Tennessee Medigap: Open Enrollment, Under 65, Guaranteed Issue (2026)

Tennessee Medigap rules give you one six-month window, starting the first month you are both 65 and on Medicare Part B, when an insurer cannot turn you down or charge more because of your health. Under Tennessee rule 0780-01-58-.14, the Medigap (Medicare Supplement) open enrollment window applies to every policy the insurer has available, and Medicare describes it as a one-time period that does not repeat.1 Tennessee also reaches people federal law generally leaves out: under 2010 Public Chapter 978, insurers that sell Medigap to Tennesseans 65 and older must also offer Medigap policies to Tennesseans under 65 who have Medicare because of a disability or end-stage renal disease (ESRD).1,2 Outside those protected windows, a Tennessee Medigap insurer may deny you a policy unless you have a guaranteed-issue right, and Tennessee rule 0780-01-58-.15 puts several of those rights on 63-day deadlines.3

In This Guide

• Your One-Time Tennessee Medigap Open Enrollment Window
• Pre-Existing Conditions During Tennessee Open Enrollment
• Tennessee Medigap Under 65: Disability and ESRD
• Tennessee Medigap Guaranteed-Issue Rights and the 63-Day Clock
• Which Medicare Supplement Plans You Can Buy in Tennessee
• Medigap or Medicare Advantage in Tennessee
• Tennessee Medigap at a Glance
• Where to Get Medigap Help in Tennessee
• Frequently Asked Questions
• Learn More

Your One-Time Tennessee Medigap Open Enrollment Window

Tennessee's Medigap open enrollment rule is paragraph (1) of Rule 0780-01-58-.14, part of the Tennessee Department of Commerce and Insurance's Medicare supplement minimum standards (the version effective February 18, 2019). The Tennessee window is six months long and begins on the first day of the first month in which you are both 65 or older and enrolled in Medicare Part B.1

For a Medigap application submitted during that six-month window, Tennessee rule 0780-01-58-.14(1) says the insurer may not:

• deny or condition the issuance or effectiveness of any Medigap policy it has available for sale in Tennessee;
• set a higher price because of your health status, claims experience, receipt of health care, or medical condition.

Every Medigap policy a Tennessee insurer currently has available must be made available to open enrollment applicants who qualify under the Tennessee rule.1

Federal law sets the same floor nationwide. Section 1882 of the Social Security Act, at §1882(s)(2)(A), bars a Medigap issuer from denying, conditioning, or pricing a policy on health for an applicant who applies during the six months beginning with the first month the person is 65 or older and enrolled in Part B.2 The Tennessee rule closely tracks the wording of that federal Medigap Open Enrollment Period provision.

The Tennessee window happens once. Medicare's March 2026 guide Choosing a Medigap Policy calls the six-month Medigap Open Enrollment Period a one-time enrollment period that does not repeat every year. The same Medicare guide warns that outside the Medigap Open Enrollment Period, there is no guarantee an insurance company will sell you a Medigap policy if you don't meet its medical underwriting requirements, and it may deny you a policy unless you have a guaranteed-issue right.1

Because the Tennessee window is tied to Part B, the start month moves if Part B does. A Tennessean who turns 65 but delays Part B has a Medigap open enrollment period that begins the first month both conditions are true.1

For the federal version of the same window, see Brevy's guide to the Medigap open enrollment period.

Pre-Existing Conditions During Tennessee Open Enrollment

Buying during the Tennessee Medigap open enrollment window guarantees the sale, but whether a policy can wait to cover a pre-existing condition depends on your prior coverage.

Under Tennessee rule 0780-01-58-.14(2)(a), a Medigap insurer may not exclude benefits based on a pre-existing condition if you apply during the Tennessee open enrollment window and, as of the application date, have had at least six months of continuous creditable coverage.1 Medicare's guide states the federal version plainly: "If you've had at least 6 months of continuous prior creditable coverage, the Medigap insurance company can't make you wait before it covers your pre-existing condition."1

Tennessee rule 0780-01-58-.14(3) sets the outer limit of a pre-existing-condition wait. Except as that rule's paragraph (2) and Tennessee Rules 0780-01-58-.15 and .26 provide, open enrollment does not prevent a Tennessee Medigap policy from excluding benefits, during its first six months, for a pre-existing condition that was treated or diagnosed during the six months before the coverage took effect.1

If you are coming off employer coverage or another plan, ask the insurer how it counts your creditable coverage before you sign. Brevy's guide to Medigap and pre-existing conditions walks through the federal mechanics.

Tennessee Medigap Under 65: Disability and ESRD

Medicare.gov states that federal law generally doesn't require insurance companies to sell Medigap policies to people under 65 who have Medicare because of a disability or ESRD, although in some states insurance companies do offer them.2

Under Tennessee's 2010 Public Chapter 978, insurers that offer Medigap policies in Tennessee to people 65 or older must also offer Medigap policies to Tennesseans under 65 who are eligible for and enrolled in Medicare by reason of disability or end-stage renal disease. Public Chapter 978 took effect for most purposes on January 1, 2011.1

Except as the act otherwise provides, Public Chapter 978 extends to Tennessee Medigap applicants under 65 with disability or ESRD Medicare all the benefits, protections, policies and procedures that apply to Tennessee applicants 65 or older. The Tennessee Department of Commerce and Insurance explained the act in a December 1, 2010 bulletin: carriers that offer Medigap plans to people 65 and older must also offer those same plans to eligible people under 65, and no one eligible for Medicare because of a disability or ESRD may be denied Medigap coverage because of health status.1

Medicare's March 2026 guide Choosing a Medigap Policy lists Tennessee among the states that, at the time of printing, require insurance companies to offer at least one kind of Medigap policy to people with Medicare under 65.1

When a Tennessean under 65 can enroll

As enacted, Public Chapter 978 lets a Tennessean under 65 with Medicare because of disability or ESRD enroll in a Medigap policy at any time the federal government authorizes or requires, or within six months after any one of these events:1

• enrolling in Medicare Part B;
• the date of the notice that the person has been retroactively enrolled in Part B because of a retroactive eligibility decision by the Social Security Administration;
• losing access to other health coverage, such as an accident and sickness policy, employer-sponsored group health coverage, or a Medicare Advantage plan, because that coverage was terminated or cancelled due to the person's employment status or an insurer's or employer's action unrelated to the person's status, conduct, or failure to pay premiums;
• being involuntarily disenrolled from Medicaid (Title XIX) or the Children's Health Insurance Program (Title XXI).

Any one of the four Public Chapter 978 events is enough to open a six-month Tennessee Medigap window for a person under 65; the events are alternatives, not a checklist. Losing employer coverage is not an extra requirement for someone who is simply enrolling in Part B.1

Rates, and a second window at 65

Public Chapter 978 allows premium rates for Tennessee Medigap policies sold to people under 65 with disability or ESRD to differ from rates for people 65 or older, as long as the differences follow rate schedules based on sound actuarial principles.1 Compare the quotes each Tennessee insurer gives for your age before you choose.

Buying a Tennessee Medigap policy under 65 does not use up the open enrollment window at 65. Medicare's March 2026 guide states that a person who already has Medicare Part B still gets a Medigap Open Enrollment Period on turning 65.1 A Tennessean on disability Medicare can therefore revisit plan choices and prices during the six-month window at 65. For how other states handle the same group, see Brevy's Georgia and North Carolina Medigap guides.

Tennessee Medigap Guaranteed-Issue Rights and the 63-Day Clock

Medicare.gov notes that its answers about switching apply only to federal rights, and that in most cases you won't be able to switch your Medigap policy outside your six-month Medigap Open Enrollment Period except in specific situations when you have a guaranteed-issue right. Switching outside that window without such a right, Medicare.gov warns, may mean paying more for the new policy and answering medical questions.4

Tennessee's guaranteed-issue rights are set by Rule 0780-01-58-.15. For an eligible person who applies during the guaranteed-issue period, Tennessee rule 0780-01-58-.15 bars the insurer from denying or conditioning a covered Medigap policy it offers to new enrollees, from pricing that policy on health status, claims experience, receipt of health care or medical condition, and from imposing a pre-existing-condition exclusion.3

Three Tennessee guaranteed-issue situations

The list of eligible persons in Tennessee rule 0780-01-58-.15(2) is longer than the three situations below.3

Your employer plan that supplements Medicare ends. Tennessee rule 0780-01-58-.15(2)(a) covers a person enrolled in an employee welfare benefit plan that supplements Medicare when the plan terminates or stops providing all of those supplemental benefits. The Tennessee guaranteed-issue period for an ending employer plan begins on the later of the notice of termination or cessation (or, if no notice arrives, a claim denial notice) or the date the coverage ends, and it ends 63 days after that.3

Your TennCare coverage ends after 65. For a Tennessean 65 or older and enrolled in Medicare Part B whose TennCare (Tennessee Medicaid) enrollment involuntarily ends, Tennessee rule 0780-01-58-.15(2)(h) makes that person eligible for guaranteed issue, and the guaranteed-issue period begins when the person receives notice of the involuntary disenrollment and ends 63 days after the coverage is terminated. The Tennessee Department of Commerce and Insurance's 2010 bulletin states that anyone 65 or older who becomes disenrolled from TennCare must be given 63 days from the date of disenrollment to purchase a Medigap policy.3

You tried Medicare Advantage or PACE at 65 and want to leave. Under Tennessee rule 0780-01-58-.15(2)(f) and (5)(c), a person who, on first becoming eligible for Medicare Part A at 65, enrolls in a Medicare Advantage plan or with a Program of All-Inclusive Care for the Elderly (PACE) provider and disenrolls within 12 months after the enrollment's effective date is entitled to any Medigap policy offered by any issuer.3 Brevy's guide to switching between Medicare Advantage and Original Medicare covers the federal side of the trial right.

How the 63-day clocks run

Tennessee rule 0780-01-58-.15(3) gives each guaranteed-issue situation its own start date, and the rule's periods end 63 days after a set point:

• Involuntary terminations: when enrollment in one of the situations under Tennessee rule .15(2)(b), (c), (e) or (f) is terminated involuntarily, the guaranteed-issue period begins on the notice of termination and ends 63 days after the coverage is terminated.
• Any other eligible person: for an eligible person the Tennessee rule does not otherwise describe, the guaranteed-issue period begins on the effective date of disenrollment and ends 63 days after that date.3

Missing a Tennessee 63-day deadline can leave you back in medical underwriting, because outside open enrollment an insurer may deny a Medigap policy to someone without a guaranteed-issue right. Keep every termination notice and apply as soon as you know your coverage is ending.1

Which plans a guaranteed-issue right reaches

Tennessee's plan list for guaranteed issue depends on the situation. For eligible persons under Tennessee rule 0780-01-58-.15(2)(a), (b), (c), (d) and (h), which include the employer-plan and Medicaid situations above, rule .15(5)(a) names Medigap policies classified as Plan A, B, C, F (including high-deductible F), K or L offered by any issuer, and, in the rule's words, "after January 1, 2020, Plan A, B, D, G (including G with a high deductible), K, or L offered by any issuer."3 For what the 2020 cutoff means for Plans C, F, D and G, see Which Medicare Supplement Plans You Can Buy in Tennessee.

The Tennessee rule .15(5)(a) plan list does not govern every guaranteed-issue situation: the first-year Medicare Advantage or PACE trial situation above is the exception, and Tennessee rule 0780-01-58-.15(5)(c) entitles that person to any Medigap policy offered by any issuer.3 For the federal picture, see Brevy's guide to Medigap guaranteed-issue rights.

Which Medicare Supplement Plans You Can Buy in Tennessee

Medigap plans are standardized by letter. Medicare's 2026 guide charts the Medigap plans as Plans A, B, C, D, F, G, K, L, M and N, and states that every insurance company that sells Medigap policies must offer at least Medigap Plan A.1

Medigap plans sold to people new to Medicare on or after January 1, 2020 aren't allowed to cover the Part B deductible, so Medigap Plans C and F are no longer available to people new to Medicare. Tennesseans new to Medicare on or after that date have the right to buy Medigap Plans D and G, which give the same benefits as Plans C and F but don't cover the Part B deductible.1 Medigap Plans E, H, I and J are no longer sold, but someone who already has one can generally keep it.1

Brevy's guides to whether you can still get Medigap Plan F and to how the lettered Medigap plans work compare the letters benefit by benefit.

Medigap or Medicare Advantage in Tennessee

Medigap works only alongside Original Medicare. The Centers for Medicare & Medicaid Services (CMS) booklet Understanding Medicare Advantage Plans states that you can't use a Medigap policy to pay Medicare Advantage Plan copayments, coinsurance, deductibles, and premiums.5

The same CMS booklet states that if you're in a Medicare Advantage Plan, it's illegal for anyone to sell you a Medigap policy unless you're switching back to Original Medicare. If you aren't planning to drop Medicare Advantage and someone tries to sell you a Medigap policy, the CMS booklet says to report it to your State Insurance Department.5 Brevy's guide to illegal Medigap sales to Medicare Advantage members explains how this happens.

Dropping a Medigap policy to join Medicare Advantage is hard to undo. The CMS booklet states that in most cases, if you drop your Medigap policy to join a Medicare Advantage Plan, you may not be able to get the same policy back. Under federal law, a person who joins a Medicare Advantage Plan for the first time and isn't happy with it has a trial right to buy a Medigap policy on returning to Original Medicare within 12 months of joining.5

Tennessee Medigap at a Glance

The table summarizes Tennessee rules 0780-01-58-.14 and .15 and 2010 Public Chapter 978; the sections above give the exact wording and conditions.1,3

Where to Get Medigap Help in Tennessee

The Tennessee Department of Commerce and Insurance's Health Insurance Information page lists a Medicare Supplement Companies document and a Medicare Supplement Rates page under its Medicare Supplement Information heading.1 The two Tennessee Department of Commerce and Insurance listings are the state's own starting point for comparing Medigap companies and rates.

Medicare's March 2026 Medigap guide tells people to call their State Insurance Department or State Health Insurance Assistance Program (SHIP) for state-specific Medigap information, and to visit shiphelp.org to get the number for their local SHIP.1 Brevy's Tennessee Medicare hub covers the rest of Medicare in the state.

For questions about Original Medicare itself, 1-800-MEDICARE (1-800-633-4227) is the official Medicare line run by CMS, and TTY users call 1-877-486-2048. Medicare.gov says callers can talk or live chat with a real person 24 hours a day, 7 days a week, except some federal holidays.6

Learn More

Find personalized help timing your Tennessee Medigap window and checking a guaranteed-issue right at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.