Medicare Coverage in Tennessee

 

The Medicare program provides health insurance coverage to eligible U.S. citizens and legal permanent residents (having lived in the U.S. at least five continuous years) who are age 65 or older.  In Tennessee, as in the rest of the country, you might qualify for Medicare under the age of 65 in certain situations.

There were 1,224,504* beneficiaries enrolled in the Medicare program in Tennessee in 2015, according to a Centers for Medicare & Medicaid Services report. Of this total, there were 426,921 residents enrolled in Medicare Advantage plans. Another CMS report stated that every Medicare beneficiary in 2016 has access to at least one of the 68 Medicare Advantage plans available statewide.

Types of Medicare coverage

There are various ways you can get Medicare coverage in Tennessee (as in all states). You can enroll in Original Medicare, Part A and Part B (many beneficiaries are automatically enrolled when they become eligible). You can also explore other options, such as Medicare Advantage plans, Medicare Advantage Prescription Drug plans (MAPDs), Medicare Prescription Drug Plans (PDPs), and Medicare Supplement (Medigap) plans. Each comes with different out-of-pocket costs and coverage details. Medicare beneficiaries in Tennessee may want to compare all available plans in their service area with their health and prescription drug needs in mind.

Original Medicare refers to Medicare Part A (hospital insurance) and Part B (medical insurance).  This coverage comes with out-of-pocket costs (such as copayments and deductibles), and includes only limited prescription drug coverage. Original Medicare doesn’t cover most prescription medications you’d take at home.

You can augment your Original Medicare coverage with a Medicare Supplement plan and/or a Medicare Prescription Drug Plan, or you can receive your Medicare benefits through a Medicare Advantage plan – many of them include prescription drug coverage.  No matter which way you decide to get Medicare coverage, in most cases you need to continue paying your Part B premium.

Medicare Insurance Plan Type Description
Medicare Advantage plan A health plan offered by private insurance companies that contract with Medicare. Medicare Advantage plans provide your Medicare Part A and Part B benefits; hospice care is covered directly under Part A, however, instead of through your Medicare Advantage plan. Many Medicare Advantage plans include extra benefits, such as routine vision services. There are several types of Medicare Advantage plans; not every type may be available in your part of Tennessee.
Medicare Advantage Prescription Drug plan A type of Medicare Advantage plan that provides Medicare prescription drug coverage (and may include extra benefits as well, such as routine dental services). This type of plan offers all your Medicare coverage in a single policy.
Stand-alone Medicare Part D Prescription Drug Plan Prescription drug coverage offered by private insurance companies that contract with Medicare. Meant to work alongside your Original Medicare coverage, a Prescription Drug Plan can help pay for your medications. Please note that each plan maintains its own formulary (list of covered prescription drugs); this is also true of Medicare Advantage Prescription Drug plans. A plan’s formulary may change at any time. You will receive notice from your plan when necessary.
Medicare Supplement (Medigap) plan If you decide to stay with Original Medicare, another option you may have is to enroll in  a Medicare Supplement (Medigap) plan to help pay for Original Medicare’s out-of-pocket costs. Different Medigap plans pay for different amounts of those costs, such as copayments, coinsurance, and deductibles.

Please note that the plans described above may vary in terms of availability, certain coverage details, and out-of-pocket costs. To get details about plans in your part of Tennessee, just enter your zip code in the form on this page.

Tennessee SHIP and Commission on Aging & Disability

The state of Tennessee offers a variety of programs that aim to educate and empower its senior population, including the State Health Insurance Assistance Program (SHIP) and the Tennessee. Volunteer counselors in the SHIP program offer free and unbiased counseling on Medicare insurance plans to beneficiaries, caregivers, and family members. The Commission website offers links to various resources related to aging and disability. These agencies help answer questions Tennesseans may have regarding their Medicare coverage.

*Statistical data from the Centers for Medicare & Medicaid Services, “On its 50th anniversary, more than 55 million Americans covered by Medicare” as of July 28, 2015; and “2016 MA Part D Landscape State-by-State Fact Sheet” as of September 21, 2015.

To learn about Medicare plans you may be eligible for, you can:

  • Contact the Medicare plan directly.
  • Call 1-800-MEDICARE (1-800-633-4227), TTY users 1-877-486-2048; 24 hours a day, 7 days a week.
  • Contact a licensed insurance agency such as Medicare Consumer Guide’s parent company, eHealth.
    • Call eHealth's licensed insurance agents at 888-391-2659, TTY users 711. We are available Mon - Fri, 8am - 8pm ET. You may receive a messaging service on weekends and holidays from February 15 through September 30. Please leave a message and your call will be returned the next business day.
    • Or enter your zip code where requested on this page to see quote.

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