Tennessee residents have new options for buying health insurance due to the Affordable Care Act (ACA), also known as ObamaCare. Tennessee did not implement a state-run marketplace. Instead, citizens must use the federal Healthcare.gov Marketplace to apply for and purchase private health insurance.

Tennessee also decided not to move forward with the expansion of Medicaid eligibility. This decision means that some Tennesseans will be ineligible for financial assistance with paying for private insurance and won’t be eligible for Medicaid, either. However, ObamaCare did increase funding for community health centers, which may be able to provide some assistance in making health care more affordable for those who live in Tennessee.

Purchasing Health Insurance in Tennessee

Reviewing and purchasing health insurance in Tennessee is simply a matter of filling out a Marketplace application. There are several ways to do this:

  • Apply online at Healthcare.gov
  • Apply by phone by calling 1-800-318-2596 anytime, 24 hours a day 7 days a week
  • Apply by mail using the application form and instructions
  • Apply in person with the help of an assister

Regardless of which way Tennesseans choose to apply, all applications will be automatically reviewed for any applicable financial assistance, as well as eligibility for Medicaid and the Children’s Health Insurance Program (CHIP). Tennesseans who earn between 100% and 400% of the poverty level will be eligible for assistance with private insurance premiums, and those who earn between 100% – 250% of the poverty level will also receive assistance with cost-sharing, such as copayments and deductibles. In 2013, the federal poverty level was $23,550 for a family of four.

Using the federal Marketplace, a general search can be done to preview coverage in the applicant’s local area. However, citizens of Tennessee should fill out a full application to see exact prices after the financial assistance is applied. It’s important to note that the lowest price plans may not turn out to be the best option – it’s possible that the plan has high cost-sharing amounts, or a very narrow medical network. When choosing a plan, be sure to call important medical providers and make sure they accept that particular plan. Many Marketplace policies do not offer coverage for out-of-network providers.

Uninsured Tennesseans should be sure to obtain coverage by March 31, 2014 to avoid a tax penalty. The tax penalty increases each year after 2014. Citizens who have job-based health insurance, Medicare, or other qualified coverage are considered covered by the ACA and do not need to purchase additional insurance. If insurance is not obtainable due to cost or other circumstances, an exemption may be available to avoid the penalty. Typically, a plan purchased by the 15th of the month will go into effect on the 1st of the next month.

Medicaid and CHIP in Tennessee

Although the state of Tennessee did not expand Medicaid guidelines, there are still many low-income Tennessee residents who will qualify for the coverage. Application can be made through the Marketplace or by contacting the state office directly. Citizens who do not qualify for Medicaid due to moderate income may still be able to take advantage of CHIP to obtain coverage for uninsured children in the family. This program works closely with Medicaid to provide check-ups, doctor visits, immunizations, and more for Tennessee’s young people.

For Tennesseans who cannot obtain health insurance either privately or through the state, ObamaCare increased funding for community health centers that may provide some assistance. These centers can provide basic primary care and referrals to specialists, and often charge on a sliding scale based on income. To locate a nearby community health center, Tennesseans can visit the Find a Health Center site.

The people of Tennessee have new ways to access health insurance after the passage of the ACA. Whether a citizen chooses to call, apply online, or apply in person, all applications will be reviewed to make sure that all appropriate financial assistance is applied. Even without Medicaid expansion, low-income Tennesseans may still qualify for Medicaid or CHIP. Knowing what options are available to you and your family will help you make the best choice for your household.