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 every one of Tennessee's 1,496,872 Medicare beneficiaries has access to a Medicare Advantage plan. 132 are available across the state for 2026, and the lowest monthly premium among them is $0.,

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

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.

Cost Amount
Monthly premium $0 for most people (40+ quarters of work history)
Hospital deductible $1,736 per benefit period
Hospital coinsurance, days 61-90 $434 per day
Lifetime reserve days $868 per day
SNF coinsurance, days 21-100 $217 per day

The hospital deductible went up $60 from 2025, to $1,736 per benefit period. 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 has a broad market for these plans. Every one of the state's 1,496,872 Medicare beneficiaries has access to at least one Medicare Advantage plan, and 132 plans are available for 2026, one more than the 131 offered in 2025. The average monthly plan premium in Tennessee came down from $16.89 in 2025 to $12.83 in 2026, and the lowest monthly premium in the state is $0. Nationally, the average beneficiary can choose from about 32 Medicare Advantage plans with drug coverage for 2026.

What's on Offer Depends on Your County

That statewide count of 132 plans is not a menu any one person gets to order from. Plan availability, premiums, networks, and extra benefits are set county by county, so two people in different parts of Tennessee can pull up the same tool and see very different options. What the statewide picture does tell you is that coverage reaches everyone: 100% of people with Medicare in Tennessee have a Medicare Advantage plan available to them, and somewhere in the state the monthly premium goes as low as $0. Whether a $0 plan is offered in your county, and whether it covers your doctors, is a question only your ZIP code can answer.

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. In Tennessee, 12 stand-alone Part D plans are available for 2026, and 24.24% of the Tennesseans in one of them get Extra Help paying for it.

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 drug-spending growth. The 2026 national base beneficiary premium is $38.99 a month, though actual plan premiums vary. People who qualify for Extra Help often pay much less, sometimes nothing.

Not sure which Part D plan fits your prescriptions? Chat with Brevy's care navigator at brevy.com.

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.

Program Individual Couple What it pays
QMB Up to about $1,350 Up to about $1,824 Part A and B premiums, deductibles, coinsurance
SLMB Up to about $1,616 Up to about $2,184 Part B premium
QI Up to about $1,816 Up to about $2,455 Part B premium

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 the Social Security Administration's POMS 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 the Social Security Administration at ssa.gov/extrahelp 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 of All-Inclusive Care for the Elderly) 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:

Period Dates What you can do
Initial Enrollment 7 months around your 65th birthday Sign up for Parts A, B, and D; pick MA or Medigap
Annual Open Enrollment Oct 15 - Dec 7 Switch MA plans, move between MA and Original Medicare, change Part D
MA Open Enrollment Jan 1 - Mar 31 Switch MA plans or drop MA for Original Medicare (if already in MA)
General Enrollment Jan 1 - Mar 31 Sign up for Part B if you missed your initial window (coverage starts the month after you enroll)
Medigap Open Enrollment 6 months from age 65 + Part B Buy any Medigap plan at the standard rate, no health screening

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.

Key Tennessee Medicare Contacts

Tennessee SHIP (State Health Insurance Assistance Program) Free, unbiased one-on-one Medicare counseling and plan comparison statewide; counselors do not sell insurance. 1-877-801-0044 Tennessee Department of Disability and Aging SHIP
TennCare (Tennessee Medicaid) Applications for the QMB, SLMB, and QI Medicare Savings Programs that help pay your Medicare premiums and cost-sharing. Medicare Savings Programs through TennCare
Social Security Extra Help (the Part D Low-Income Subsidy) applications, plus automatic Part A and Part B enrollment questions. 1-800-772-1213 Apply for Extra Help
Medicare Compare Medicare Advantage, Part D, and Medigap plans by ZIP code and get answers to general Medicare questions (1-800-MEDICARE). 1-800-633-4227 Medicare Plan Finder
Your next step Call Tennessee SHIP at 1-877-801-0044 for a free appointment with a counselor who can compare your Tennessee plan options and screen you for the QMB, SLMB, and QI programs that lower your costs, without ever selling you anything.

Frequently Asked Questions

What does Medicare cost in Tennessee in 2026?

Most people pay $0 for Part A. The standard Part B premium is $202.90 a month with a $283 annual deductible. Part D premiums vary by plan (the base is $38.99), and many Medicare Advantage plans charge no extra premium. Your total depends on the plan you pick and the care you use.

Does Tennessee have a Medigap birthday rule?

No. Tennessee has no birthday rule and no annual guaranteed-issue window to change Medigap plans. Your one guaranteed window without health questions is the federal six-month Medigap Open Enrollment Period that starts when you're 65 and enrolled in Part B. After that, an insurer in Tennessee can use medical underwriting, so it pays to choose your plan carefully up front.

How do I get help paying for Medicare in Tennessee?

Apply for a Medicare Savings Program through TennCare, and apply for Extra Help with Part D through Social Security at 1-800-772-1213. QMB covers all your Medicare premiums and cost-sharing if your income and assets are under the 2026 limits. A Tennessee SHIP counselor (1-877-801-0044) can walk you through both applications for free.

What happens if I have both Medicare and TennCare?

You can enroll in a Dual Eligible Special Needs Plan (D-SNP) that coordinates your Medicare and TennCare benefits through a single plan, with the tightest coordination when it's aligned with your TennCare CHOICES coverage. TennCare also keeps paying for costs Medicare doesn't, like long-term care and many in-home services.

Learn More

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.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.