TennCare MCOs Compared (2026), BlueCare, UHC, Wellpoint

Tennessee runs the most concentrated Medicaid managed care market in the country. Almost every one of TennCare's 1.4 million members is enrolled in one of just three Managed Care Organizations: BlueCare Tennessee (BlueCross BlueShield of Tennessee), UnitedHealthcare Community Plan of Tennessee, and Wellpoint Tennessee (formerly Amerigroup, rebranded January 2024). A fourth plan, TennCare Select, serves special populations and is run by BlueCare under a separate contract.

Most other Medicaid managed care states have ten or more plans, regional carve-outs, separate networks for different programs, and complicated carve-out rules for behavioral health, dental, or long-term care. Tennessee has three statewide MCOs with a unified pharmacy formulary, a unified dental network, and a unified non-emergency transportation rule. That makes the comparison much simpler than it looks.

This guide explains who must enroll, how the three plans actually differ, how to switch, and how to pick the right one for your family.

By Brevy Care Team · Last verified May 2, 2026

Why Tennessee Has Only Three MCOs

TennCare operates under §1115 demonstration authority, TennCare III, approved by CMS through December 31, 2030, rather than the more common state-plan-plus-§1915(c)-waivers structure most other states use. The §1115 demonstration lets Tennessee operate a fully capitated managed care system covering virtually every Medicaid eligibility category, statewide, through a small number of full-risk contracted MCOs.

The current MCO contracts were implemented January 1, 2023 with a three-year base term plus seven one-year renewal options. Total contract value runs approximately $12 billion per year. Tennessee is currently in renewal-option years; no new procurement has been issued as of mid-2026. The 2026 contract amendment added requirements from the CMS Interoperability and Prior Authorization Final Rule, including a Patient Access API and tighter prior-authorization timing decisions.

Why the small-number structure: Tennessee's TennCare design philosophy has been to leverage scale, simplify the member experience, and concentrate accountability in a few large plans. The trade-off is less plan choice; the upside is uniform pharmacy and dental coverage and easier switching when a plan isn't working.

Who Must Enroll in a TennCare MCO

Most TennCare members must enroll in a plan. The major exception is Medicare-only QMB beneficiaries, people whose Medicaid coverage pays only their Medicare premiums (Part B = $202.90/month in 2026) and cost-sharing under federal authority at 42 USC § 1396a(a)(10)(E)(i) and the QMB billing prohibition at 42 USC § 1396a(n)(3)(B), without providing full Medicaid benefits. Full-benefit dual eligibles (those with both Medicare and full TennCare, sometimes called "QMB Plus" or "SLMB Plus") ARE enrolled in MCOs for their Medicaid services. For the full breakdown of QMB / SLMB / QI eligibility, the QMB-Plus / SLMB-Plus / Other FBDE category matrix, and how MSPs interact with TennCare CHOICES, see our Tennessee Medicare Savings Programs deep guide.

Special populations are auto-assigned to TennCare Select (the BlueCare-operated PIHP) rather than a standard MCO:

• SSI children under 21
• Children in state custody / foster care, including former foster youth ages 18–20
• Members with intellectual or developmental disabilities (through SelectCommunity, the BlueCare I/DD product line)
• Members in institutional eligibility categories
• Members in geographic areas with insufficient MCO capacity

Most adults age 65+ on standard TennCare and most adults under 65 with disabilities enroll in one of the three standard MCOs (BlueCare, UHC, or Wellpoint).

Initial MCO Assignment, How TennCare Picks for You (Or You Pick)

When you apply through TennCare Connect (online at tenncareconnect.tn.gov or by phone at 1-855-259-0701, Mon–Fri 7am–6pm CT), you can request a specific MCO. If your requested MCO is currently accepting new enrollees, you'll be assigned to it. If not, the Bureau of TennCare assigns you to an MCO that is accepting new members.

Members who reach TennCare through Social Security Administration channels, for example, automatic SSI cascade enrollment, are auto-assigned without an upfront pick. They can switch later within their initial window or during their region's annual open enrollment.

There is no external enrollment broker. Tennessee handles choice counseling internally through TennCare Connect, unlike Michigan (which uses MI ENROLLS) or Texas (which uses an HHSC enrollment broker). Free enrollment help is available from local TennCare advocates, community health navigators, and Legal Aid groups.

Open Enrollment, Switching Windows, and For-Cause Changes

Tennessee's switching rules are easy to get wrong because the state has both a regional annual open enrollment window AND a new-member without-cause grace period AND federal for-cause flexibility, and the three operate on different timelines.

Annual open enrollment by region

During your region's annual open enrollment month, you can switch to any of the three MCOs without giving a reason. Outside that window, you need either (1) to be inside your initial new-member grace period or (2) a federally qualifying for-cause reason.

New-member without-cause window

There is a real discrepancy in TN's published materials worth flagging. The administrative rule (Tenn. Comp. R. & Regs. 1200-13-13-.03) says newly enrolled members may change MCOs once within 90 calendar days (inclusive of mail time) of the date of the MCO assignment letter. TennCare's consumer-facing FAQ materials commonly say 45 days. The discrepancy likely stems from TN's §1115 waiver of the federal 90-day floor at 42 CFR 438.56 plus operational guidance issued at a shorter window. The practical recommendation: call TennCare Connect at 1-855-259-0701 to confirm your specific window before relying on either figure, and act on the earlier of the two windows to be safe.

For-cause changes (any time)

Federal regulation 42 CFR 438.56(d)(2), applicable in Tennessee, allows mid-year MCO changes any time for any of these reasons:

• The member moved out of the MCO's service area.
• The plan does not cover the service the member needs because of moral or religious objection.
• The member needs related services performed concurrently and not all are available in network.
• Other reasons, including poor quality of care, lack of access to needed services, or lack of providers experienced with the member's specific care needs.

The most common real-world for-cause reason in Tennessee is that a member's primary care doctor or specialist is no longer in their plan's network. If this happens to you, document the disruption (dates, providers, services denied) and call TennCare Connect.

How to switch and when it takes effect

Switch through TennCare Connect at tenncareconnect.tn.gov, the TennCare Connect mobile app (iOS and Android), or by phone at 1-855-259-0701. Approved switches take effect the first day of the following month.

What's the Same Across All Three Plans

Before getting to differences, it's important to know what is uniform, because three of the categories families most often plan-shop on are not plan-by-plan choices in Tennessee.

Pharmacy: a single statewide formulary

TennCare uses a single statewide Pharmacy Benefit Manager, OptumRx, under a contract effective January 1, 2020 that continues into 2026. All three MCOs use the same Preferred Drug List (PDL), most recently effective May 1, 2026. If a drug is on the TennCare PDL, it's covered the same way by BlueCare, UHC, and Wellpoint. If it's not on the PDL, the same prior-authorization process applies regardless of plan. Plan-shopping for prescription coverage doesn't work in Tennessee the way it does in Medicare Part D.

Dental: a single statewide network

TennCare added adult dental coverage on January 1, 2023, a major expansion. As of 2026, all dental services for both adults and children are administered through Renaissance (formerly DentaQuest, contract awarded 2024) at 866-864-2526. Coverage includes cleanings, exams, x-rays, fillings, crowns, root canals, and dentures, with no benefit caps on root canals or crowns. The same dentist network and the same authorization rules apply across all three MCOs.

Non-emergency medical transportation

NEMT is uniform across MCOs. Members must schedule rides at least two business days in advance through their plan's NEMT vendor (Verida for BlueCare, Tennessee Carriers for UHC and Wellpoint). The Mileage Reimbursement Program (paying a family member or friend who drives you) pays $0.70/mile from April 1, 2025 and $0.725/mile effective January 1, 2026.

Vision

Pediatric vision (eyeglasses, frames, replacement lenses) is covered for children under 21. Adult vision is generally not covered unless medically necessary. Same rule across all three MCOs.

Behavioral health

Integrated into each MCO's medical benefit; no statewide carve-out like Michigan's PIHPs.

What Genuinely Differs Across the Three Plans

This is where the comparison gets interesting. Below is the side-by-side.

BlueCare Tennessee

BlueCare is the largest TennCare MCO and operates the broadest provider network in the state, leveraging BlueCross BlueShield of Tennessee's commercial network footprint. Tennova Healthcare facilities returned to the BlueCare network in 2024. Major in-network systems include Erlanger (Chattanooga and East Tennessee), Methodist Le Bonheur (West Tennessee), and Vanderbilt.

For LTSS members, BlueCare runs a layered care-coordinator structure:

• CHOICES members (adults 65+ and 21+ with physical disabilities): dedicated Care Coordinators reachable at 1-800-468-9698.
• SelectCommunity for I/DD: nurse Care Managers at 1-800-292-8196.
• SelectKids for foster youth and state-custody children: enhanced supports.
• ECF CHOICES participants: dedicated support coordinators.

The MyHealth Toolkit mobile app (BCBST member app) provides digital ID card, find-care search, claims, telehealth, and secure messaging. CareTN is BlueCare's case-management text-message platform, useful for high-needs members and pregnant women.

Best fit for: families in East Tennessee where BCBST's network is strongest; LTSS members who value the most layered care-coordinator structure; families whose existing providers are in-network with BCBST commercial.

UnitedHealthcare Community Plan of Tennessee

UHC operates a strong statewide network with national-scale infrastructure. The flagship UHC differentiator is Healthy First Steps, an outreach and rewards program for pregnant members that pays incentives for attending prenatal visits, postpartum visits, and well-child checks through baby's first 15 months. National Healthy First Steps data shows participants average 14% more physician visits and 5.7% lower ED utilization. Hotline: 1-800-599-5985.

The standard UnitedHealthcare mobile app provides digital ID card, claims, find-care, and virtual visits. NEMT runs through Tennessee Carriers at 1-866-405-0238 (TTY 711).

A localized network note for Memphis-area members: Memphis Medical Care Clinic announced it will stop accepting UnitedHealthcare TennCare effective January 1, 2026 due to unresolved contracting issues. This is a localized provider-network issue, not a UHC market exit. If you're a current UHC member who uses Memphis Medical Care Clinic, this is a federally qualifying for-cause reason to switch plans.

Best fit for: pregnant members and families with young children (Healthy First Steps); members who value a strong national app and customer service infrastructure; families whose existing providers are in-network with UHC.

Wellpoint Tennessee

Wellpoint is the new name for what was Amerigroup until January 1, 2024, the rebrand was rolled out by Elevance Health across Arizona, Iowa, New Jersey, Tennessee, Texas, and Washington. Despite the new name, the contract, network, and Tennessee operations are continuous from Amerigroup. Pre-2024 sources still reference Amerigroup.

Wellpoint's signature program is Healthy Rewards, cash and gift-card incentives for completing prenatal visits, postpartum visits, well-child checks, and other preventive milestones. Specific dollar amounts per activity vary; members can check the current Tennessee-specific reward grid at the Wellpoint Healthy Rewards page.

The Sydney Health mobile app (Elevance's member app) provides digital ID card, find-a-doctor, live chat with member services, claims, prescriptions, and Health Risk Assessment. Member services: 1-833-731-2153 (TRS 711).

Wellpoint integrates Elevance's whole-health and community-resource programs (housing, food access, employment supports), with explicit Care Coordinators for CHOICES, ECF CHOICES, Katie Beckett A members, members with complex chronic conditions, and high-risk pregnancies.

Best fit for: members who want a feature-rich mobile experience; families participating in maternity rewards programs; members who benefit from community-resource referrals beyond medical care.

What About D-SNPs and Medicare Marketing?

This is one of the most common sources of confusion among Tennessee Medicaid families.

The big extras you see in TV ads, $5,000 dental allowances, $290 monthly OTC cards, healthy-food cards, SilverSneakers gym memberships, Uber Health rides, are almost always Medicare Dual-Special-Needs-Plan (D-SNP) features, not TennCare Medicaid features. D-SNPs are Medicare Advantage plans designed for dual-eligibles (people with both Medicare and full Medicaid). Each TennCare MCO has an aligned D-SNP product:

• BlueCare Tennessee → BlueCare Plus (D-SNP)
• UnitedHealthcare Community Plan → UnitedHealthcare Dual Complete (D-SNP)
• Wellpoint Tennessee → Wellpoint Dual Priority (D-SNP) and similar product names

The straight TennCare Medicaid product does not carry these big extras. Don't pick a TennCare MCO based on Medicare D-SNP marketing copy, they're different product lines. If you're a dual-eligible age 65+ and considering a D-SNP, that's a separate Medicare decision that interacts with but is not the same as your TennCare MCO.

For dual-eligibles, the cleanest model is to align your D-SNP and your TennCare MCO under the same parent company (e.g., BlueCare Plus paired with BlueCare TennCare). Aligned products often share a single Care Coordinator and reduce paperwork. We'll cover the dual-eligible alignment decision in our forthcoming Tennessee Medicare guide.

Quality, Accreditation, and Where to Look for Performance Data

All three TennCare MCOs hold NCQA Health Plan Accreditation. Tennessee was a Medicaid pioneer in requiring statewide NCQA accreditation. Specific 2025 star ratings are published on each plan's NCQA Report Card page (the 2026 ratings release around September 15, 2026).

TennCare publishes annual HEDIS reports comparing plan-by-plan performance on measures including well-child visits, immunizations, asthma, diabetes, and behavioral-health follow-up. The most recent published report is HEDIS 2024, archived at tn.gov/tenncare/information-statistics/mco-quality-data.html. QSource serves as TennCare's External Quality Review Organization; the 2025 Tennessee EQR Technical Report is archived at the TN State Library digital commons.

TennCare does not publish a unified consumer-facing MCO report card the way some states do. The HEDIS reports and EQRO technical report are the closest equivalents.

For dual-eligibles also picking a Medicare D-SNP, CMS Star Ratings (a separate methodology from NCQA) apply to the Medicare side and are published annually at medicare.gov.

How to Pick, A Simple Decision Framework

Most Tennessee families will spend less time on this decision than they should. Here's a five-minute framework that catches most of the meaningful differences.

1. List your current doctors, specialists, and hospitals. Call each MCO's member services and confirm in-network status. This is the single most important step, a plan with great extras isn't worth losing your relationship with the doctor your parent has been seeing for ten years.
2. Identify your dominant care need. Pregnant or planning? Lean toward UHC (Healthy First Steps) or Wellpoint (Healthy Rewards). Adult on CHOICES with complex needs? Lean toward BlueCare (broadest network, layered care-coordinator structure). Child with I/DD? BlueCare's SelectCommunity may be the right fit (or you may be auto-assigned to TennCare Select).
3. Check the mobile app. If digital tools matter to you, try the apps before enrolling. They're free to download, MyHealth Toolkit (BCBST), UnitedHealthcare, Sydney Health (Wellpoint).
4. Geography matters less than you think. All three operate statewide. BlueCare's network is broadest in East TN; UHC and Wellpoint are competitive everywhere.
5. Don't agonize. Switching is straightforward, annual open enrollment in your region, plus the new-member grace period, plus federal for-cause flexibility. If your first pick doesn't work, you can change.

How TennCare Compares to Other States

If you've moved to Tennessee from another state, or are considering moving, the structural differences are worth understanding.

• Michigan runs 10 Medicaid Health Plans across 10 Prosperity Regions, with a behavioral health carve-out to PIHPs and the MI Choice waiver carved out of MHPs entirely. Plan choice is wider; complexity is higher.
• Texas runs STAR (general Medicaid), STAR+PLUS (LTSS), STAR Health (foster youth), STAR Kids (children with disabilities), and CHIP as separate programs with different MCO networks per service area. Multiple plans per region.
• Tennessee runs everything through the same three MCOs (plus TennCare Select for special pops). One pharmacy formulary statewide, one dental network statewide, one set of switching rules.

The Tennessee approach trades plan choice for simplicity. For most families, simplicity wins.

What to Read Next

• Tennessee Medicaid Programs, the master Medicaid hub explaining how CHOICES, ECF CHOICES, Katie Beckett, standard ABD, and MSPs fit together.
• Tennessee Medicare Savings Programs (QMB / SLMB / QI): The Complete 2026 Guide, the deep dive on Medicare premium and cost-sharing assistance for low-income Tennessee Medicare beneficiaries.
• How to Apply for TennCare, the four application channels, document checklist, and ex parte renewal mechanics.
• TennCare CHOICES, the LTSS umbrella for adults 65+ and adults with physical disabilities.
• ECF CHOICES, the I/DD program for children and adults with intellectual or developmental disabilities.
• Katie Beckett, the program for severely disabled minors whose family income would otherwise disqualify them from TennCare.
• Tennessee Medicaid Nursing Home Coverage, how nursing facility care under CHOICES Group 1 actually works.
• Managed Care Organization (MCO), Glossary, the technical primer on Medicaid managed care.

Find personalized help comparing TennCare MCO plans at brevy.com.

This guide reflects TennCare MCO contract terms in effect as of May 2026. Plan rosters, value-added benefits, and contract amendments change. The 2026 contract amendment added CMS Interoperability and Prior Authorization Final Rule requirements; subsequent amendments may shift specific timelines. For decisions involving a specific family member, call TennCare Connect at 1-855-259-0701 or your MCO's member services line.