Tennessee Medicare Advantage: The Best & Worst Plans
Updated October 29, 2021
Reading time: 9 minutes
Updated October 29, 2021
Reading time: 9 minutes
There are hundreds of Medicare Advantage plans to choose from in Tennessee —finding the best one is easy as 1-2-3.
Medicare beneficiaries who want benefits like dental, vision, and prescription drug coverage are often drawn to Medicare Advantage. Also known as Medicare Part C, Advantage plans are an alternative to Original Medicare, which tends to be more “bare-bones” and a cheaper healthcare option. If this sounds like you and you’re interested in switching to an Advantage plan, you may notice while shopping for Medicare Advantage plans that it isn’t as simple as enrolling in Original Medicare.
Original Medicare is offered by the federal government, which means that the plan coverage and costs are the same nationwide. On the other hand, Medicare Advantage is regulated by the Centers for Medicare & Medicaid Services but is offered by private insurance companies. Since each insurance company has worked out their own terms and pricing with healthcare providers, that means coverage details and costs will vary from one plan to the next.
Having hundreds of options available can feel overwhelming at first, but narrowing them down to your top choices doesn’t have to be a long or complicated endeavor. In fact, thanks to online comparison tools, you can likely forgo having to call a licensed insurance agent and quickly find the best plan all on your own and on your own terms. Here, we’ll review the top eight highest-rated Medicare Advantage plans in Tennessee and everything else you need to know to find the best plan for you.
Ready for a Medicare plan that works for you? Use the Insurify Medicare comparison tool to find Medicare plans near you. Start with your ZIP code, and you’ll be comparing plans in less than two minutes. Try it today!
The “best” Medicare Advantage plan can be hard to pin down. Since healthcare is such a personal subject, what is considered the best for one person may not be the best for another. For example, one person may prioritize a low monthly premium, while another person prioritizes the lowest prescription drug co-payments that an insurance plan can offer.
1. Humana Gold Plus - Score: 72.59 (Tie)
1. Cigna Preferred Medicare - Score: 72.59 (Tie)
3. AARP Medicare Advantage Plan 2 - Score: 72.58
4. Cigna Primary Medicare - Score: 70.97 (Tie)
4. Cigna Preferred Plus Medicare - Score: 70.97 (Tie)
6. Cigna Alliance Medicare - Score: 70.51
7. Aetna Medicare Value Plan - Score: 69.26 (Tie)
7. Aetna Medicare Premier Plus Plan - Score: 69.26 (Tie)
However, you should start your comparison shopping journey by taking a look at the highest-rated plans your state has to offer. The eight plans we’ll review are rated based on the Medicare star rating system, which takes into consideration factors like monthly premiums and customer service. One of these plans might be the perfect match for you—and even if one isn’t, you can at least get an understanding of what you can expect in terms of cost, benefits, service area coverage, and more. Without further ado, let’s get started.
Monthly Premium: $0
Deductible: $0
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $5,900
Counties Covered: Tipton, Lauderdale, Hardeman, Haywood, Fayette, Shelby, Madison
This plan is also rated 4.5 stars with a $0 monthly premium and $0 deductible. With this plan, you’ll get low co-pays for generic prescription drugs and doctor visits, and you’ll also receive excellent coverage for vision, hearing, preventive dental, and comprehensive dental. Available in seven Tennessee counties, this health insurance plan has fairly good service area coverage.
Monthly Premium: $0
Deductible: $0
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $6,700
Counties Covered: Unicoi, Washington, Sullivan, Johnson
This four-star plan offers great benefits and low co-pays. According to this plan’s formulary, which is the tiered system that classifies the type of prescription drug and amount you are responsible for, Tier 1 preferred generic drugs have a $0 co-pay. With this health insurance plan, you’ll also receive coverage for vision, hearing, dental, mental health, skilled nursing, rehabilitation, and podiatry services.
Monthly Premium: $33
Deductible: $0
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $3,200
Counties Covered: Campbell, Bradley, Meigs, Marion, Claiborne, Carter, Hamblen, Greene, Cocke, Grainger, Cumberland, McMinn, Hawkins, Hancock, and many more
Available in nearly 40 counties, this four-star plan is a solid option with an affordable monthly premium. Co-payments are generally low across the board for services like doctor visits, vision, hearing, dental, mental health, rehabilitation, and podiatry. The co-pays on prescription drugs are also low, as little as $0 for some generics, and you get extras included, like wellness programs.
Monthly Premium: $24.10
Deductible: $0
Prescription Drug Plan Deductible: $445
Out-of-Pocket Maximum: $6,700
Counties Covered: Loudon, Union, Sevier, Grainger, Sequatchie, Hamilton, Hamblen, Grundy, Jefferson, Morgan, Marion, Knox, Cocke, Blount, Anderson, Bradley
This 4.5-star plan has good service area coverage and is offered in 16 Tennessee counties. Beneficiaries enjoy $0 co-payments on all in-network doctor visits for both primary care physicians and specialists.
This plan doesn’t have a robust prescription drug formulary and simply offers a 25 percent coinsurance across the board for all prescription drugs, regardless of whether they are generic or name brand. Although the prescription drug coverage isn’t the greatest, beneficiaries receive excellent coverage for vision, hearing, dental, mental health, skilled nursing, rehabilitation, and podiatry services.
Monthly Premium: $79
Deductible: $0
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $4,800
Counties Covered: Davidson, Sumner, Rutherford, Williamson, Wilson
This 4.5-star plan is a solid option with a wide variety of covered benefits. The co-pays for doctor visits and prescription drugs are low, and you’ll receive coverage for additional benefits like vision, hearing, dental, mental health, skilled nursing, rehabilitation, and podiatry services. You’ll also receive wellness program coverage, which usually includes nice-to-haves like a nursing hotline and fitness incentives.
Monthly Premium: $0
Deductible: $0
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $6,700
Counties Covered: Wilson, Williamson, Sumner, Davidson
This 4.5-star plan has an attractive $0 monthly premium and $0 deductible. Co-pays for generic prescription drugs are generally low, ranging from $3 to $12, and the co-pay for a primary care doctor visit is $0. With this health plan, you’ll also receive great coverage for vision, hearing, and dental (both preventive and comprehensive)—all with a $0 co-pay. You’ll also receive coverage for mental health, skilled nursing, rehabilitation, and podiatry services.
Monthly Premium: $15
Deductible: $0
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $5,900
Counties Covered: Sequatchie, Rhea, Polk, Hamilton, Marion, Meigs, Bradley, Bledsoe
Here’s a plan that’s great for people who take prescriptions daily. You’ll get $0 copays for Tier 1 and Tier 2 drugs from preferred retailers. You also get $0 copays for preventive and primary care office visits, some diagnostic services, preventive dental, comprehensive dental, and routine vision.
Plus you get access to covered care outside of the provider network, often at low rates. This makes things easy for people with special needs or people with limited access to their network.
Monthly Premium: $0
Deductible: $0
Prescription Drug Plan Deductible: $0
Out-of-Pocket Maximum: $6,700
Counties Covered: Williamson, Trousdale, Rutherford, Cheatham, Cannon, Robertson, Hickman, Davidson
Here’s another Aetna plan that’s great for prescriptions. You get that same $0 copay for Tier 1 and Tier 2 drugs from preferred retailers. You also get $0 copays for preventive and primary care office visits, some diagnostic services, preventive dental, comprehensive dental, and routine vision. Plus out-of-network benefits.
The main difference between this and the above plans is that when you do pay a copay it will be slightly higher than in the Value plan. But not by much! Usually just $5 to $15. But in return, you get a $0 monthly premium.
Although the federal government provides guidelines and regulates Medicare Advantage plans, private insurance companies actually provide plans to Medicare beneficiaries. That means the cost of Medicare Advantage plans is variable.
Some plans’ premiums can be as low as $0, while others can be over $200 per month. And remember, your Medicare Advantage costs are more than just the monthly premium. You will also need to account for deductibles, co-payments, and out-of- pocket costs. Take a look at the chart below to learn the average costs for Medicare Advantage in Tennessee.
You’ll notice a few common acronyms included in the names of Medicare Advantage plans: HMO, PPO, HMO -POS, SNP, and PFFS. These acronyms indicate the type of Medicare Advantage plan it is. Each type operates in a particular way and has its own sets of advantages and disadvantages. Here’s what you need to know about each plan type:
- Health Maintenance Organization (HMO): This is one of the most common healthcare plans you’ll find and is usually more affordable than a PPO plan. With these health insurance plans, there is a provider network that you will need to stick to in order to keep costs low. You will only receive coverage with in-network providers, except in the case of an emergency. You will also need to choose a primary care physician and get a referral to see a specialist.
- Preferred Provider Organization (PPO): These plans tend to be a tad more expensive than HMOs but offer beneficiaries greater freedom and flexibility. PPOs have a provider network, but you can still receive coverage with out-of-network providers—albeit with higher co-payments or coinsurance than if you visited an in-network provider. You also don’t need to have a designated primary care physician or get a referral to see a specialist.
- Health Maintenance Organization Point of Sale ( HMO -POS): You can think of this plan as a hybrid of an HMO and a PPO. This plan allows you to visit out-of-network providers for a slightly higher cost, just like a PPO plan would. The only caveat is that seeing a specialist still requires you to have a designated primary care physician to issue referrals. This affords you a bit more freedom than an HMO would, but not quite as much as a PPO plan.
- Special Needs Plan (SNP): These types of plans are available for groups of people who meet specific qualifications, such as having a chronic illness or living in an institution for long-term care, like a skilled nursing facility. SNP coverage is designed to meet the unique needs of these groups of people.
- Private Fee-for-Service (PFFS): This type of plan affords beneficiaries greater flexibility. Instead of having a network, this plan allows you to see any healthcare provider who accepts the plan’s terms. PFFS plans are not as common as HMOs or PPOs, and some people may find it inconvenient to have to check with a provider each visit rather than have a list of approved providers that can be easily referenced.
Did you know that you can use the Insurify Medicare comparison tool to find the right Medicare prescription plan for you? Enter your ZIP code to find plans in your area. Try it now!
If you are a Medicare beneficiary, you are eligible to enroll in a Medicare Advantage plan regardless of which U.S. state you live in. All U.S. citizens or permanent residents (for the past five consecutive years) can become eligible for Medicare benefits when they turn 65.
There are a couple of unique circumstances where some people may be eligible for Medicare coverage even if they are under 65. These include being diagnosed with end-stage renal disease (ESRD) or receiving S ocial Security benefits for the past 24 consecutive months.
If you’re unsure about your Medicare eligibility, you can always visit Medicare.gov or call 1 (800) 633-4227—TTY users call 1 (877) 486-2048—for more details. Tennessee also has a State Health Insurance Assistance Program (SHIP) that offers free and objective counseling if you have questions about Medicare.
To enroll in a Medicare Advantage plan, you must first be enrolled in an Original Medicare plan. It’s imperative to remember to enroll in Original Medicare during your Initial Enrollment Period, which begins three months before your 65th birthday and ends three months after. If you enroll during this period, you can avoid fees tacked onto your monthly premium.
Once you’ve enrolled in Original Medicare, there are a couple of opportunities for you to switch over to a Medicare Advantage plan. You can do so during the Open Enrollment Period, which occurs every year from October 15 to December 7. You can also switch to a Medicare Advantage plan during the Medicare Advantage Open Enrollment Period from January 1 to March 31 each year.
Original Medicare is made up of Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance). With Original Medicare, you do not receive coverage for benefits like vision, dental, and hearing. If you want prescription drug coverage, you will need to add on Medicare Part D prescription drug coverage. While Original Medicare is affordable and may work great for some, the coverage included is very basic.
Medicare Advantage, on the other hand, covers everything that Original Medicare covers plus more. Typically, recipients enjoy additional benefits like vision, dental, hearing, mental health services, and more. Many Advantage plans also come with a prescription drug plan. While these plans tend to be more expensive than Original Medicare, it can be well worth it for those who know they will require frequent doctor visits or prescription medication.
No. Medigap is a Medicare Supplement Insurance plan intended to cover the gaps of Original Medicare. Since Medicare Advantage already serves that purpose, you cannot have both a Medigap and Medicare Advantage plan at the same time.
Although many Advantage plans come with a prescription drug plan, not all do. If this is an essential benefit for you, make sure to read the plan's coverage details closely before enrolling.
When you dream of retirement, searching for a good health insurance plan isn’t exactly at the forefront of your mind. Finding the right Medicare Advantage plan may seem like a tedious task, but it doesn’t have to be a complicated or time-consuming process.
Before searching for the best plan, take stock of what’s most important to you. Think through questions like this:
1. What can I afford on a monthly basis?
Do I need prescription drug coverage?
How often do I anticipate visiting the doctor?
Do I have a family medical history to keep in mind for what benefits and services I want covered?
How much can I afford to pay out of pocket each year?
Once you get a handle on some of the basics and your priorities, rounding up your top plan options is simple—and you can do it all right in the comfort of your own home, at your own pace.
Uncover health plans in your area at no cost to you. With the Insurify Medicare comparison tool, all you need is your ZIP code, and you’ll instantly get matched with Medicare Advantage plans available to you. Try it for free.
And because we know your health plan choices can be overwhelming, we have licensed insurance agents available to provide objective assistance, free of charge. Give us a call at 1-844-965-1378 (TTY 711) Monday-Friday 8am – 8pm ET.
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Insurance Writer
Emily Vasquez is a content marketing writer based in Tampa, Florida. A graduate from the University of South Florida, Emily has worked as a copywriter, communications lead, and content strategist for high-growth start-ups and global brands and retailers. You can learn more at www.emvwrites.com
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