Knowing your options is crucial before signing up for Medicare or making any changes to your current Medicare plans in Tennessee. Tennessee is becoming increasingly popular as a retirement destination. With a pleasant environment for most of the year and stunning mountain views, some Tennessee Medicare recipients are looking to retire to a quieter lifestyle. In 2022, about 1.4 million Tennesseans will be enrolled in Medicare, up from roughly 1 million in 2010. In the past decade, enrollment in Medicare Advantage plans has risen.
Medicare in Tennessee: Details
Medicare coverage patterns in Tennessee during the 2022 fiscal year, as reported by the CMS:
- There are now 1,397,568 Tennesseans enrolled in Medicare.
- Tennessee’s average monthly Medicare Advantage premium dropped from $20.18 in 2021 to $18.74 in 2022.
- In 2022, Tennesseans can choose from 112 different Medicare Advantage plans, down from 117 the year before.
- Medicare recipients in Tennessee can choose from various Medicare Advantage plans, including those that offer a $0 monthly fee.
- In the year 2022, residents of Tennessee can choose from 12 unique Medigap policies.
Medicare Annual Enrollment Period 2022
The Medicare Annual Enrollment Period is annually held from October 15 through December 7. You can modify your Medicare decisions for the future year during this enrollment time.
During Medicare Annual Enrollment Period, you can change your Medicare choices to better fit your needs, budget, and way of life. If you are dissatisfied with changes you have made in the past or your current plan, the Annual Enrollment Period is the chance to make adjustments for the following year.
Medicare Plans in Tennessee
In Tennessee, you have multiple Medicare coverage alternatives. Medicare Advantage (Part C) and Medicare supplement (Medigap) plans are two optional extras that can be added to original Medicare if desired. Let’s examine medicare plans in Tennessee.
Original Medicare plans in Tennessee
There are many different parts to the original Medicare. If an enrollee has paid enough into Medicare through payroll taxes throughout their lives, they will receive free coverage under Part A. It pays for hospitalization, skilled nursing, hospice, at-home medical care, and emergency medical services. Preventive care, diagnostic tests, outpatient operations, medical transportation, and FDA-approved medical supplies and equipment are all covered under Part B, which will cost you $170.10 in 2022.
Medicare Advantage Plans In Tennessee 2022
Right Medicare Advantage plans in Tennessee are provided by private insurers and may contain benefits that Original Medicare does not, such as:
- Prescription Drugs
In some regions of Tennessee, various Medicare Advantage plans are available. However, in others, there may be fewer possibilities.
Most Popular Medicare Advantage Plan Types in Tennessee HMO
The HMO plan, or Health Maintenance Organization Plan, is a type of health insurance that coordinates patient treatment among a group of doctors and hospitals. Only care provided by in-network providers is covered by a Tennessee Medical Advantage HMO Plan, with the following exceptions:
- Out-of-area Urgent Care
- Emergency Care
- Out-of-area Dialysis Treatments
Those who choose health maintenance organization (HMO) coverage must establish a relationship with a primary care physician. In Tennessee, you will often require a referral from your primary care physician before seeing a specialist. Some services, including annual mammograms, don’t need a recommendation.
Part D, prescribed drug coverage, is included in many Medicare Advantage plans. Not all plans in Tennessee offer this, so it’s important to research this before making a purchase.
A PPO plan also called a Preferred Provider Organization, is another type of Medicare Advantage Plan you can buy. Private insurance companies participating in the Tennessee Medicare program also provide PPO coverage. Whether or not the doctor you wish to see is part of your insurance’s network determines how much your care will cost. It will save you money if you utilize a doctor who is part of your insurance plan’s network rather than one who is not. You can usually choose the doctor or specialist you wish to visit, but out-of-network care will cost extra.
Prescription drugs are typically covered under PPO insurance. However, suppose you sign up for a PPO that does not offer prescription drug coverage. In that case, you will not be eligible to enroll in Medicare Part D. In this case; it may be prudent to look for a plan that offers prescription drug benefits in Tennessee if you currently use or anticipate using such prescriptions.
Members of PPO plans are not required to designate a “primary care physician.” Additionally, specialist referrals are not needed. The cost of seeing a specialist will be lower if you do so through a network provider rather than an out-of-network one.
Private Fee For Service (PFFS)
Another prominent insurance option, private fee-for-service (PFFS) plans, are provided by private insurance companies that have contracted with Medicare to provide services at a predetermined rate. When using a PFFS, you can save money by seeing in-network providers rather than paying the higher rates charged by those not part of the plan’s network. A primary care physician in Tennessee is not required to participate in this plan. Additionally, you can visit any doctor or healthcare practitioner without a recommendation.
Private Fee For Service plans is far rarer than their HMO and PPO counterparts. However, given the wide variety of service providers from which to select, they could be a good fit for some customers.
Your PFFS Plan is comparable to Original Medicare Parts A and B in terms of coverage. The following are some of the things that will be included:
- Ambulance rides
- Short-term inpatient rehabilitation
- Hospital stays
- Some medical equipment
- Preventative care and medical screenings
- Doctor’s visits
In Tennessee, some of these plans will include coverage for both medical and surgical procedures. Medicare Part D can be bought independently of your employer if they don’t offer coverage.
A healthcare provider’s decision to accept PFFS Plan coverage for a given service is made individually. It is possible, for instance, for the same doctor in the same office to accept the PFFS plan pricing for one kind of visit but not for another.
Special Needs Plan (SNP)
Only persons with specific conditions or concerns are eligible for a special needs plan. The members of these plans are their primary focus. Therefore their benefits, providers, and drug formularies are all customized to meet their needs. Private insurance businesses contract with Medicare to deliver healthcare services and offer Special Needs Plans.
You must satisfy qualification requirements to participate in an SNP. The type of health insurance plan you enroll in will depend on your individual medical needs. For instance, people with congestive heart failure have their specialized treatment strategy.
You must be registered in both Parts A and B of Medicare before you may join an SNP. Once you enroll in the SNP, you will still be required to pay Medicare premiums. The SNP may foot a portion of your Medicare premium costs under certain conditions. You will need to research each plan to see if it covers the cost of your Medicare premiums, as different private insurance firms provide them.
Only Medicare Part D Special Needs Plans in Tennessee can provide Medicare prescription drug coverage. In addition, you’ll need to select a primary care physician under most SNP plans. Additionally, most experts require references before seeing their patients.
Top Rated Medicare Advantage Plan in Tennessee:
- Cigna is the top in Tennessee overall.
- Humana has the cheapest Medicare in TN.
- BCBS of Tennessee is good for people with diabetes.
- UnitedHealthcare is the right choice for a PPO.
- Bright Health is the finest for perks.
Medicare Supplement Plans in Tennessee
More than one-third of Tennessee’s Medicare recipients have been aided by the state’s finest Medicare Supplement plans in controlling their healthcare expenditures. Medicare Supplement Insurance, or Medigap, is supplemental health insurance that helps pay for part or all of the gaps in coverage left by Original Medicare, such as deductibles and copayments. Finding the finest Medicare Supplement insurance plan in Tennessee and paying the affordable premium rates is possible with some research into how Medicare and Medigap operate in the Volunteer State. Here are some facts concerning Medigap plans and Tennesseans who receive benefits as a result of enrolling in Medicare Parts A and B:
- Approximately 800,000 Tennesseans are enrolled in Original Medicare and get its benefits.
- In Tennessee, about 270,000 people have opted for Medicare Supplement plans.
- Plan F is the most popular Medicare Supplement policy.
- Knox, Davidson, Shelby, Hamilton, and Rutherford are the most populous counties in Tennessee.
Affordable Medicare Supplement Plans in Tennessee
Medicare Plan F in Tennessee
Medicare Plan F in Tennessee includes:
- Coinsurance for Parts A and B of Medicare
- Deductibles for Parts A and B of Medicare
- Extra costs for Medicare Part B
- Foreign travel emergency (80%)
Medicare Plan G in Tennessee
Medicare Plan G in Tennessee includes:
- Coverage like Plan F, but without the Part B deductible
- This is a good deal if you can choose between Plan F and Plan G.
- Pick any U.S. doctor who accepts Medicare.
- Doctors can be changed at any time.
- Use the hospital or health care facility of your choice that accepts Medicare.
- You don’t need a referral to see a specialist.
Medicare Plan N in Tennessee
The Medigap Plan N rates are lower than those of Medigap Plans F and G, but the benefits are similar.
- Coinsurance for Medicare’s Part B
- Deductible for Part A
- No coverage for the deductible, copayments, or extra charges for Medicare Part B.
- You have to pay the following copayments under Plan N:
- Up to $20 for office visits
- Up to $50 for visits to the ER
Plan F with a high deductible
- Similar benefits to the original Plan F
- Before benefits may be paid, a $2,490 deductible must be fulfilled.
- Monthly premiums that are much lower than the original Plan F
Medicare Part D Plans in Tennessee for 2022
Part D is one of the ways to obtain coverage for pharmacy-purchased prescription medications. Among the four Medicare parts, Part D is optional. Remember that if you initially qualify for prescription coverage but choose not to accept it, you will be charged a fee if you later decide you need it.
Tennessee Cost-effective Medicare Prescription Drug Plans
Aetna’s SilverScript medication plans offer the most affordable monthly premiums. They’ve been among the top health insurance providers for prescription drugs for many years. With a premium of less than $7, the plan is quite inexpensive.
The next affordable premium in the state is with Wellcare. The monthly price for their policy is less than $13. Wellcare is one of the leading Medicare drug coverage providers.
A monthly package from Clear Spring costs over $16. They have the lowermost star rating, but they are a fairly new company that is improving.
Tennessee Medicare Part D has a zero-dollar deductible.
Medicare’s standard model includes deductibles, but that doesn’t mean the plans have to charge them. Here are a few plans that cover prescription drugs without a deductible. Some plans only have a deductible for prescriptions in Tier 3 and above.
SilverScript is the most well-known medication plan on the market. Therefore it is not unexpected to find Aetna at the top again.
After Aetna, Wellcare re-enters the market. Wellcare is a subsidiary of Centene. They are working hard to improve and add products and features that help people with Medicare.
UnitedHealthcare ranks third overall. They are the largest Medicare insurance provider in the United States.
Medicare Part D Plans in Tennessee with Gap Coverage
In the coverage gap, beneficiaries are responsible for 25% of their prescription costs. Some plans, fortunately, offer extra coverage to fill in the gaps.
UnitedHealthcare offers an economic 4-star plan with gap coverage. This helps people who fall into the “donut hole” pay for some of the costs.
In this category, Aetna comes in second. Not only does their plan cover the coverage gap, but there is also no deductible.
Cigna makes up the top three. Cigna appears to have a specialty in the donut hole drugs they cover. Likewise, their plan has a $100 deductible.
What is the cost of Medicare in Tennessee?
- Original Medicare: Monthly premiums for Medicare Part A can be anywhere from $0 to $499. A yearly Part A hospital deductible of $1,556 for Medicare recipients. People typically pay the normal $170.10 monthly premium for Part B. Part B has a $233 deductible.
- Medicare Advantage Plans: In 2022, Medicare Advantage Plans in Tennessee will typically cost enrollees $18.74 per month. Some plans begin with a zero-dollar premium.
- Part D plans: The cheapest Medicare Part D plan has a monthly cost of $6.50.
- Medigap Plans: Insurance to supplement Original Medicare: In Nashville, a nonsmoking 65-year-old female will pay between $97 and $355 monthly for Plan G.
Medicare in Tennessee: By Numbers
|Original Medicare participants||Average plan cost||Tennessee’s annual spending on each recipient||Spending per recipient compared to the national average|
|803,720||Part A: $0 to $499 per month*
Part B: $170.10 **
Overall, having an advocate is beneficial if you’re shopping for a Medicare Supplement, Medicare Advantage, or Medicare Part D coverage. We can help you comprehend Original Medicare and your available coverage options. In addition, our licensed insurance agents are experts in all parts of Medicare.
Let our experts take all the guesswork out of the process for you. We can evaluate your medications and physicians to ensure that your selected plan meets your needs. Also, we’ll walk you through the steps of enrolling.
Reach out Today at NewMedicare, and get your quotes now!