearing Aids
No
Yes*
*Select plans offer this coverage
** Most plans offer this coverage
Eligibility for Medicare Advantage in Tennessee
Medicare is available to all adult U.S. citizens or legal residents who are over 65 years old or have a disability that qualifies them for enrollment. To enroll in an Advantage Plan, someone must first enroll in Original Medicare Parts A and B and then live in the service area covered by their chosen plan. Enrollees must also meet the eligibility requirements decided by the insurance company managing the plan.
There are several types of enrollment periods that allow seniors to sign up for Medicare coverage. Missing an enrollment period could result in costly penalties, so it’s important for seniors to be aware of when their enrollment periods begin and end. Once seniors enroll in an Advantage Plan, they can change their coverage once a year during the annual election period. The following list offers more information about enrollment periods.
Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.
Start Date
End Date
Initial Coverage Election Period
3 Months Before One’s 65th Birth Month
3 Months After One’s 65th Birth Month
Annual Election Period (AEP)
October 15th
December 7th
Medicare Advantage Open Enrollment Period
January 1st
March 31st
Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.
How to Find & Choose a Medicare Advantage Plan in Tennessee
Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.
First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.
TennCare is Tennessee’s state Medicaid plan. While it doesn’t administer Medicare plans, it does provide some assistance to individuals who require assistance determining their eligibility for Medicaid or Medicare programs. Additionally, it offers benefits coordination assistance to beneficiaries who are dually eligible for Medicaid and Medicare.
Seniors can contact TennCare by calling (855) 259-0701.
Tennessee Department of Commerce & Insurance
The Tennessee Department of Commerce & Insurance regulates all health insurance providers throughout the state, including those that provide Medicare Advantage plans. Seniors can contact this department if they wish to verify an insurance agent or file a complaint about their provider. This department also offers consumer education resources about Medicare Advantage and other insurance policies.
Seniors who wish to contact the Tennessee Department of Commerce & Insurance can call (615) 741-2241.
Tennessee State Health Insurance Assistance Program
State Health Insurance Assistance Programs (SHIP) are federally-funded programs that are available in every state. In Tennessee, the SHIP program offers regular educational and counseling events in various cities throughout the state for Medicare beneficiaries and potential enrollees. These events help seniors to access the information they need to choose appropriate Medicare or Medicare Advantage plans to suit their needs.
Seniors can contact SHIP via email at [email protected] or by phone at (877) 801-0044. In-person counseling is available at various locations throughout the state.
Seniors who are U.S. veterans, as well as their immediate family members and dependants, can access health insurance counseling from the Tennessee Department of Veterans Services. This department administers its own benefits but can also provide coordination and other assistance services to those who carry Medicare Advantage policies.
The Tennessee Department of Veterans Services is located at 312 Rosa L. Parks Avenue. in Nashville. Seniors can call this department at (615) 741-2345 or email [email protected] for more information.
The Aging and Disability Resource Center (ADRC) offers a variety of services and supports for seniors and their caregivers. Its staff are qualified to provide insurance counseling services to Medicare Advantage beneficiaries. Other services that seniors can access at ADRC locations include transportation services, nutritional counseling and caregiver training.
Seniors can contact Tennessee’s ADRC by calling (866) 836-6678.
Local Medicare Advantage Resources
Southeast Tennessee Area Area Agency on Aging and Disability
This Area Agency on Aging office serves seniors in 13 counties in the Nashville area and throughout Southeast Tennessee. The office provides information and assistance to seniors in a variety of matters. Its services include insurance counseling for Medicare participants.
Seniors can visit this Area Agency on Aging office in-person at 1000 Riverfront Parkway in Chattanooga or call (866) 836-6678 for more information about the programs and services that are available.
Greater Nashville Regional Council Aging and Disability Programs
The Greater Nashville Regional Council (GNRC) offers Medicare counseling services for senior citizens as part of the federal SHIP program. The services provided by this program are free of charge and this organization is not affiliated with any insurance providers; therefore, information provided to beneficiaries is entirely non-biased.
Seniors can visit the Greater Nashville Regional Council at 220 Athens Way, Suite 200 in Nashville or call (615) 862-8828 for more information.
Aging Commission of the Mid-South
Serving seniors in Shelby County, the Aging Commission of the Mid-South helps seniors with a variety of free and low-cost supports and services. This Area Agency on Aging and Disability employs SHIP-certified insurance counselors who provide seniors with Medicare counseling, as well as assistance with Medicare Advantage claims, appeals and complaints.
The Aging Commission of the Mid-South is located in the Vasco A. Smith, Jr. County Administration Building at 160 North Main St. in Memphis. For more information about the programs and support services this office offers, seniors can call (901) 222-2300.
