Average Cost of Health Insurance in Tennessee (2026)

2026 premium snapshot

Figures are statewide averages and vary significantly by county, age, tobacco use, and plan metal tier. Always compare exact quotes for your ZIP code.

Why premiums are rising

Tennessee insurers received one of the largest average rate increases in the country for 2026, driven mainly by the December 2025 expiration of the enhanced federal premium tax credits that had been in place since 2021, along with rising medical and prescription drug costs. Because those enhanced credits are gone, more Tennesseans are feeling the full weight of the underlying rate increase rather than having it absorbed by a larger subsidy, which is why it's worth getting a personalized quote rather than assuming last year's price still applies.

Premium tax credits (subsidies)

Most people who enroll through the ACA Marketplace in Tennessee still qualify for a premium tax credit that reduces their monthly cost, based on household income and family size. Roughly three out of every four Tennessee Marketplace enrollees receive a subsidy, and the credit is applied directly to your monthly premium, so the "sticker price" of a plan is often not what you'll actually pay. It's worth getting a personalized quote before assuming coverage is unaffordable.

Ways to lower your cost

• Get your exact subsidy amount before comparing sticker prices — many people qualify for more than they expect.
• Compare Bronze vs. Silver plans carefully: Silver plans can unlock additional cost-sharing reductions if your income qualifies.
• Check whether your preferred doctors are in-network for an HMO before assuming a pricier PPO is necessary.
• Review your plan every open enrollment — carriers change pricing and networks in Tennessee every year.

What changes at each metal tier

Bronze plans carry the lowest monthly premium but the highest deductible, generally covering around 60% of average costs for a typical enrollee over the year. Silver plans balance a moderate premium with a moderate deductible, covering roughly 70% of average costs, and are the only tier eligible for cost-sharing reductions if your income qualifies. Gold plans cost more monthly but cover about 80% of average costs, which can pay off for someone who expects regular doctor visits or ongoing prescriptions. Platinum plans, where available, cover roughly 90% of costs for the highest premium, and tend to make sense mainly for people who expect to hit their deductible early in the year regardless of plan choice.

How Tennessee compares nationally

Tennessee's 2026 rate increase is among the steepest in the country, but because Tennessee hasn't expanded Medicaid, a larger share of low-income Tennesseans depend on Marketplace subsidies than in expansion states, which makes federal tax credit policy changes hit Tennessee households harder than the national average. That's part of why comparing your actual subsidized cost, rather than assuming coverage is unaffordable, matters so much here.

Questions worth asking before you enroll

• Is my current doctor or preferred hospital in-network for this specific plan, not just this carrier generally?
• What's the deductible, and does it apply before or alongside copays for routine visits?
• Are my current prescriptions on this plan's formulary, and at what cost tier?
• What's the total out-of-pocket maximum for the year if something unexpected happens?