How health insurance works in Tennessee
Tennesseans buying their own coverage have two markets: HealthCare.gov (healthcare.gov), where plans from BlueCross BlueShield of Tennessee, Ambetter, Cigna, Oscar, and UnitedHealthcare are guaranteed-issue and priced on income, and the private shared-network market, where PPO plans on Cigna, Aetna and PHCS PPO are underwritten and priced on age and health.
Medicaid is not expanded in Tennessee. Tennessee has no state individual mandate.
What it costs
Full-price marketplace plans for a 40-year-old in Nashville commonly run $550–$850 a month in 2026; with a subsidy, often under $300. Private PPOs for the same healthy person run roughly $320–$480. Tennessee has no state income tax, so the only lever on a health premium is the premium itself.
The Tennessee picture
Tennessee didn't expand Medicaid, so self-employed people with modest incomes can fall in a gap with no subsidy — and Nashville's self-employed music, creative and healthcare workforce is one of the biggest private-plan markets in the South.