Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – December 21, 2023
Reviewed by Dr. Brindusa Vanta, MD

Medicare is typically the most popular health insurance program for folks aged 65 and above, as well as adults with specific disabilities. In Tennessee, a little less than half of all eligible residents were enrolled in Medicare in 2022, which is right on par with the national average. From 2022 to 2023, enrollment in Medicare increased. Now, more than half of the 1.2 million seniors in the population have chosen a plan.

Most in this age group know Original Medicare has a few parts. Part A comes at no cost for those who have paid sufficient payroll taxes during their working years—typically a minimum of 10 years. It covers essentials such as emergency care, inpatient treatment, hospice care and even home health services. Part B may come with a monthly premium of $170.10 in 2022, but it covers most outpatient procedures and medical equipment.

There is a trending pattern shifting away from the traditional options and heading for Medicare Advantage (Part C), which allows the selection of customizable options from a private insurance plan to better suit personal preferences. All Advantage Plans match the provisions of Part A and Part B—minus hospice care being exclusive to Part A—but additions such as dental, vision, prescription drug coverage and a medical savings program are also available. For prescription drugs, Medicare Part D will handle the medications, but most Advantage Plans have drug coverage in their bundles. Costs differ depending on what’s chosen, and if a reduction in costs is needed, a Medicare Supplement (Medigap) plan will help limit those out-of-pocket expenses such as deductibles.

This guide presents all the Medicare options for those aged 65 and up, so seniors can select the health coverage to suit their needs. There are also several resources provided to help answer any questions about all the customizable aspects of the varying healthcare plans. The end goal is to ensure seniors have what they need when it comes to their health.

Options for Medicare Coverage in Tennessee

Original Medicare provides basic coverage that’s not always suitable for seniors who need more comprehensive insurance. Tennessee residents have access to the Original Medicare program as well as many insurance plans administered by private insurance companies. Seniors can customize their coverage as they see fit using the original program or available private options. 

Original Medicare (Parts A & B)

Original Medicare provides a foundational level of coverage, but it may not encompass all the needs of seniors seeking more comprehensive insurance solutions. In the state of Tennessee, residents are presented with the choice of enrolling in the Original Medicare program or exploring a range of insurance plans administered by private insurance companies (Medicare Advantage). This empowers seniors to tailor their coverage according to their unique or specific needs, whether they choose the standard benefits of the original program or wish to leverage the flexibility and additional features offered by the private options.

Who Should Consider Original Medicare

Original Medicare may be a good option for those who:

  • Travel frequently within the United States
  • Don’t need extra benefits such as home-delivered meals and coverage for over-the-counter medication
  • Want to choose their own prescription drug coverage

Medicare Advantage (Part C)

Medicare Advantage offers seniors an alternative to standard Medicare. Administered by private insurers, these plans receive a federal subsidy, lowering monthly premiums. They are required to duplicate Part A and Part B coverage, but they also offer extra benefits to make their plans more appealing. Five types of Medicare Advantage Plans exist: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee-for-Service (PFFS), Special Needs Plans (SNP) and Medicare Savings Account (MSA), each with distinct rules, regulations and eligibility. Plus, the out-of-pocket limitations allow seniors to predict expenses and have a bit more control over their medical budget.

Who Should Consider Medicare Advantage

A Medicare Advantage plan is best for people who:

  • Would like coverage for vision or dental care
  • Are generally healthy and want lower premiums
  • Need more control over out-of-pocket expenses

The Top 10 Medicare Advantage Plans in Tennessee

Seniors in Tennessee have a growing number of Advantage plans to choose from. The following table reviews the most popular insurers in the state by enrollment numbers, plan costs as of August 2023 and the types of plans available. More information is available on the Medicare Advantage plans in Tennessee page

Enrollment Medicare Star Rating Monthly Cost Range Plan Types
Humana 194,082 3.5 $0 – $107 PPO, HMO
BlueCross BlueShield of Tennessee 142,851 5 $0 – $189 PPO
UnitedHealthcare 103,124 3 $0 – $31 PPO, HMO
Cigna 79,424 3 $0 – $55 PPO, HMO
AMERIGROUP Community Care 41,438 3.5 $0 – $9 HMO
Blue Cross and Blue Shield 18,926 3.5 $0 – $15 PPO
Aetna Medicare 16,455 2.5 $0 – $17 HMO
Amerigroup 2,897 3.5 $15 HMO
Ascension Complete 1,759 N/A $0 PPO, HMO
Anthem Blue Cross and Blue Shield 1,336 N/A $0 PPO

Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t pay for most prescription drugs through Part A or B coverage. Instead, seniors purchase separate prescription drug policies, also called Part D coverage. Medicare contracts with private health insurance companies to provide this coverage. There are multiple plans to choose from with varying monthly premiums, which beneficiaries pay in addition to their Original Medicare premiums. While seniors don’t have to purchase prescription drug coverage when they’re first eligible for Medicare, not obtaining this coverage at this time may result in late enrollment penalties they pay for as long as they have Medicare if they enroll later. Most Advantage Plans cover prescription drugs, and therefore seniors enrolled in these plans do not need enrolment in a separate Plan D. 

Each prescription drug plan has its own formulary, or list of covered drugs. Formularies are typically split up into tiers. The tier a medication is in determines how much the insurance company pays and how much the beneficiary pays for it. Lower-level tiers are usually made up of generic and low-cost brand name drugs, while higher tiers are composed of more expensive brand name and specialty drugs. In most cases, the lower the tier, the lower the policyholder’s cost-sharing responsibility.

Who Should Consider Medicare Prescription Drug Coverage

Seniors who may benefit from prescription drug coverage include those who:

  • Take prescription medication or expect to in the future
  • Want to avoid late enrollment penalties
  • Want to reduce out-of-pocket prescription drug expenses

Medicare Supplement Insurance (Medigap)

While Original Medicare provides coverage for many medical costs, seniors may still have significant out-of-pocket expenses. These may include copays, coinsurance and deductibles. Seniors may be able to reduce their cost-sharing obligations by purchasing a Medigap plan. These plans can only be used with Original Medicare. It’s illegal for private insurance companies to sell Medigap plans to those with Medicare Advantage plans.

For more information on Medigap plans, seniors can refer to the Best Medicare Supplement Companies of 2023 page.

Who Should Consider Medicare Supplement Insurance

Good candidates for Medigap may be those who:

  • Have ongoing health issues and expenses
  • Travel overseas often
  • Want to access an expanded network of health care providers
  • Expect to need health services not covered by Original Medicare

Medicare Resources in Tennessee

Enrolling in Medicare can be confusing and frustrating, especially when seniors have so many insurance plans to choose from to meet their needs. Tennessee residents have access to several programs and resources to help them review insurance plans, understand their benefits, apply for financial aid, learn how to protect themselves against fraud and file complaints against abusive health care providers. The following resources can help seniors get started with the Medicare enrollment process. 

Social Security Administration (SSA)

The Social Security Administration provides educational materials for seniors to help prevent late enrollment penalties, review the differences between Original Medicare and Medicare Advantage and determine if they qualify for financial assistance programs. The Social Security Administration website also offers guidance on what to do if seniors lose their Medicare cards, how to avoid scams and where to report suspicious activity.

Contact Info

Seniors can visit their local SSA office for assistance or call 1-800-772-1213. The Social Security Administration has an office locator to help seniors find the office closest to them. 

Visit Website
Tennessee State Health Insurance Assistance Program (SHIP)

The Tennessee SHIP program helps seniors understand their Medicare choices and benefits. Residents are connected with volunteer SHIP counselors who can help them narrow their insurance options to plans that address their needs. Counselors also help seniors determine if they qualify for programs such as Medicaid and can help people complete their applications. 

Contact Info

Seniors can learn more about the SHIP program through their local Area Agency on Aging or by calling 1-800-801-0044.

Visit Website
Senior Medicare Patrol

Tennessee’s Senior Medicare Patrol is a program that helps protect seniors from Medicare fraud and scams. It educates Tennessee residents on the tactics criminals use to steal their financial information or commit insurance fraud while also explaining how Medicare actually works. Residents can request assistance reviewing their insurance options or report suspected cases of abuse and fraud. 

Contact Info

Residents who’d like more information can visit the Senior Medicare Patrol website or call 1-866-836-7677 to speak with a representative.

Visit Website
Tennessee Disability Coalition

The Tennessee Disability Coalition is a partnership between several charitable organizations that advocates on behalf of seniors and adults with disabilities. In addition to running programs to help seniors understand and enroll in benefits programs, it helps under-served individuals access additional financial assistance through partnered charitable organizations. 

Contact Info

Tennessee seniors may send inquiries to [email protected] or call 1-615-383-9442 to speak with someone over the phone. They can also fill out the contact form to have someone reach out.

Visit Website
Tennessee Commission on Aging & Disability Information and Assistance Program

The Information and Assistance program helps connect seniors with the best resources to address their concerns. Callers can speak with someone about their current situation and needs and learn more about what programs they qualify for and where they can get help filling out the appropriate paperwork. The hotline also helps seniors in a crisis situation who may need help with housing, food and transportation. 

Contact Info

The Information and Assistance program uses the TENNOPT hotline to provide assistance. Seniors can call 1-866-836-6678 to speak with a counselor.

Visit Website