Medicare in Tennessee
Key Takeaways
- You are eligible for Medicare in Tennessee when you turn 65 years old.
- Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). features hospital (Part A) and medical (Part B) coverage and offers you the option to add drug (Part D) and supplemental (Medigap) coverage.
- Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). in Tennessee bundles Part A, Part B, and usually Part D coverage while offering additional coverages like dental and vision care.
Music is a little bit like Medicare. Everything sounds good until someone misses a note. Medicare in Tennessee is too complex to just play by ear. GoHealth is here to help.
Who Is Eligible for Medicare in Tennessee?
The federal government created Medicare in 1965 to benefit U.S. citizens ages 65 and older. You also are eligible for Medicare in TN regardless of your age if:
- You have received 24 monthly payments of Social Security Disability Insurance or Railroad Retirement Board benefits.
- You have end-stage renal disease or Lou Gehrig’s disease (also known as amyotrophic lateral sclerosis or ALS).
If you decide to stay enrolled in Parts A and B, you have the option to add Part D to cover a portion of your prescription expenses. You may also choose to add Medigap, which is supplemental coverage that helps fill in the gaps in out-of-pocket costs like copays and coinsurance.
Looking for dental, vision and hearing coverage?
How Do I Apply for Medicare in Tennessee?
Your choices for applying for Medicare in Tennessee include:
- Enrolling online with the Social Security Administration.
- Visiting a local Social Security office.
- Enrolling over the phone at 1-800-772-1213 (TTY: 1-800-325-0778).
What Is the Difference Between TennCare and Medicare?
TennCare is the name of the Medicaid program in Tennessee.
Each state has its plan for administering Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those in need with their healthcare costs regardless of age. As of 2021, TennCare assists more than 1.4 million Tennesseans who are low-income or struggling with qualifying disabilities.
TennCare also administers Medicare Savings Programs for Medicare beneficiaries who don’t qualify for Medicaid but still have eligible needs.
My Medicare coverage doesn’t address all of my needs.
Is Every 65-Year-Old Eligible for Medicare?
If you’re a U.S. citizen or permanent resident of at least five year, you become eligible for Medicare in Tennessee at age 65.
A GoHealth study found that one in seven older Americans surveyed incorrectly thought the Medicare eligibility age was 62. That may be because Americans are eligible to start drawing Social Security benefits at age 62. The Social Security Administration oversees Medicare enrollment and deducts Medicare premiums from Social Security payments, if you choose.
While Medicare is an individual policy, a person on Medicare can benefit from their younger spouse turning 62. Any Medicare beneficiary who hasn’t worked 10 years must pay a Part A premium, but they no longer have to when a spouse who has worked at least 10 years turns 62. That spouse, however, like everyone else, still has to wait to turn 65 before joining Medicare.
What Are the Different Plans of Medicare?
If you’re on Original Medicare, perhaps you’re considering a switch to Medicare Advantage in Tennessee.
Here are some things to consider.
- Medicare Advantage bundles the hospital and medical coverage offered by Parts A and B of Original Medicare and usually includes prescription drug coverage.
- Medicare Advantage also offers additional coverage options not provided by Original Medicare like dental and vision coverage and a monthly stipend for purchasing over-the-counter supplies.
- Medicare Advantage and Original Medicare have different coverage areas and various costs. Original Medicare is nationwide coverage anywhere that accepts Medicare. Medicare Advantage uses a network of providers in your area, but that distinction often allows Medicare Advantage in Tennessee to offer more affordable options.
What is the Highest Rated Medicare Advantage Plan?
The Centers for Medicare & Medicaid Services has a Medicare Star Ratings system that assigns a rating of up to five stars to individual Medicare Advantage plans, and Medicare Advantage beneficiaries even are offered the opportunity to switch once a year to a five-star plan.
While the rating system can shed light on Medicare Advantage plans’ performance, it’s not as easy as just picking the highest-rated plan. A GoHealth licensed insurance agent, without obligation, can help you compare plans and find the one that’s the right fit for you.
Find the Medicare Plan that works for you.
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 1,330,544 people are enrolled in Medicare Part A and B in Tennessee. The total number of beneficiaries enrolled in Medicare Advantage increased from 575,592 to 620,122 year over year. Medicare Advantage participation in Tennessee went from 44.23% to 46.61% year over year. If you’d like to dive deeper into how Medicare in Tennessee breaks down across the state, we provide a glance at who is using Medicare and how.
1,330,544 Beneficiaries with Part A & Part B
620,122 Medicare Advantage Beneficiaries
46.61% Medicare Advantage Participation Rate
55.02% Female
44.98% Male
86.85% Non-Hispanic White
9.61% African American
0.96% Hispanic
2.58% Other/Unknown
13.91% Eligible for Medicaid
0.99 Average HCC Score
$9,850.69 Actual Per Capita Costs
18.10% Hospital Readmission Rate
26.63% % of Beneficiaries with an Emergency Department Visit
575,592 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
44.23% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
TN SHIP - Medicare Counseling
https://www.tn.gov/aging/our-programs/state-health-insurance-assistance-program–ship-.html
What should I know about TN SHIP?
Free advice is available from the Commission on Aging & Disability, which runs Tennessee’s State Health Assistance Insurance Program.
Learn more
Tennessee Department of Commerce & Insurance
https://www.tn.gov/commerce/resources-services/file-a-complaint.html
What should I know about the Tennessee Department of Commerce & Insurance?
The state agency responds to insurance-related complaints.
Learn more
TennCare
https://www.tn.gov/tenncare/members-applicants/how-do-i-apply-for-tenncare.htmll
What should I know about TennCare?
It is the official state Medicaid program, with representatives available to answer questions and help Tennesseans apply.
Learn more
Tennessee Department of Veterans Services
https://www.tn.gov/veteran/veteran-benefits/tn-state-benefits.html
What should I know about the Tennessee Department of Veterans Services?
It helps veterans and their families understand and optimize their health-related benefits.
Learn more
Nationwide Resources
Speak with a GoHealth insurance agent that is licensed in Tennessee about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration by phone for general questions. Not all questions can be answered over the phone.
Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online
1-800-722-1213
TTY 1-800-325-0778
Speak to SSA Representative, Monday – Friday, 8 AM – 7 PM ET
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
- Apply for Benefits. SSA.gov.
- Social Security Office Locator. SSA.gov.
- Do you need help applying for TennCare? TN.gov.
- Enrolling in Medicare Part A & B. Medicare.gov.
- 5-star special enrollment period. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.