Medicare in Tennessee
Key Takeaways
You are eligible for Medicare in Tennessee when you turn 65 years old.
Original Medicare features hospital (Part A) and medical (Part B) coverage and offers you the option to add drug (Part D) and supplemental (Medigap) coverage.
Medicare Advantage 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 an important 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).
Those who are eligible can enroll in Part A (also known as “hospital insurance”), Part B (“medical insurance”), or both. Once enrolled in Part A and B (known collectively as Original Medicare), you have the option of switching to Medicare Advantage in Tennessee (also known as Part C) to receive the benefits of Parts A and B from a private insurance company along with other benefits like dental and vision coverage.
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.
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).
If you are receiving Social Security benefits before you turn 65, you may be automatically enrolled in Original Medicare. If not, you have to apply. Your first chance to sign up is during your Initial Enrollment Period, a seven-month window that includes the month of your 65th birthday and the three months before and the three months after your 65th birthday.
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.
Is Every 65-Year-Old Eligible for Medicare?
Yes. As long as you’re a U.S. citizen, you become eligible for Medicare in Tennessee at age 65.
A GoHealth study found that 1 in 7 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 in TN, as well as the drug coverage and supplemental 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 allows Medicare Advantage in Tennessee to often 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.
Medicare in Tennessee by the Numbers
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.
Medicare
Tennessee
1,330,544 Beneficiaries with Part A & Part B
620,122 Medicare Advantage Beneficiaries
46.61% Meducare 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% Meducare Advantage Participation Rate, Previous Year
See more +
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.
Tennessee Medicare Resources & Contacts
Beneficiaries spend an average of $9,850.69 each year on Medicare in Tennessee. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Tennessee-based resources, like these, may be able to help:
Nationwide Resources
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.
Medicare guide
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare guide
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare guide
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Medicare guide
Low Income and Medicare Guide
For individuals with a qualifying income status
Medicare guide
A Caregiver’s Guide
For individuals with a qualifying income status
