Around 1,409,142 Tennessee residents were enrolled in Medicare as of December 2021. This number includes both Original Medicare and Medicare Advantage enrollees. 84% of Medicare recipients in Tennessee qualify because of their age, while 16% qualify because of a disability.
In 2016, Tennessee had one of the highest enrollments for people qualifying due to a disability among all states in the country. This explains why Tennessee has a larger percentage of Medicare recipients who qualify due to a disability than the rest of the country. Considering how enrollment for seniors and those with disabilities is on the rise and the various Medicare plans on the market, it is important to compare your options carefully.
Keep reading to find out more about different Medicare plans in Tennessee and learn why you need the services of a licensed Medicare insurance agent.
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Medicare Supplement (Medigap) Plans in Tennessee
Medicare Supplement or Medigap plans in Tennessee are supplementary insurance that can be purchased by Medicare beneficiaries to pay for medical expenses not covered by Original Medicare. The federal government regulates the Medigap insurance market and provides a standard enrollment period of six months.
During this window, applicants are guaranteed coverage regardless of their health status, and their premiums cannot be based on their age or gender. However, if you are under 65 and qualify for Medicare due to a disability, you are not guaranteed access to a Medigap plan under federal guidelines.
Like many states in the US, Tennessee has enacted regulations to make Medigap policies available to those under the age of 65. According to a law passed in 2011, Medicare providers in Tennessee who sell Medigap policies to retirees aged 65+ are required to provide the same policies to those under the age of 65 who qualify for Medicare due to a disability.
Read MoreMedicare Advantage Plans in Tennessee
Medicare Supplements plans in Tennessee provide the most comprehensive coverage, but many beneficiaries can also opt for Medicare Advantage or Part C Plans. Medicare Advantage plans are provided by private companies that contract with Medicare and offer the same coverage as Original Medicare.
Different Advantage plans may have vastly different out-of-pocket costs since they determine their own coinsurance, copayment, and deductible amounts. Many Medicare Advantage plans also cover prescription medicines through Medicare Part D and may provide other benefits like dental and vision care.
Many Medicare plans don’t pay for medical like hospital stays, checkups, lab work, supplies, etc., so you have to bear these expenses yourself. To keep these costs low, make sure your doctor is in the plan’s network before enrolling.
Around 46% of Medicare beneficiaries in Tennessee were enrolled in Medicare Advantage plans by the end of 2021. This is consistent with the nationwide increase in the number of people enrolled in Medicare Advantage plans. Nearly 44% of Medicare recipients were enrolled in private plans during that time, with Medicare Advantage plans accounting for a majority of those enrollments.
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Comparing Medicare Advantage Plans in Tennessee
Medicare Advantage plan availability in Tennessee varies by county, but the market is healthy statewide. To get coverage in 2022, you can choose from 33 different Medicare Part C plans in Lake County or 59 options in Davidson County.
With all the options on the market, you need to make sure you’re picking a plan that fits your individual requirements and budget. Here are some factors to consider while weighing your options:
Provider Network
Since each Medicare Advantage plan has its own set of providers, you might have to stick to a much smaller geographic area. If the size of the provider network is a problem, or if you plan to travel a lot within the US during retirement, consider getting Original Medicare with a Medigap plan and Part D coverage.
However, if you already have a provider in mind, it is important to research all of your options before deciding on coverage. Some doctors are contracted with Medicare Advantage plans but aren’t part of the Original Medicare network.
Amount of Coverage Required
Are you looking for plans with perks like health care, retirement plans, and gym memberships? Medicare Advantage plans often include these, but Medigap plans don’t. Your Medicare insurance agent will help you find and compare plans based on the benefits you want.
Check Plan Ratings
Make sure you compare Part c and Part plans before open the enrollment period begins on the CMS website. The plans are rated on a scale of 1 to 5 (5 being the highest).
Out-of-Pocket Expenses
Out-of-pocket expenses include deductibles, copayments, and coinsurance that you pay yourself. You can keep these costs at a minimum by sticking to a provider network. Enrollees can use our plan finder tool to learn more about the expenses they’ll incur on different plans.
Monthly Premium
Since you’re already paying Part B deductibles, your Medicare Advantage or Supplement plan premiums add to your monthly cash flow. You’re responsible for these expenses whether you use your benefits or not. To keep your costs low, it is important to have at least one zero-premium plan with affordable drug coverage in your area.
Drug Coverage
If you’re interested in prescription coverage, consider Part C plans. Medicare Advantage plans often include integrated Part D coverage, which pays for your prescription drugs. If you choose Original Medicare and a Medigap policy, you’ll also need to enroll in a Medicare Part D plan to cover your prescription drug costs.
Deductibles, Coinsurance & Copays
You will be paying these expenses when you start using your Medicare insurance benefits. So, you need to be aware of your plan’s hospital and medical coverage. This includes hospital stays, medication, and other medical expenses.
Freedom to Travel
Unlike the limited coverage for international travel provided by Original Medicare, most Medigap policies do include some coverage for international travel. Medicare Advantage programs may extend coverage for travel abroad beyond what is available under Original Medicare, but unlike Medigap policies, Medicare Advantage plans vary across providers. Before signing up, make sure you understand the plan’s terms on international travel.
Medicare Eligibility in Tennessee
Medicare enrollment is open to Tennessee residents over the age of 65. Patients of chronic or incurable conditions, such as end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS), can also enroll for Medicare at any point in their lives.
Medicare Enrollment in Tennessee
Once you have received at least four Social Security or Railroad Retirement Board payments before your 65th birthday, Medicare will enroll you automatically. Otherwise, you can reach out to your local Social Security Office or apply online. We recommend you avoid mailing your application since that could take a few days to reach the office and even more time to process.
Enrollment in Medicare is open during the following time frames:
Initial Enrollment
The initial enrollment period begins three months prior to your 65th birthday to the third month after it. People who have never had Medicare before should sign up during this period. If you started receiving Medicare benefits at a younger age, you could also adjust or upgrade your current plan.
General Enrollment
Enrollment is open again from January 1st to March 31st for individuals who missed the initial period. During this timeframe, you can sign up for Original Medicare (Parts A and B), Medicare Advantage (Part C), a Medigap policy, or Medicare Part D.
Read MoreWhy Choose Medicare Hope Insurance at Integrity Now Insurance Brokers?
The Medicare insurance agents at Integrity Now Insurance Brokers are required to renew their accreditation with AHIP every year. We are qualified to handle all of your Medicare Insurance concerns. We help people of all ages who are struggling to pay for necessary medical treatment, including the elderly and disabled youth.
Medicare insurance options continue to expand each year with the introduction of new companies and plans. Existing plans may also undergo modifications and updates. You don’t need to worry about keeping track of these changes – that’s what we’re here for.
You can discuss your healthcare and financial requirements with one of our licensed Medicare insurance agents in Tennessee, and they will help you compare your options. They’ll help you compare quotes and decide whether you would be better off with a Medicare Advantage Plan or a Medicare Supplement Plan. We offer all the knowledge you require to begin living debt- and stress-free.
Call us today, and we’ll put you in touch with a Medicare insurance agent so you can get started right away.
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