Medicare Advantage Plans in Tennessee

Medicare Advantage in Tennessee is an alternative type of Medicare coverage. All Medicare Advantage plans must provide the same benefits as Original Medicare, i.e., Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).

Specific Medicare Advantage plans in Tennessee also offer beneficiaries extra benefits like prescription drug coverage, hearing, vision, and dental care, and wellness club memberships like SilverSneakers.

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Popular Medicare Advantage Plan Types in Tennessee

Best for network freedom: Medicare Advantage PPO plans

  • PPO plans allow enrollees to use a more extensive network of healthcare providers, suppliers, and facilities.
  • Referrals are not required.
  • Monthly premiums for PPO plans range between $0 to $100.00.

Best for low out-of-pocket costs: Medicare Advantage HMO plans

  • HMO monthly premiums are generally $0
  • HMOs require enrollees to use network providers and referrals from primary care physicians. But this relates to lower personal costs.

Best plan for low income or health conditions: Special Needs Plans (SNPs)

  • SNPs are unique insurance plans for people living on a limited income or with chronic health issues such as end-stage renal disease or ALS.
  • Enrollees may be eligible for both Medicare and Medicaid and can get lower copays, coinsurance, deductibles, and premiums.

Tennessee Enrollment Facts:

  • Number of people enrolled in Medicare Advantage in Tennessee: 427,168
  • The number of people enrolled according to plan type:
  • Local HMOs: 255,650
  • Local PPOs: 162,455
  • Regional PPOs: 9,063
  • The percentage of enrollees in Medicare Advantage in Tennessee: 42%
  • The number of people enrolled in Medicare Advantage nationwide: Expected to reach 29.5 million in 2022.
  • The percentage of Medicare beneficiaries enrolled in Medicare Advantage nationwide: 42%

When can I enroll in a Medicare Advantage plan?

Initial Enrollment Period (IEP)

If you are 65:

The Initial Enrollment Period starts three months before the month of your 65th birthday. It includes the entire month of your birthday, and it ends three months after the month of your 65th birthday, lasting for a total of seven months.

If you receive disability benefits:

Eligibility for Medicare includes getting Social Security or RRB benefits because of a qualifying disability, end-stage renal disease, or ALS. In these cases, IEP begins three months before the 25th month of receiving disability benefits, including the 25th month and ends three months after.

Open Enrollment Period (OEP) or Annual Election Period (AEP)

During this enrollment period, you can sign up for a Tennessee Medicare Advantage plan, switch to a different plan, or go back to Original Medicare Part A and Part B.

During AEP, enrollment is open for Part D plans. AEP starts on October 15th and goes up to December 7th. Changes take effect on January 1st.

Medicare Advantage Open Enrollment Period

From January 1st to March 31st, you can switch from Medicare Advantage to Original Medicare. You can also enroll in a different Part C plan. Changes take effect on the first day of the following month.

Special Enrollment Periods

If they qualify, Medicare beneficiaries can change current health plans or enroll in Part C or Part D during special enrollment periods.

Special Enrollment Periods are granted in the following circumstances:

  • You are moving out of your current plan’s service area
  • You are moving back to the United States
  • You are moving to or from a skilled nursing or long-term care facility
  • You have been released from prison
  • You are no longer eligible for Medicaid or dually eligible for Medicare and Medicaid.
  • Medicare terminates or does not renew your current plan
  • You change from Medigap to Medicare Advantage coverage

The five-star Special Enrollment Period

You can change from your current coverage during a special enrollment period if a plan with a five-star rating becomes available in your service area.

Special Enrollment Period for the “Extra Help” program

If you are in the Extra Help program or getting Medicaid, you can change your Medicare Advantage plan or Part D coverage once during the following time periods:

  • January – March
  • April – June
  • July – September

How much does Medicare Advantage in Tennessee cost?

In Tennessee, as in other states, HMOs with zero monthly premiums are available for enrollment. You may also have access to PPOs with zero monthly premiums, depending on what is available in your service area.

How much you pay for your Medicare Advantage plan in Tennessee, the deductions, and copayments, depends on which county you live in and which plan you choose.

The average cost for Medicare Advantage and Medicare Part D coverage together in one plan (MAPD) is $25.00 per month for the premium. The average drug deductible is $124.00.

The standard monthly Medicare Part B premium for 2023 is $164.90. The annual Part B deducible for 2023 is $226.

How much do Advantage Plans cost in Tennessee?

PPO Plan $0.00 to $25.00

HMO Plan $0.00

Medicare Advantage Highlights:

Features of Medicare Advantage in Tennessee:

  • Enrollees in Medicare Advantage must continue paying the Medicare Part B premium to stay eligible for coverage.
  • The standard monthly Medicare Part B premium for 2022 is $164.90.
  • The annual Part B deducible for 2023 is $226.
  • Medicare Advantage is quickly becoming more popular in Tennessee.
  • Private health insurance providers sell Medicare Advantage plans.
  • The insurance company selling the plan is responsible for your healthcare claims, customer service, and administration of your Medicare benefits.
  • Most Medicare Advantage plans require beneficiaries to use network providers for health care.
  • Many Medicare Advantage policies also include prescription drug plans
  • Some plans have additional coverage, including over-the-counter drug allowances, transportation allowances, and meal delivery.

Ready to learn more?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Call us today, or request a quote online to learn more about plan options.

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