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Tennessee

Medicare in Tennessee

Resources for Tennessee Medicare Beneficiaries 

In the US, it’s essential to prepare for your healthcare costs, so it’s very important to learn about Medicare’s different parts, enrollment periods, and applications or to compare and choose a Medicare plan. So great news, you are in the right place. 

Medicare Basics         Choosing the Right Medicare Plan         Enrolling in Medicare

Seeking guidance is beneficial while making Medicare decisions. As a Tennesseean, you have a number of places where you can get assistance from, including the State Health Insurance Program (SHIP), commonly known as the Tennessee State Health Insurance Assistance Program (TN SHIP). TN SHIP has counselors around the state who collaborate with local nonprofits, public health agencies, and Area Agencies on Aging (AAAs) specific to your county to provide individuals in the Volunteer State with Medicare information.  

Medicare Plan Options in Tennessee  

If you reside in Tennessee, you have many Medicare alternatives to choose from. You can apply for Original Medicare if you are 65 or older or have a qualifying disability to be eligible for Medicare. A Medicare Advantage plan may be the best option if you want more comprehensive coverage, given the variety of plans offered to Big Benders. Other Medicare plan options also include Medicare Supplement Insurance and prescription drug plans. 

Original Medicare (Parts A & B)  

When it comes to Medicare, let’s go over the basics of Original Medicare. Medicare Part A covers hospitalization, and Medicare Part B covers medical care. Medicare Part A and Part B deductibles vary per service. In particular, Part A has a deductible design as a per-benefit period (each time you’re admitted) as an inpatient hospital stay, while Part B has an annual deductible before Original Medicare pays for services. Other things to consider if you’re thinking about having Original Medicare: 

  • Original Medicare in Tennessee lets you choose and access Medicare-accepting providers nationwide. 
  • There are no networks, there are no copays, there are no waiting periods, and there are no limitations on pre-existing conditions. 

Medicare Advantage (Part C)  

Medicare Advantage, or Part C, is a private insurance option to Original Medicare. These plans provide at least the same coverage as Medicare Parts A and B, and the most significant thing is that they include additional benefits as well. Like how a Health Maintenance Organization (HMO) works, this arrangement places the onus of providing care on a network of providers. It often necessitates the involvement of a primary care physician, the acquisition of a referral to a specialist, and, in some cases, obtaining prior approval for services, treatments, and medications. Some of the other plan options include a Private Fee for Service (PFFS) plan, a Preferred Provider Organization (PPO), or a mix of an HMO and PPO. 

Tennessee Medicare Advantage programs often provide more comprehensive coverage. Visit our Medicare Resource Page for Part C to find out more about Medicare Advantage. 

Medicare Prescription Drug Plan (Part D)  

Numerous Medicare Advantage plans offer Medicare Part D prescription medication coverage automatically. Additionally, you can add a stand-alone Prescription Drug Plan (PDP) to your Original Medicare or a Medicare Supplement Insurance policy. Similar to Medicare Advantage plans, private insurance companies that are Medicare-approved offer Part D coverage separately, called a stand-alone PDP plan. Depending on the selected plan, each approved prescription may be subject to a deductible, copayment, or coinsurance.  

Medicare Supplement Insurance (Medigap)  

Some people living in Tennessee who are eligible for Medicare choose to purchase a Medigap policy, which is also known as Medicare Supplement Insurance. These plans are designed to assist in paying for the medical expenses that aren’t covered by the traditional Original Medicare program. Coverage for medical care received outside the United States is one example of one of these coverage gaps, along with Medicare Parts A and B deductibles and coinsurance. 

Because Original Medicare does not cover all medical expenses, the Tennessee State Government provides information on how Medicare Supplement Insurance coverage may lower out-of-pocket costs. 

You ought to be aware that Medigap does not cover anything that is associated with Medicare Advantage. A Medicare Advantage plan and a Medigap plan are mutually exclusive options (you cannot have both at the same time). If you currently have a Medicare Advantage plan and you wish to buy Medigap insurance, the start date of your Medigap policy should begin the day after the end date of your Medicare Advantage plan. 

Medicaid 

Medicaid is a public insurance program that has been in operation since 1965. It assists qualified low-income individuals, such as children, parents, pregnant women, the elderly, and people with disabilities, in obtaining access to health care. It is paid for by both the state and federal governments. According to federal regulations, each state administers its own Medicaid program. Because federal regulations are broad, states have leeway in developing and implementing their own programs. Because of this, Medicaid eligibility and benefits can vary from one state to the next and often do. 

How and when to sign up for Medicare in Tennessee

Medicare is a federally funded, government-run insurance program available to those who qualify. Most U.S. citizens can enroll in Medicare after they reach the age of 65.  

In addition, the following conditions will result in Medicare eligibility: 

  • You are under the age of 65, permanently disabled, and have been receiving Social Security disability benefits for at least 24 months. Also, if you were a railroad worker, you might be qualified for Railroad Retirement Board disability benefits. 
  • Been diagnosed with End-stage renal disease (ESRD). 
  • Been diagnosed with Lou Gehrig’s disease, commonly known as Amyotrophic Lateral Sclerosis (ALS). 

Medicare Advantage Enrollment Periods in Tennessee and nationwide  

Here is a quick overview of the Medicare enrollment periods in which you can elect or change your Medicare Advantage plan.  

Healthpilot Medicare Advantage Enrollment Period Guide

Tennesseeans, never fear. Healthpilot understands that navigating Medicare can be tough and that adding enrollment deadlines can add to the pressure. 

What is the most exciting news you will hear today? We would be more than happy to do the boring stuff for you. We will recommend our best Medicare plan tailored for you after you answer a few questions. You can even enroll quickly and securely online. 

We will take care of this for you every year as long as you are a Healthpilot customer. Enrollment periods do not need to be memorized when you have Healthpilot on your side. 

Let’s take a peek.

Check out your plan

Key Stats

Some interesting facts about Medicare coverage in Tennessee 

  • There is a total of 1,385,253 Medicare beneficiaries in Tennessee. This means that 20% of people have Medicare, which is slightly more than the average of 19% for the whole country. 
  • About 47% of Medicare recipients in Tennessee is enrolled in a private Medicare Advantage program. (Above the national average of 45%.) 
  • 129 Medicare Advantage plans are available to Tennesseans in 2023, compared to 112 plans in 2022, a 15.2% increase in plan options. 
  • In TN, $7.40 is the lowest monthly premium for a stand-alone Medicare prescription drug plan. 
  • And since we promised you a fun fact about TN: Josephine Myrtle Corbin, a four-legged woman, was born in Tennessee in 1868. She lived a pretty normal life, getting married and having kids (she had two pelvises side by side). 

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