Medicare Plans in Tennessee: Coverage and Costs (2026)

If you're turning 65 in Tennessee or helping a parent sort out Medicare, you're facing four parts, dozens of plan choices, and costs that reset every January. The standard Part B premium for 2026 is $202.90 a month, the Part D donut hole is gone for good, and more than half of Tennessee's roughly 1.5 million Medicare beneficiaries have picked a Medicare Advantage plan over Original Medicare.

This guide walks through every piece of Medicare as it works for Tennesseans in 2026, what it costs, the plan choices in this state, and how to get free help paying for it.

In This Guide

• Key Takeaways
• Original Medicare: Parts A and B
• Medicare Advantage in Tennessee (Part C)
• Medicare Part D: Prescription Drugs
• Medigap in Tennessee
• Help Paying for Medicare in Tennessee
• If You Have Both Medicare and TennCare
• Medicare Enrollment Periods
• Free Medicare Help: Tennessee SHIP
• Frequently Asked Questions

About these numbers: The premiums and deductibles below come from CMS for calendar year 2026, effective January 1. Medicare costs change every year. For the most current figures, contact Medicare at 1-800-633-4227 (1-800-MEDICARE) or Tennessee SHIP at 1-877-801-0044.

Original Medicare: Parts A and B

Original Medicare is run directly by the federal government, and it comes in two parts.

Part A (Hospital Insurance)

Part A covers inpatient hospital stays, limited skilled nursing facility care, hospice, and some home health care.

The hospital deductible went up $60 from 2025. A benefit period starts the day you're admitted and ends 60 days after you leave. Get readmitted after that, and the deductible applies again.

Part B (Medical Insurance)

Part B covers doctor visits, outpatient care, preventive services, durable medical equipment, and mental health care. It doesn't cover routine dental, vision, or hearing.

• Monthly premium: $202.90 (higher if your income is above $109,000 single or $218,000 married, under the income-related adjustment)
• Annual deductible: $283
• After the deductible: you pay 20% of the Medicare-approved amount for most services

Part B is technically optional, but nearly everyone signs up. Delay past your enrollment window without other creditable coverage and you'll owe a late penalty of 10% for every 12 months you could have had it, for as long as you keep Part B.

Medicare Advantage in Tennessee (Part C)

Medicare Advantage plans are an alternative to Original Medicare, sold by private insurers. They cover everything Parts A and B do, and most bundle in Part D drug coverage along with extras like dental, vision, and hearing.

Tennessee leans heavily toward these plans. Nearly 53% of the state's roughly 1.5 million Medicare beneficiaries were enrolled in Medicare Advantage as of late 2024, a bit above the national split where just over half of all beneficiaries are in Medicare Advantage. Nationally, the average beneficiary can choose from about 32 Medicare Advantage plans with drug coverage for 2026, and Tennessee's metro areas around Nashville, Memphis, Knoxville, and Chattanooga usually sit at or above that.

The Major Insurers in Tennessee

The familiar national carriers dominate the Tennessee market: UnitedHealthcare, Humana, BlueCross BlueShield of Tennessee, Aetna, and Cigna, which is headquartered in the state. Wellpoint (formerly Amerigroup) also sells plans here. Plan availability and pricing differ by county, so two people in different parts of Tennessee can see very different menus.

How These Plans Work

• You keep paying your Part B premium ($202.90) on top of any plan premium, though many plans charge $0 extra.
• Plans run on networks (HMO or PPO). Confirm your doctors and hospitals are in-network before you enroll, since rural Tennessee networks can be thinner than metro ones.
• Every plan caps your annual out-of-pocket spending. Original Medicare has no such cap.
• Extras vary widely. Compare the dental, vision, hearing, and transportation benefits, not just the premium.

Use the Medicare Plan Finder at medicare.gov to compare plans by ZIP code. Enter your doctors and prescriptions and it shows which plans cover them and your estimated cost.

Medicare Part D: Prescription Drugs

Part D covers outpatient prescription drugs. You can get it as a standalone plan paired with Original Medicare, or built into a Medicare Advantage plan.

The Inflation Reduction Act eliminated the old coverage gap, the donut hole, so that higher-cost middle stage is gone. Part D now moves through three phases:

1. Deductible: you pay full price until you meet your plan's deductible (up to $615 in 2026).
2. Initial coverage: you pay copays or coinsurance while your plan and drug makers cover the rest.
3. Catastrophic: once your out-of-pocket spending reaches $2,100, you pay $0 for covered drugs the rest of the year.

That $2,100 cap is the number that matters most in Part D. It was $2,000 in 2025 and rises with inflation. The base premium is $38.99 a month, though actual plan premiums vary, and increases are capped at 6% a year through 2029. People who qualify for Extra Help often pay much less, sometimes nothing.

Medigap in Tennessee

Medigap policies are sold by private insurers to fill the gaps in Original Medicare: the deductibles, coinsurance, and copays. They work only with Original Medicare, never with Medicare Advantage.

Tennessee offers the federally standardized plans, labeled A, B, C, D, F, G, K, L, M, and N. Plans C and F are closed to anyone who became Medicare-eligible on or after January 1, 2020. Plan G is the popular choice for people newly eligible: it covers the Part A deductible, Part A and Part B coinsurance, and skilled nursing coinsurance, leaving only the $283 Part B deductible on you.

Your strongest opening is the federal Medigap Open Enrollment Period, the six months that begin when you're 65 and enrolled in Part B. During that window an insurer has to sell you any plan at the standard rate regardless of your health.

Tennessee Has No Birthday Rule

Worth being clear about, because readers often hear otherwise: Tennessee does not have a Medigap "birthday rule" or any annual guaranteed-issue window to switch plans. A handful of states, including California and Oregon, let you change Medigap policies each year without health questions. Tennessee isn't one of them. Once your six-month window closes, an insurer here can use medical underwriting and turn you down or charge more based on your health when you apply to switch or buy. So choose carefully during your initial window, and weigh Plan G or Plan N before you're locked in.

Tennessee does require that Medigap policies be guaranteed renewable, meaning an insurer can't drop you for getting sick once you're covered. Medigap insurers and policies are regulated by the Tennessee Department of Commerce & Insurance, which licenses carriers and handles complaints.

Medigap or Medicare Advantage?

You can't hold both. Choose Medigap and you stay on Original Medicare with the freedom to see any provider who takes Medicare nationwide, at a higher monthly premium. Choose Medicare Advantage and you trade some of that freedom for a network and a lower upfront cost. In Tennessee, the lack of a birthday rule raises the stakes on a Medigap decision, because switching later usually means passing a health screening.

Help Paying for Medicare in Tennessee

If you're on a fixed income, two programs can cut your Medicare costs sharply.

Medicare Savings Programs

Tennessee runs its Medicare Savings Programs through TennCare, the state's Medicaid program. They pay some or all of your Medicare premiums and cost-sharing based on income.

QMB is the most generous, covering your Part B premium and your deductibles and coinsurance, which can be thousands of dollars in savings a year. Tennessee applies the federal asset test for these programs: $9,950 for one person and $14,910 for a couple in 2026, per Social Security's rules. The income limits above are tied to the federal poverty level and update each spring, so confirm the current figures with TennCare or Tennessee SHIP before you rule yourself in or out. Qualifying for any of the three programs also enrolls you automatically in Extra Help for Part D.

Extra Help for Part D

Extra Help, also called the Low-Income Subsidy, pays Part D premiums, deductibles, and copays for people with limited income and resources.

• Resource limits: $16,590 for an individual, $33,100 for a married couple
• If you qualify for QMB, SLMB, or QI, you're automatically enrolled in Extra Help

Apply through Social Security at ssa.gov or call 1-800-772-1213.

If You Have Both Medicare and TennCare

Many people who have Medicare also qualify for Medicaid. In Tennessee, the state aligns Medicare Dual Eligible Special Needs Plans (D-SNPs) with TennCare CHOICES, the program that runs long-term services and supports for TennCare members. A D-SNP coordinates your Medicare and TennCare benefits, your doctors, your drugs, and any long-term care, through one plan with one set of member materials.

Tennessee's D-SNPs come from BlueCare Plus (BlueCross BlueShield of Tennessee), UnitedHealthcare Community Plan, and Wellpoint. You get the tightest coordination when your D-SNP is run by the same company that manages your TennCare and CHOICES coverage. If your needs are more intensive and you'd otherwise need nursing-home care, the PACE program is another fully integrated option in parts of Tennessee. For the full picture, see our guides to TennCare CHOICES and Tennessee's BlueCare Plus FIDE D-SNP.

Medicare Enrollment Periods

Miss a deadline and you can face coverage gaps or permanent penalties. The key dates:

Changes you make during Annual Open Enrollment take effect the following January 1. That's when most people review their plan and switch.

Free Medicare Help: Tennessee SHIP

You don't have to figure this out by yourself, and you don't have to pay a broker to help. Tennessee's State Health Insurance Assistance Program, or SHIP, gives free, unbiased Medicare counseling. It's run by the Tennessee Department of Disability and Aging and it doesn't promote any insurance company.

A SHIP counselor can help you:

• Understand your Medicare options and what each part covers
• Compare Medicare Advantage, Part D, and Medigap plans side by side
• Apply for Medicare Savings Programs and Extra Help
• Sort out billing problems, denials, and appeals
• Work out how Medicare fits with TennCare if you have both

Call 1-877-801-0044 or email dda.ship@tn.gov to get connected with a counselor near you.

Learn More

• Tennessee Medicare Savings Programs: QMB, SLMB, QI
• Medicare vs Medicaid in Tennessee
• TennCare CHOICES: Eligibility and Services
• Tennessee BlueCare Plus FIDE D-SNP
• Tennessee PACE Program
• Tennessee Medicaid (TennCare) Guide

Find personalized help comparing your Medicare options in Tennessee 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.