2024 Guide to Individual and Family Health Insurance in Tennessee
View Rates, Benefits and Apply for 2024 Plans HERE
We have written this guide to help you make an educated decision about your health insurance plan for the 2024 plan year. It includes information about the carriers, their networks to date and some plan guidance for the different plans available in Tennessee for the 2024 plan year, including helpful advice on applying for a plan.
You do not pay anything extra for our help and applying through us is the same as applying through the Marketplace except you get expert help. That is because the price of all Individual and Family health plans includes compensation paid to Agents, whether you take advantage of our help or not.
How to pick the most appropriate plan to meet your needs
- Run your Quote HERE. Be sure to Save your quotes using your proper name.
- Making sure to enter your preferred Doctors & Hospitals when given the chance during the quoting process.
- Using My Notes Below, focus on the carrier that is showing more of your preferred hospitals in network.
- The key with any plan is to confirm that your doctor is in-network before you apply. All plans are EPO Networks, meaning there is NO out of Network Coverage except for true emergencies.
- Choose your Plan then click Add to Cart then Start Application
- Call us if you run into trouble while applying and tell us you are stuck so we can help you. As long as you use the link found in this email to quote & apply, we can pop into your application on the page you are stuck on and finish the application with you over the phone if you need help.
When Buying from the Marketplace, ALL the plans are Major Medical plans, and ALL have these benefits:
- You cannot be turned down or charged more if you have a pre-existing condition.
- Your Medical Record cannot be looked at when calculating the price of your health insurance plan, which means you will not receive a higher price because of your medical history.
- All preventive services are free and at no cost to you. Here is the link from HealthCare.Gov to the list of preventive services available to anyone with a major medical health plan: https://www.healthcare.gov/coverage/preventive-care-benefits/
Except for the Hospitals that are talked about below, everything about the insurance carriers will be relevant no matter what part of TN you live in. If you do not live in Nashville and would like to know what hospitals in your area are in network, give us a call and we would love to assist you!
Frequently Asked Questions
Question 1: Will you sell my information to call centers so that I get spammed by 100’s of emails and calls?
Answer 1: NEVER! We will never send you spam mail or spam you with phone calls. We will never give your information out to marketing organizations. We are a Tennessee based, family owned agency that has local employees and we care about you having a good experience when you work with us. That means no spam.
Question 2: Does my insurance cost more through you? How are you paid?
Answer 2: Your insurance will not cost any more when you go through us. Major medical plan pricing is set by the marketplace and cannot be changed. We are paid a commission by the insurance company we help you enroll with. We are an independent agency so we are not required to sell one product vs another. We help you find the best product for your situation by looking at ALL the options in Tennessee.
Question 3: What is a major medical plan?
Answer 3: A “Major Medical Plan”, also known as a “Qualified Health Plan” is a plan that is certified by the Healthcare.gov Marketplace to provide coverage for “essential health benefits” as well as a plan that has limits on cost-sharing and covers pre-existing conditions. These are the most comprehensive plans available on the market in Tennessee and are the best option for most individuals and families. Beware that there are many plans out there that do not meet these requirements and people are often tricked into buying them. We often get calls from people who bought some other type of plan and did not find out how it worked until it was too late.
Question 4: Can I get a PPO health insurance plan?
Answer 4: No. The Major Medical plans offered in Tennessee for Individuals and Families are limited to EPO options. However some carriers have large networks and do not require referrals to see a specialist. There are 5 insurance companies offering major medical plans in Tennessee so there are lots of good options for 2024.
How to pick the most appropriate plan to meet your needs
- Run your Quote HERE. Be sure to Save your quotes using your proper name.
- Making sure to enter your preferred Doctors & Hospitals when given the chance during the quoting process.
- Using My Notes Below, focus on the carrier that is showing more of your doctors and preferred hospitals in network.
- The key with any plan is to confirm that your doctor is in-network before you apply. All plans but one are HMO Networks, meaning there is NO out of Network Coverage except for true emergencies.
- Choose your Plan then click Add to Cart then Start Application
- Call us if you run into trouble while applying and tell us you are stuck so we can help you. As long as you use the link found in this email to quote & apply, we can pop into your application on the page you are stuck on and finish the application with you over the phone if you need help.
Confused, still have questions after saving your quotes?
Click here to schedule a time to talk to Josiah
Prepare for your Appointment-To make the most out of your appointment time with us, we require that you run your quotes, including entering your providers, and saving your quotes under your proper name so that we can quickly pull up your quotes to discuss with you at your phone appointment.
Bottom Line is that you need an agent you can trust! Check out our Google reviews HERE to see why our clients value our help so much.
Ambetter
Key Metro Nashville Hospitals In-Network (check with providers)
Key Nashville Hospitals in Network (check with providers)
Vanderbilt
Saint Thomas
Tristar
Our thoughts for 2024
Ambetter is one of the most affordable and popular plans in Tennessee and is the #1 ACA Carrier. For 2024 Ambetter will be in every county in TN, making it an option everywhere in the state.
Pros
- Number one carrier on the marketplace for the past 5 years
- You do not need a referral to see a specialist
- Some of the most affordable plans in TN with great networks
- Plans with the SELECT network for those around Nashville who want lower premiums and don’t mind having a smaller network.
- Every county in TN has Ambetter
- Best option on the Marketplace if you travel since you can use Ambetter out of the state as long as you go to doctors that accept Ambetter (normally, you can only use a plan outside of the state if you are in an emergency situation)
Cons
- Mediocre Customer Service (but as agents we can help alleviate that)
Recommended plans in each category
Tip: when ever a bronze or silver plan says $0 deductible, it will usually have a separate deductible on prescription drugs so be sure to check the Summary of Benefits, first page. The “Elite Bronze” mentioned below has a separate deductible for example, but the “Elite Gold” does not.
Networks: Ambetter has their large network, called the Bronze/Silver/Gold network and their SELECT network which is a smaller network of doctors and hospitals that is only available around Nashville (plans that have this smaller network have lower premiums). Plans that use the SELECT network will have “SELECT” in their plan name.
- Bronze – Standard Expanded Bronze or Elite Bronze
- Silver – Complete Silver
- Gold – Everyday Gold or Elite Gold
BlueCross BlueShield of Tennessee
Key Nashville Hospitals in Network (check with providers)
Vanderbilt
Saint Thomas
Our thoughts for 2024
BlueCross BlueShield has one of the largest network of doctors and hospitals in TN making is a good pick for many people who want access to their network. However, while they have many positive features, if you do not need access to their networks, I usually recommend that people also look to another carrier because their plans are often more expensive and don’t offer many co-pays features. If this isn’t an issue for you, BlueCross BlueShield is a great Carrier.
Pros
- Has almost 80% of all doctors and Hospitals in TN and is in every county
- You do not need a referral to see a specialist
- Has the option of a smaller network of hospitals in return for better prices
- Good customer service
Cons
- Plans are often expensive and have almost no copays
- Does not have Tristar hospitals in their Network
- Does not have St. Thomas West in Network
Recommended plans in each category
BlueCross BlueShield has three networks, the S network, which is their largest, the E network which is available if you are around Nashville and Memphis and is a smaller network that offers lower costs on plans. And lastly if you are in the Knoxville Area you have access to the L network, which is a smaller network that offers lower costs if you want that over the S network.
Tip: How to read the plan names, “Bronze B16E” the B stands for Bronze, and the E stands for the Network. So is all you had was “B16S” you know that the plan is a bronze tier plan and uses the S network. “S01S” is a Silver plan that uses the S network.
-
- Bronze – Bronze B16E or Bronze B16S
- Silver – BlueCross S26E or BlueCross S26S
- Gold – Gold G08E or Gold G08S
Ascension
Key Nashville Hospitals in Network (check with providers)
- Ascension Saint Thomas Hospitals only
Our thoughts for 2024
Ascension is a good option if you already like going to their clinics are working with their doctors, or do not mind switching over to them. They are new to TN, but have great prices and though their network is smaller, it is reliable.
Pros
- You do not need a referral to see a specialist
- Some of the most affordable plans in TN
Cons
- Limited to only Ascension Hospitals and Clinics which means a smaller overall network
Recommended plans in each category
-
- Bronze – Ascension Personalized Care Balanced Bronze (for lowest premium) or Ascension Personalized Care No Medical Deductible Bronze (better rounded plan)
- Silver – Ascension Personalized Care No Deductible Silver
- Gold – Ascension Personalized Care Standard Gold
Cigna HealthCare
Key Nashville Hospitals in Network (check with providers)
Vanderbilt
Saint Thomas
Our thoughts for 2024
Cigna has an excellent Network in Nashville when it comes to hospitals. Their plans are affordable and have good features. Cigna is popular and I am always quick to recommend them.
Pros
- Offer plans specifically designed to help with Asthma and Diabetic patients
- You do not need a referral to see a specialist
Cons
- No obvious downsides to Cigna. This does not mean that they are perfect and that no one will have negative experiences dealing with them but this goes without saying for every insurance carrier.
Recommended plans in each category
Tip: when ever a bronze or silver plan says $0 deductible, it will usually have a separate deductible on prescription drugs so be sure to check the Summary of Benefits, first page. For the plans below, the Bronze tier “Cigna Connect 0A” has a separate deductible for prescription drugs but the Silver tier “Cigna Connect 0B” does not.
-
- Bronze – Connect Bronze 8500 Indiv Med Deductible (this option has better copays) or Connect Bronze 3500 Indiv Med Deductible Enhanced Diabetes Care (this option has better deductible)
- Silver – Connect Silver 0 Indiv Med Deductible (better all around coverage) or Connect Silver 4000 Indiv Med Deductible (better doctor co pays)
- Gold – Connect Gold 500 Indiv Med Deductible
Oscar
Key Nashville Hospitals in Network (check with providers)
Tristar
Saint Thomas
Vanderbilt
Our thoughts for 2024
Oscar is only available in Nashville and Memphis and offers very attentive customer service. Oscar members will be paired with a team of care guides and a nurse that will be available to assist you with nay issues you may have, medication questions, refilling existing prescriptions and searching for physicians in your area. These Care Teams sets Oscar apart from the other carriers. even though Oscar’s plans are not poorly priced, if you don’t feel like you would use their resource, or need access to their network, I would recommend looking at another carrier that offers a more affordable plan.
Pros
- You do not need a referral to see a specialist
- Care team made up of several guides and one nurse who’s job it is to virtually assist Oscar members
Cons
- Does not operate outside of Nashville and Memphis
Recommended plans in each category
Tip: when ever a bronze or silver plan says $0 deductible, it will usually have a separate deductible on prescription drugs so be sure to check the Summary of Benefits, page 1. The “Bronze Elite $0” has a very high prescription drug deductible.
- Bronze –Bronze Classic Standard or Bronze Classic 4700 (for a little better coverage)
- Silver – Silver Classic Standard or Silver Classic (for a little better coverage)
- Gold – Gold Elite
United HealthCare
Key Nashville Hospitals in Network (check with provider)
Tristar
Saint Thomas
Our thoughts for 2024
Unless you need access to their network or already have UHC (United HealthCare) and would really like to keep them, I would recommend looking at other plans since UHC has some of the highest cost plans that are not that different from other carriers who offer more affordable prices.
Pros
- Has most of the hospitals in Nashville
- Covers most areas in TN
- You do not need a referral to see a specialist
Cons
- Their plans are expensive for what you get
Recommended plans in each category
- Bronze – UHC Bronze Standard or UHC Bronze Copay Focus
- Silver –UHC Silver Copay Focus
- Gold – UHC Gold Copay Focus
Dental and Vision
DENTAL- If you want a dental plan, I recommend the Anthem Dental Family PPO or the Anthem Dental Family Enhanced (even for single people).
If you do not find an ACA plan that fits your budget or lifestyle and you want to view other options, you can learn about the non-ACA plans we recommend HERE.
Use the search feature cautiously with the knowledge that not all providers have been updated by the carriers, so it is best to call your doctor’s office to confirm if they are in network for 2022 if that is really important to you.
Schedule your Phone or Video Appointment
Please visit our Enhanced Direct Enrollment site for Quotes, Benefits and to Apply for 2022 Plans HERE.
- Applying through our link will allow you to access your existing Marketplace account, but faster and easier, or create a new one.
- Makes us your agent and costs you nothing! This also allows us to get paid by the insurance company for the help and service we are providing to our clients at no charge to you!
- Or you can apply on the Marketplace and enter Daniel Potter and my NPN #18032692 as your agent that is helping you. Please let us know if you apply this way so we can follow up on your application process for you.
If you want to know a little bit more about us please feel free to check out our website https://www.tn-health-insurance.com/ and check out our Google Reviews so you can see what people think of our services. We look forward to working with you to help you have a smooth transition into your new plan.
Sincerely,
Josiah Lee// Tennessee Health Insurance, Inc.
P: 615-528-1227 F: 615-528-1227