What the numbers say about Tennessee
Tennessee ranks the 7th highest of 51 on our State COBRA Exposure Index, which combines those three measures. Uninsured figures are 2024 Census estimates covering all 95 counties in the state.
What is different about Tennessee
Tennessee uses the federal marketplace at HealthCare.gov.
Open Enrollment for 2027 coverage runs from November 1, 2026 to January 15, 2027, the federal schedule. Enroll by December 15, 2026 for coverage starting January 1.
Where plans are priced
Individual health plans are not priced statewide. Tennessee is divided into geographic rating areas, and the plans available to you — and what they cost — depend on which one your county falls into. Two households an hour apart can face a different list at a different price. This is why a national quote figure means very little, and why a licensed agent will ask for your ZIP code before anything else.
COBRA in Tennessee
COBRA is federal law, so it works identically in every state. If your employer had 20 or more employees you have 60 days to elect from the later of losing coverage or receiving your notice, then 45 days to make the first payment, and coverage reaches back to the day your old plan ended. You pay 102% of the full premium.
What varies by state is what happens when federal COBRA does not apply. If your employer had fewer than 20 employees, Tennessee may have its own continuation law — often called mini-COBRA — with different durations and eligibility. Ask about this specifically if you worked for a small employer, because it is easy to be told "you do not qualify for COBRA" and not be told about the state alternative.
How COBRA works in detail · COBRA compared with a marketplace plan · All your options after a job ends
The largest counties in Tennessee
Because plans are priced by rating area rather than statewide, the figures below differ between places that sit an hour apart. Each one has its own page with the local uninsured count, how many people bought marketplace coverage there, and how many insurers actually sell in it.
| County | Uninsured, under 65 | 2026 plan selections | Insurers |
|---|---|---|---|
| Davidson County | 13.3% | 81,397 | 5 |
| Hamilton County | 11.5% | 31,362 | 5 |
| Knox County | 9.8% | 38,099 | 4 |
| Montgomery County | 8.6% | 13,611 | 5 |
| Rutherford County | 11.0% | 30,649 | 5 |
| Shelby County | 12.6% | 86,784 | 5 |
| Sumner County | 9.6% | 13,540 | 5 |
| Williamson County | 6.5% | 16,038 | 5 |
| Wilson County | 8.8% | 10,757 | 5 |
The 9 largest counties in Tennessee by population, covering 54% of the state's under-65 residents. Uninsured rates are 2024 Census estimates; plan selections and insurer counts are from the 2026 CMS public use files. Figures for every county in Tennessee — including those without their own page — are in the state data set.
Common questions
How much is health insurance in Tennessee?
There is no single answer, because Tennessee is split into geographic rating areas and prices differ between them. Your age, household size and income all change the figure too. What we can say concretely is that a full COBRA premium consumes about 14.2% of median monthly household income here, which is the 9th highest of 51 in the country — one reason so many people in Tennessee look for an alternative.
When is Open Enrollment in Tennessee?
November 1, 2026 to January 15, 2027 for 2027 coverage, following the federal schedule. Enroll by December 15, 2026 if you want coverage starting January 1.
Can I get short-term health insurance in Tennessee?
Yes, they are available in Tennessee. They are not comprehensive coverage — typically medically underwritten and not minimum essential coverage — so they suit a short, defined gap rather than an ongoing need.
What if my employer in Tennessee had fewer than 20 employees?
Federal COBRA would not apply, but Tennessee may have its own continuation law covering smaller employers. Durations and eligibility differ from federal COBRA. Ask specifically about state continuation — people are often told they do not qualify for COBRA without being told the state alternative exists.
Does losing my job in Tennessee let me buy insurance right away?
Yes. Losing job-based coverage opens a 60-day Special Enrollment Period for a marketplace plan, and only 30 days to join a spouse's or parent's employer plan. Medicaid has no window at all and can be applied for any day of the year.
Is Medicaid an option in Tennessee?
It is worth checking first either way, because there is no enrollment window and no premium, and eligibility is assessed on your current monthly income rather than your annual figure. Be warned, though: Tennessee has not expanded Medicaid. That leaves a coverage gap — adults earning too much for the state's restrictive Medicaid limits but too little to qualify for marketplace subsidies. Losing a job can drop you into that gap rather than out of it, which is exactly why it is worth finding out where you stand before you decide anything else.
Why does my premium differ from someone else in Tennessee?
Because plans are priced by rating area rather than statewide, and your age and household composition also matter. Someone in a neighboring county can genuinely face a different set of plans at different prices.
Is there a health insurance agent near me in Tennessee?
You do not need one physically nearby. Plans in Tennessee are sold and priced by county, and a licensed agent can look up exactly what is available in yours from anywhere. Calling (866) 821-1808 connects you with a licensed agency covering Tennessee.
Talk it through with a licensed agent
Which option is right depends on your state, your income and which doctors you need to keep. A licensed agent can walk through it with you in about eight minutes.
Free to call, no obligation, and we never ask you for payment. CobraScout is paid by the agency that answers, not by you. TTY 711.
Sources
- U.S. Census Bureau, Small Area Health Insurance Estimates, 2024 (released August 2026)
- U.S. Bureau of Labor Statistics, Job Openings and Labor Turnover Survey, state layoffs and discharges, July–December 2025
- U.S. Census Bureau, American Community Survey 5-year estimates, median household income
- KFF, 2025 Employer Health Benefits Survey
- U.S. Department of Labor, FAQs on COBRA Continuation Health Coverage for Workers