Medicare in Tennessee: How to Apply, Costs, and More

From mild weather to natural beauty, there are good reasons that 6.8 million people call Tennessee home. 

If you’re about to join the 12% of the population in Tennessee that is 65 or older, you might be wondering how to manage your healthcare. Should you sign up for Medicare? What Medicare plan is the best for you? What if you’re still working — should you continue with health insurance through your employer?

This guide will answer all of these questions and provide information on how to apply and how much Medicare plans cost. Let’s get started!

Who is Eligible for Medicare in Tennessee?

Medicare was introduced as a way to provide health coverage to those who are unlikely to have access to group health plans from an employer. This includes those of retirement age, as well as disabled individuals and those with specific health conditions. 
Medicare Tennessee eligibility is based on these factors. To get Medicare, you need to be a U.S. citizen or permanent resident who has lived in the US for at least five years, and one of the following conditions must also apply:

• You’re age 65 or older
• You’re under 65 but disabled and receiving disability benefits from Social Security or the Railroad Retirement Board
• You have Amyotrophic Lateral Sclerosis (ALS), better known as Lou Gehrig’s disease
• You have end-stage renal disease (ESRD)

Most people who are eligible for Medicare should sign up right away. If you sign up late, your monthly premium will be higher due to a late-enrollment fee. There is one exception — if you have a qualifying group plan, you can delay enrollment with no penalty.

How Much Does Medicare Cost in Tennessee?

There are two kinds of costs for Medicare plans: the monthly premium and out-of-pocket costs like your deductible and copayment or coinsurance.

If you choose Original Medicare, most Americans don’t have a premium for Medicare Part A (hospital insurance). However, there is a monthly premium of $170.10 in 2022 for Medicare Part B (medical insurance). 

If you want prescription drug coverage, you’ll also need to sign up for a Medicare Part D plan, which will have its own monthly premium. Compare plans in your area to find one that covers the medications you need and includes the pharmacies you prefer.

Those who have a Medicare Advantage plan will pay a single premium for all of their coverage, which usually includes prescription drugs and other benefits. Sometimes this premium is the same as Medicare Part B, and sometimes you’ll pay an additional amount on top of your Part B premium.

When it comes to out-of-pocket costs, how much you pay depends on which coverage you’re using.
 

• Medicare Part A has a $1,556 deductible and $0 coinsurance for days 1-60, with a $389 coinsurance per day for days 61-91 within a year.
• Medicare Part B has a $233 deductible, and then you pay 20% of the Medicare-approved amount, while Medicare pays the rest.
• Medicare Part D deductibles and copayments vary depending on the plan, so be sure to compare costs.
• Medicare Advantage deductibles and copayments also vary depending on the plan, so you want to shop around and compare plans.

Is Medicare Free in Tennessee?

Medicare is not free, but there are ways to save money on monthly premiums and out-of-pocket costs.

One way to save is to have Original Medicare with a Medigap plan. These plans do have an additional monthly premium but can help you pay for your out-of-pocket costs in return. You’ll want to apply for Medigap right away because you have guaranteed approval during your initial enrollment period. After that timeframe, you may get denied if you try to enroll.

There are also options if you have a lower income and assets. 

For example, there are several Medicare Savings Plans (MSP) that can help you pay your monthly premiums and out-of-pocket costs. Some people also qualify for Extra Help with Medicare Part D plans. 

If you qualify for Medicaid, you can use that alongside Medicare to get all of your medical costs covered with little to no charge as well.
Medicare.gov has more information on these programs as well as other options that can help you save on your Medicare costs.

How to Apply for Medicare in Tennessee

Are you ready to get started with your Medicare coverage? 

Many Americans are automatically enrolled in Medicare when they become eligible, but keep in mind that the automatic enrollment is for Original Medicare Part A and Part B only. You won’t have prescription drug coverage and you also won’t have the extra benefits you might get from a Medicare Advantage plan. 

Instead of allowing automatic enrollment to make your choice for you, compare the plans available in your area. You can do this online or over the phone with a licensed agent. You might find that Original Medicare with a Medigap plan makes the most sense for you, or you might decide on a Medicare Advantage plan.

Does Tennessee Have Medicare Advantage Plans?

As you review your options, you’ll probably be excited to see what benefits you can get with a Medicare Advantage plan. Advantage plans are sold by private insurers. They are available in every state, but different plans are offered in different states. There are over six million people with a Medicare Advantage plan in Tennessee.

Medicare Advantage plans offer at least as much coverage as Original Medicare but often include additional benefits. For example, there is likely to be a prescription drug plan included, and you may be able to get vision or dental coverage as well. There may also be discounts on fitness programs.

The thing to keep in mind with Advantage plans is that they have a provider network that is based in your local area. Often, these plans do not cover non-emergency care outside the network. That means if you travel often, an Advantage plan may not be the best for you.

It’s important to know all of your options and compare them so that you get the coverage you need at a price that makes sense for you.

Learn More About Medicare in Tennessee

This guide has answered many of the most common questions about Medicare in Tennessee, but don’t hesitate to reach out if you have more concerns related to your specific situation. Our licensed agents would be happy to help you understand your Medicare options and choose the right plan. Contact us today!