Medicare Plan Options
You have numerous Medicare options in Tennessee. If you’re healthy, Original Medicare may be all the coverage you need. A Medicare Advantage Plan might be your best option if your health situation is a bit more complex, and those who only need a little extra coverage may find that a Medicare Supplemental Insurance Plan fits the bill. Medicare Part D can also help you with prescription drug costs. If you’re still covered by your employer’s or your spouse’s insurance, you don’t need to select a Medicare plan until that insurance ends.
Original Medicare is the basic Medicare plan that is available to everyone aged 65 or older and those with disabilities. It consists of Medicare Parts A and B, but it doesn’t include Part D. If you want Part D coverage, you’ll need to sign up and pay for that separately. Medicare Part A covers hospitalization, hospice, nursing home care, and home health care. Medicare Part B includes doctor’s visits, mental health coverage, ambulance services, clinical research, durable medical equipment, and some preventative screenings. Under Original Medicare, you pay a deductible and your share of the cost for an inpatient or outpatient visit.
Medicare Advantage Plans
Medicare Advantage Plans are offered through private insurance companies. There are four types of Medicare Advantage Plans available in Tennessee: HMOs, PPOs, Private Fee-For-Service Plans (PFFS), and Special Needs Plans (SNP). While there are 57 Medicare Advantage Plans available in Tennessee, you can only select a Medicare Advantage Plan that is available in your county. These plans include all of the same benefits of Original Medicare Parts A and B and offer some additional benefits, such as vision and dental, and hearing. Some plans may also include a fitness membership, transportation to and from medical appointments, and prescription drug coverage. These plans have different premiums and fee structures than Original Medicare.
Medicare Prescription Drug Coverage Plans
If you’re enrolled in Original Medicare, you can add a Medicare Part D plan. Most plans require a copay. How much you pay depends on several factors, including the pharmacy you use, what tier the drug is in, and whether you receive any extra help from a drug company to pay for the cost. Many Medicare Advantage Plans include prescription drug coverage, but not all of them do. Medicare Part D is offered to all Medicare enrollees. If you don’t select it during your initial enrollment and decide to add it later, you’ll pay a penalty for the duration of your policy.
Medicare Supplement Insurance Plans
If you’re enrolled in Original Medicare and you’d like to have extra coverage but you’re not ready to enroll in Medicare Advantage, you might want a Medicare Supplemental Insurance Plan, also known as Medigap. Medigap plans cover your copays for Parts A and B, as well as additional Part B charges. Some of these plans include coverage when you’re traveling outside the United States. You can’t use Medigap with any Medicare Advantage Plan.
Medicare in Tennessee by the Numbers
|People enrolled in Original Medicare||Average plan cost||Annual state spending per beneficiary||Spending per beneficiary compared to the national average|
|791,707||Plan A: $0 to $471 per month*
Plan B: $148.50 per month**
*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.
Medicare Advantage Resources in Tennessee
It’s a good idea to review your Medicare coverage annually as your health needs may change. Whether you’re joining Medicare for the first time or shopping for a new plan, check out these resources that can help you understand the Medicare options available in Tennessee.
Tennessee Area Agencies on Aging
Created by an act of Congress in 1973, every county in Tennessee is served by an Area Agency on Aging office. Each office works to provide services, connections, and resources for you in your community. This includes access to Medicare and Medicare Advantage counseling, nutritious meals for homebound or disabled seniors, transportation to medical appointments, and caregiver support services.
Contact Information: Website | 866-836-6678
Tennessee Drug Card
A statewide program that provides free prescription assistance to all residents of Tennessee, the Tennessee drug card is designed to help uninsured and underinsured Tennesseans afford prescription drugs. Even if you have a Medicare Part D plan, it may not cover all your prescriptions, and you can use this card to help you cover some of those expenses. It can provide a discount of up to 80% on brand-name and generic drugs. You don’t need to fill out an application or meet any qualifications to use the card.
Contact Information: Website | 888-987-0688
State Health Insurance Assistance Program (SHIP) for Medicare Participants
The SHIP program is part of a national network that provides free counseling and information to Medicare-eligible individuals. You can receive information on Original Medicare, Medicare Advantage, Medicare Supplement Insurance, and Medicare Part D programs. The program’s experienced counselors can help you, your family, or your caregivers select your best health care option. SHIP counselors are located throughout the entire state.
Contact Information: Website | 877-801-0044
Tennessee Department of Commerce and Insurance
If you have a consumer-related question about health care insurance in Tennessee, the Department of Commerce and Insurance can help. It can answer many of your questions about Medicare Advantage, Medicare Supplement Plans and Prescription Drug Plans. While the federal government regulates many of these plans, the department licenses them and ensures they remain financially solvent. The department oversees all Medicare Supplemental Insurance Plans offered in Tennessee.
Contact Information: Website | 800-342-4029
Learn from Our Sources
- Medicare | What Medicare covers | Last accessed June 2021
- Medicare | What Part A covers | Last accessed June 2021
- Medicare | What Part B covers | Last accessed June 2021
- Medicare | Part D | Last accessed June 2021
- Medicare | Joining a health or drug plan | Last accessed June 2021
- Medicare | What’s Medicare Supplement Insurance (Medigap)? | Last accessed June 2021
- Medicare | How to get prescription drug coverage | Last accessed June 2021
- Medicare| Who can join a Medicare Advantage Plan | Last accessed June 2021
- Medicare | How do Medicare Advantage plans work? | Last accessed June 2021
- Medicare | Health Maintenance Organizations (HMO) | Last accessed June 2021
- Medicare | Preferred Provider Organizations (PPO) | Last accessed June 2021
- Medicare | Private Fee-for-Service Plans (PFFS) | Last accessed June 2021
- Medicare |Special Needs Plans (SNP) | Last accessed June 2021
- Medicare | Medicare Advantage Plans cover all Medicare services | Last accessed June 2021