Medicare in Tennessee - Compare Plan Options
Tennessee residents who are 65 or older, or individuals with a qualifying disability, can enroll in Medicare, a federal program that offers medical insurance coverage. More than 1.4 million individuals in Tennessee benefit from the coverage Medicare provides.
Medicare Plans in Tennessee
Medicare plans in Tennessee provide various coverage options to meet your specific health needs and lifestyle. If you have multiple health conditions or a disability, Original Medicare may not fully cover all expenses, leading to higher out-of-pocket costs. Medicare Advantage provides a comprehensive option that can be a great choice. For maximum coverage, a Medigap plan effectively bridges any remaining gaps.
Here are the five types of Medicare plans in Tennessee:
Original Medicare (Parts A & B)
Original Medicare is the foundation of the Medicare program in Tennessee, comprising Part A (hospital insurance) and Part B (medical insurance). Part A is generally available without a premium for individuals who have worked and paid Medicare taxes for at least ten years. Part B requires a monthly premium based on income. While Original Medicare offers coverage for a wide array of healthcare services, it does not include certain benefits like prescription drug coverage.
Medicare Advantage (Part C)
Private insurers offer Medicare Advantage (MA) plans in Tennessee that Medicare approves. These plans provide the same benefits as Original Medicare and offer additional coverage for prescription drugs, vision, dental, and hearing. Furthermore, MA plans generally have lower out-of-pocket costs compared to Original Medicare. Tennessee offers a wide array of Medicare Advantage plans, so carefully compare the available options and select the one that best suits your needs.
Medicare Supplement Insurance (Medigap)
Private insurers offer Medigap plans in Tennessee to help fill the coverage gaps left by Original Medicare. These plans provide coverage for deductibles, co-payments, and coinsurance. Ten standardized Medigap plans are available, ranging from Plan A to Plan N. Among beneficiaries, Medigap Plan G is the most popular choice. Regardless of which insurance company offers the plan, the government ensures that the benefits of each plan are standardized. In addition to the premium for your Original Medicare, Medigap policies also have a monthly premium.
Medicare Prescription Drug Plans (Part D)
Prescription drug coverage is not provided under Original Medicare for Tennessee residents. However, you can obtain this coverage by enrolling in a standalone Medicare prescription drug plan offered by approved private insurers. Each plan has a formulary, which is a list of drugs covered. It is crucial to select a plan that includes the medications you need. Please be aware that formulary changes may occur annually.
Special Needs Plans (SNPs)
In Tennessee, there are Medicare Advantage plans known as Special Needs Plans (SNPs) that specifically cater to individuals with certain chronic conditions or those needing specialized care, such as those with Medicare and Medicaid. SNPs are available in three types: Chronic Condition SNPs, Dual Eligible SNPs, and Institutional SNPs. It’s important to note that the availability of SNPs may vary by area in Tennessee, and not all individuals are eligible for SNP plans.
Medicare Eligibility in Tennessee
Medicare benefits in Tennessee are available to individuals aged 65 and above, as well as to younger individuals with disabilities and those diagnosed with End-Stage Renal Disease (ESRD).
To be eligible for Medicare in Tennessee, you must meet the national standards set by the Social Security Administration (SSA). Once you have worked in positions that require Medicare taxes for at least ten years as a U.S. citizen or permanent resident, you can apply for Medicare benefits when you turn 65. It is important to note that you must have lived continuously in the United States for five years before applying.
Individuals younger than 65 may be eligible if they have received Social Security disability benefits for at least 24 months or have ESRD. Individuals with ESRD must also meet residency requirements to be eligible.
In addition to meeting specific eligibility requirements, applicants must apply for Medicare coverage before their 65th birthday or within three months after their disability begins to avoid late enrollment penalties. Applicants can use the Social Security website or visit a local office for assistance and advice.
With regard to cost, if you are not eligible for automatic qualification for Part A, you might have to pay as much as $506 per month (as of 2023). The Part B standard premium is $164.90 monthly (as of 2023), but your premium could be higher if you have a higher income.
How Do I Apply for Medicare in Tennessee?
Applying for Medicare in Tennessee is an easy process. You can apply online or by phone.
If you apply online, you must visit the Social Security Administration website and complete an application. The website includes a helpful tutorial that walks you through the process step-by-step. Once your application has been submitted, completing the process typically takes less than 10 minutes.
If you prefer to apply over the phone, call 1-800-772-1213 (TTY users should call 1-800-325-0778).
As you can see, each plan type has unique features and benefits. Although choosing the right plan may seem overwhelming, take the time to do some research, ask questions, and determine which plan aligns with your healthcare needs and budget.
Tennessee Medicare Resources
Tennessee residents should explore their available Medicare options. Tennessee offers resources for seniors and caregivers, such as AgeWell Middle Tennessee, Tennessee Commission on Aging and Disability, and the Area Agency on Aging and Disability.