Best Medicare in Tennessee

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Contributor, Benzinga
Updated: August 24, 2020

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Medicare helps cover health insurance costs for seniors and others who qualify. Are you trying to sort out your options in Tennessee? Here’s what you need to know about Medicare if you live in the Volunteer State. 

The Best Medicare in Tennessee:

What is Medicare?

Medicare is a federal health insurance program. You can be insured if you:

  • Are 65 or older
  • Have end-stage renal disease
  • Have amyotrophic lateral sclerosis (ALS)
  • Deal with another type of disability

Medicare has different parts. Each part addresses a different aspect of health care:

  • Part A is Medicare’s hospital insurance and it doesn’t have a premium. It covers inpatient care in skilled nursing facilities and hospitals. It also covers hospice care and home health care. 
  • Part B does have a premium. It covers doctor services, outpatient care, durable medical equipment, mental health services and other services. 
  • Part C is a bit different. Medicare Advantage plans provide you with your Part A and B services. These plans may also include prescription coverage (Part D) and other benefits like dental care. 
  • Part D is Medicare’s prescription benefit. You can purchase Medicare Part D plans or purchase a Medicare Advantage plan that includes Part D benefits. 

Medicare requires you to pay a lot of out-of-pocket costs. Parts A and B have deductibles, copays and coinsurance. Many people purchase a Medicare Advantage plan or Medicare supplemental insurance to help with those costs. You can use Medicare supplement plans at any provider that accepts Medicare. 

Legalities of Medicare in Tennessee

The Department of Health and Human Services oversees the Centers for Medicare and Medicaid Services (CMS) and CMS oversees Medicare. The Tennessee Department of Commerce and Insurance oversees the Medicare plans sold in the state. 

Everyone on Medicare has rights and protections. These include:

  • The right to be treated with dignity. 
  • Protection from discrimination.
  • The right to clear information from Medicare about what’s covered and what isn’t.
  • The right to get answers to your Medicare questions.
  • The right to appeal and file grievances.

If you have a complaint about Medicare, you can contact Medicare directly. If you have a complaint about your Medicare supplement or Medicare Advantage plan, you would file that complaint with the Tennessee Department of Commerce and Insurance. 

Many people pay their Medicare Part B premiums through Social Security benefits. Social Security deducts the premiums and sends them to Medicare. 

Types of Medicare Advantage Plans in Tennessee

If you’re looking at Medicare Advantage plans, keep the type of plan in mind. Medicare Advantage plans can be:

  • Health maintenance organizations (HMOs): These plans either require you to stay with network providers or pay more if you go outside the network. You also need a referral from your primary care provider to see a specialist. Most plans do have exceptions for some specialist services, like getting a mammogram. 
  • Preferred provider organizations (PPOs): PPOs are more flexible. You don’t usually need a referral. You can see out-of-network providers, but you pay more for services if you do. You don’t need to choose a primary care provider. 
  • Private fee-for-service (PFFS) plan: A PFFS plan decides how much it will pay health care providers for services. It also decides on how much you’ll pay for each service. Some PFFS plans have a network and you can go to any provider who accepts the PFFS plan’s terms. You also don’t need referrals to see a specialist. 
  • Special needs plan (SNP): An SNP is a plan for a specific population. It could be an HMO, PPO or PFFS plan. SNPs serve people who need long-term care services, people with diabetes, people on Medicaid and other populations. SNPs vary by area. 

How to Sign Up for Medicare in Tennessee

Social Security will enroll you in Medicare in Tennessee. Here’s how to sign up for Medicare:

  • If you’re already on Social Security when you turn 65, Social Security will enroll you automatically if you qualify for Medicare. To qualify for Medicare, you need to have worked at least 40 quarters and paid into Medicare, which will involve about 10 years of work. 
  • Contact Social Security to enroll. You can enroll starting 3 months before the month you turn 65. 
  • Social Security will enroll you in Medicare after you receive benefits for 24 months if you receive Social Security disability benefits. 
  • Social Security will enroll you in Medicare when your disability benefits start if you have ALS. 
  • Contact Social Security to enroll if you have end-stage renal disease. 

You can enroll during the following periods:

  • Initial enrollment: Your initial enrollment period starts 3 months before the month you turn 65 and ends 3 months after the month you turn 65. You may not need to enroll in both parts of Medicare if you have other insurance. Contact your insurance provider or human resources department for guidance. 
  • Special enrollment: You may have a special enrollment period if you missed your initial enrollment. You receive a special enrollment if you lose group health coverage through an employer. The employer can be your employer or the employer of a family member. Your special enrollment starts while you’re enrolled in your group plan. It lasts for 8 months after your group coverage ends. 
  • General enrollment: You can also enroll in Medicare from January 1 to March 31 each year. Your Medicare coverage will start on July 1. 

Most people don’t pay a premium for Medicare Part A. If you aren’t eligible for premium-free Part A and you wait to enroll, you may have to pay a late enrollment penalty of 10%. The penalty lasts for twice as long as you waited to enroll. For example, if you wait 1 year to enroll, you will pay a 10% penalty for 2 years. 

Part B also has a late enrollment penalty. The late enrollment penalty is 10% for each year you wait. If you wait 3 years to enroll, you’ll pay 30% more for as long as you have Part B. You may also pay a late enrollment penalty if you wait to enroll in a Part D plan. The penalty is 1% of the national base beneficiary premium for each month you wait. The national base beneficiary premium changes from year to year. 

Not sure whether you should enroll in Medicare? Contact Medicare or the State Health Insurance Assistance Program (SHIP). 

Average Cost of Medicare Advantage Plans in Tennessee

How much will you pay on a Medicare Advantage plan? Let’s take a look at some of Tennessee’s plans.

Plan NameCompany Plan TypeHealth DeductibleDrug Deductible
AARP Medicare Advantage Plan 1UnitedHealthcareHMO$0$0
Cigna-HealthSpring AllianceCignaHMO$0$0
Aetna Medicare Premier PlanAetna MedicarePPO$0$0
Humana Gold Plus H4461-029HumanaHMO$0$100
BlueAdvantage GarnetBlueCross BlueShield of TennesseePPO$0$0

Best Medicare Insurance Providers in Tennessee

Here are our picks for the best insurance providers in Tennessee, based on our research.

Cigna Medicare Advantage
Best For
  • Easy access to benefits
securely through Cigna Medicare Advantage's website

1. Best Overall in Tennessee: Cigna

Medicare rates Cigna 4.5 out of 5 stars. This means it has a high level of quality and performance. Cigna offers reasonably priced Medicare Advantage plans. Its HMO plans don’t require referrals to see a specialist.

It offers telehealth services, which means you can talk to a doctor without leaving your home. It also offers emergency care overseas, dental benefits, vision benefits and hearing exams. 

Humana Medicare Advantage
Best For
  • Medicare Advantage Plans

2. Most Affordable in Tennessee: Humana

Humana offers a range of affordable Medicare Advantage plans. These plans also have low deductibles, which is the amount you pay before your plan benefits start. Humana’s HMOs don’t require referrals for in-network providers.

Humana’s plans also include fitness club memberships and hearing services. Humana also offers an over-the-counter benefit to help you pay for non-prescription medicines and supplies. 

Blue Cross Blue Shield Medicare Advantage
Best For
  • Wide network of doctors, hospitals and specialists across the U.S.
securely through Blue Cross Blue Shield Medicare Advantage's website

3. Best for Diabetes: Blue Cross Blue Shield of Tennessee

The cost of diabetes testing supplies can add up. Blue Cross Blue Shield of Tennessee covers preferred monitoring supplies for $0. It covers non-preferred supplies with 20% coinsurance. It also covers foot exams with a $25 copay.

Blue Cross Blue Shield of Tennessee also includes a free fitness membership and 10 delivered meals following an inpatient hospital stay. Medicare rated this plan 4 out of 5 stars. 

UnitedHealthCare Health Insurance
Best For
  • Same day coverage available

4. Best for PPO: UnitedHealthcare

AARP endorsed UnitedHealthcare — it’s a quality option. UnitedHealthcare offers a $0 premium PPO plan.

PPO plans are flexible and this one includes virtual medical and mental health visits, so you get the care you need. It also offers free eye exams, comprehensive dental care, hearing exams and fitness memberships. 

Bright HealthCare
Best For
  • Affordable plans, some with no deductible

5. Best for Perks: Bright Health

Bright Health offers many extra benefits. It offers hearing services, preventive dental care and eye exams. It also offers a transportation benefit and a $30 per month over-the-counter benefit. It also includes a fitness center membership with no deductibles and low copays. 

Choose a Medicare Plan

Which Medicare plan is best for you? It depends on your health, which benefits you’re likely to use and your financial situation. A low monthly premium might seem like a way to save money, but if the plan has a high deductible, you might end up paying more for your care than you expected. 

Choose a plan that doesn’t require referrals if you see specialists often. If you have specific doctors you prefer, choose a plan that has those doctors in its network. Prescription coverage also varies. You can enter your prescriptions on Medicare.gov to find out which plans cover the medicines you need. 

Choosing a plan is a balancing act. Figure out which one best fits your health and your budget. 

Frequently Asked Questions

Q
1) Q: What are the different parts of Medicare?
A

Medicare has 4 parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.

Q
2) Q: Is Medicare free?
A

Because there are 4 parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.

Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.

Q
3) Q: Do I need to sign up for Medicare?
A

If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers. 

If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.