12.6% of under-65 residents in Shelby County were uninsured in 2024 — about 92,116 people — which is modestly above the Tennessee average of 11.3% and makes it the 32nd highest of the 95 counties in Tennessee. Close enough to the state figure that the county is not an outlier; far enough that coverage gaps here are a real feature rather than a rounding artifact.
Shelby County against Tennessee, and against the counties we cover
| Shelby County | Tennessee | Covered counties | |
|---|---|---|---|
| Uninsured, under 65 | 12.6% | 11.3% | 13.0% |
| Marketplace enrollees per 1,000 | 118 | — | 127 |
| Insurers selling here | 5 | 5 (median) | 5 |
| Individual plans offered | 65 | — | 84 |
State uninsured rate from the Census SAHIE series; the final column is the median across the 104 counties covered on this site. Enrollment density is CMS plan selections per 1,000 under-65 residents.
What you can actually buy here
5 insurers sell into Shelby County. At that number the market is competitive without being bewildering. Networks still differ sharply between carriers — more sharply than the monthly prices do — which is the opposite of how most people shop. Between them they offer 65 plans, about 13 for each insurer, which is a normal-sized list to work through once you know which network you need. The count is up from 3 last year. Insurers entering a county usually means they like what they see in the risk pool, and it tends to show up as more aggressive pricing the following year rather than immediately.
86,784 people here bought marketplace coverage for 2026, about 118 per thousand under-65 residents. That sits near the middle of the counties covered on this site: a working individual market, but most local coverage still arrives through an employer. 13,827 of them were new consumers and 72,957 were renewals — a 16% new share, close to the national pattern. Roughly one in six enrollees here arrived within the year.
Nearest counties on coverage
The counties we cover in Tennessee whose uninsured rate sits closest to Shelby County. Worth a look if you are comparing across a county line or moving.
| County | Uninsured | Insurers | Enrollees |
|---|---|---|---|
| Davidson County | 13.3% | 5 | 81,397 |
| Hamilton County | 11.5% | 5 | 31,362 |
| Rutherford County | 11.0% | 5 | 30,649 |
| Knox County | 9.8% | 4 | 38,099 |
| Sumner County | 9.6% | 5 | 13,540 |
| Wilson County | 8.8% | 5 | 10,757 |
Everything that applies in Tennessee · How COBRA works · Work out your COBRA premium · After a job ends
Common questions
How many people are uninsured in Shelby County?
About 92,116 people under 65, out of 732,633 in that age group — 12.6%, the 32nd highest of the 95 counties in Tennessee. The Tennessee average is 11.3%. Census Bureau estimates for 2024, the most recent published.
How many health insurers sell in Shelby County?
5 insurers offer individual marketplace plans in Shelby County for 2026, up from 3 the year before, and between them they sell 65 individual medical plans. The median across the counties covered on this site is 5 insurers and 84 plans.
How many people in Shelby County buy marketplace coverage?
86,784 plan selections for 2026 — 13,827 new consumers and 72,957 renewals. That works out at 118 per thousand under-65 residents, against a median of 127 across the counties covered here. New consumers are the group most likely to have lost a job during the year.
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.
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Sources
- U.S. Census Bureau, Small Area Health Insurance Estimates, 2024 (released August 2026)
- Centers for Medicare & Medicaid Services, 2026 Marketplace Open Enrollment County-Level Public Use File
- Centers for Medicare & Medicaid Services, 2026 Service Area Public Use File
- Centers for Medicare & Medicaid Services, 2026 Plan Attributes Public Use File
- U.S. Department of Labor, FAQs on COBRA Continuation Health Coverage for Workers