State Guides

Tennessee

Tennessee residents in need of temporary health insurance may now purchase quality short term health coverage offered by Pivot Health. Pivot Health’s short term medical plan provides comprehensive benefits coverage for physician visits, in-hospital care, urgent care facility visit and much more. Other key features for Tennesseans include:

Comprehensive coverage at an affordable price
Pivot Health’s short term health insurance provides many of the same benefits as individual major medical plans, at rates up to 50% less.
Flexible duration of coverage
choose the period of time that you will need coverage.
Freedom to seek treatment from the health care providers you want
no network restrictions enable you to choose any doctor or hospital to access your plan benefits.
Quick, easy application process
Pivot Health’s user-friendly online application process takes just a short time to use. You’ll know within minutes of applying if you have been approved for coverage.
Coverage when you want it
qualified applicants can choose their coverage start date, even as quickly as 24 hours from the time of application.

The Pivot Health membership package for short term medical plan insureds also includes several non-insurance benefits

Unlimited access to discounted telehealth doctor consultations. No need to book an appointment, drive to the office and sit in a waiting room. Talk directly with a doctor whenever and wherever it works for you – telehealth consultations are available 24/7.

Savings on eyewear and eye care. With discounts of 15 percent to 40 percent on eye exams, eyeglass lenses, frames for eyeglasses and contact lenses, it’s easy and affordable to maintain good ocular health.

Significant discounts on prescription drugs. Savings of up to 75 percent on prescription drugs at thousands of pharmacies across the country makes it easier to afford your prescription medications.

Tennessee Health Insurance Exchange Challenges

A recent study by the U.S. Department of Health and Human Services (HHS) has noted that approximately 10 percent of the state’s residents under age 65 are have no health insurance. The uninsured rate by county differs significantly, said a recent County Health Rankings & Roadmaps report. Williamson County has the lowest rate at 9 percent; Sevier and Bedford Counties have the highest rate of uninsureds at 22 percent

The Volunteer State’s 10 percent uninsured rate is slightly higher than the national uninsured rate of 9.1 percent. However, healthinsurance.org points to a Gallup Well-Being report estimated a 16.8 percent uninsured rate in Tennessee prior to the implementation of the Affordable Care Act (ACA).

Despite this good news, there are significant issues with the ACA exchange in Tennessee. The challenges the state is facing are so severe that the Tennessee Insurance Commissioner recently characterized the Obamacare exchange in the state as “very near collapse.”

Tennesseans purchasing plans on the exchange for 2017 faced premium increases ranging from 44 to 62 percent. 85 percent of exchange enrollees receive increased premium subsidies from the federal government to help offset those adjusted premium rates. However, for exchange enrollees who don’t qualify for premium subsidies or insureds who purchase coverage off the exchange, the 2017 premium increase is a staggering financial blow.

Further, in 2017, 57 of the 95 counties in Tennessee only have one insurer offering plans on the federally-operated exchange. Even more concerning is the recent announcement by Humana to withdraw from the Tennessee exchange starting in 2018. This will impact more than 79,000 Tennesseans insured by Humana – roughly one-third of the more than 234,000 Tennessee residents who purchase exchange plans. Residents in the Knoxville area – where Humana is currently the only exchange insurer – will be left with no exchange insurer option starting in 2018, unless another insurer decides to offer plans in that market.

Skyrocketing premium rates and limited carrier options point to the need for Tennessee residents to have access to a broader range of health insurance choices.

Pivot Health offers residents of the Volunteer State a short term health insurance option that may meet their needs and budgets. This type of plan provides comprehensive benefits coverage, with no network restrictions, at significantly lower rates than major medical insurance plans cost.

The State of Health in Tennessee  

The 2017 Commonwealth Fund’s Scorecard on State Health System Performance gave Tennessee an overall ranking of 44 out of 51 (the 50 states plus the District of Columbia).  This is the most recent version of the organization’s scorecard of its comparison for states in the U.S.  The Commonwealth Fund’s Scorecard rated Tennessee in several areas, including:

  • Uninsured adults aged 19 to 64: 35th ranking (15 percent in Tennessee, compared to the U.S. average of 13 percent)
  • Uninsured children ages 0 to 18:  11th ranking (4 percent, compared to the U.S. average of 5 percent)
  • Adults who went without care because of cost in the previous year:  43rd ranking (16 percent in Tennessee, compared to the U.S. average of 13 percent)
  • Individuals under age 65 with high out-of-pocket costs relative to annual household income:  45th ranking (18 percent, compared to the U.S. average of 14 percent)
  • At-risk adults who did not have a routine doctor visit in the previous two years:  27th ranking (14 percent in Tennessee, compared to U.S. average of 13 percent)
  • Adults that did not visit a dentist in the previous year: 41st ranking (18 percent, compared to U.S. average of 16 percent)
  • Adults with age- and gender-appropriate cancer screenings:  23rd ranking (68 percent in Tennessee, the same as the U.S. average of 68 percent)
  • Hospitalized people who said the hospital staff managed pain well, were responsive to calls for help and who explained medications and their side effects:  29th ranking (68 percent, the same as the U.S. average of 68 percent)
  • Breast cancer deaths per 100,000 females: 33rd ranking (21.6 in Tennessee, compared to U.S. average of 20.6)
  • Colorectal cancer deaths per 100,000 people: 35th ranking (15.3 percent, compared to the U.S. average of 14.3 percent)
  • Suicide deaths per 100,000:  25th ranking (14.1 percent in Tennessee, compared to U.S. average of 13 percent)
  • Adults who report fair or poor health or activity limitations: 44th ranking (30 percent, compared to the U.S. average of 26 percent)
  • Adults who smoke:  43rd ranking (22 percent in Tennessee, compared to the U.S. average of 17 percent)
  • Adults who are obese: 43rd ranking (35 percent, compared to the U.S. average of 29 percent)
  • Children (ages 10-17) who are overweight or obese: 37th ranking (34 percent in Tennessee, compared to the U.S. average of 31 percent)
  • Percent of adults who have lost 6 or more teeth due to decay or disease:  46th ranking (16 percent, compared to the U.S. average of 10 percent)

There were several positive ratings for Tennessee in a number of categories:

  • Children with medical and dental preventive care visits in the past year
  • Home health patients whose wounds improved or healed after an operation
  • A lower-than-national-average rate of hospital admissions for children with asthma

2017 Health Insurance Plans Available to Tennesseans

Tennessee uses the federally-run health insurance exchange. There are three insurance carriers participating on the exchange in 2017, but Humana has already announced that it will withdraw from the exchange in 2018. That will leave two exchange insurance carriers in the Volunteer State next year, and means that approximately one-third of current exchange participants will need to find new health insurance coverage.

The 2017 insurance carriers in Tennessee are:

  • Blue Cross Blue Shield of Tennessee
  • Cigna Health and Life Insurance
  • Humana Insurance

Medicaid Enrollment in Tennessee

19 states have chosen not to expand Medicaid under the terms of the Affordable Care Act, including Tennessee. A recent Kaiser Family Foundation study reported that there are approximately 93,000 Tennesseans in the Medicaid “coverage gap.” The term “coverage gap” refers to people who have income too high to qualify for traditional Medicaid benefits, yet their income is too low to qualify for subsidies to help pay for insurance plans purchased on the Tennessee state exchange.

There is a movement in Tennessee to expand Medicaid, which started when Governor Bill Haslam unveiled his “Tennessee Plan” in 2013. This proposal involved using federal Medicaid funding to purchase private coverage for up to 200,000 low-income Tennessee residents, with some enrollees having copayment responsibilities. It also recommended provider payment systems based on outcomes rather than fee-for-service, and the requirement that the Tennessee legislature would approve future renewal Medicaid expansion measures.

That measure was voted down by a Tennessee Senate Committee in 2015, due to concerns about long-term costs that the state would bear once the federal government begins reducing their Medicaid funding efforts. A further issue is that Tennessee recognizes the challenges it would face if it were to try to repeal Medicaid expansion in the future.

Further proposals for expanded Medicaid measures were rejected by the Tennessee legislature in 2015 and early 2016. The future of a new measure, proposed by the 3-Star Healthy Task Force, is uncertain – as it must be approved first by the federal Centers for Medicare and Medicaid Services, and then by the Tennessee legislature.

The Volunteer State residents caught in the Medicaid coverage gap may greatly benefit from an affordable, comprehensive health care benefits plan such as Pivot Health’s short term medical insurance.

An Affordable Health Care Coverage Option: Short Term Medical

Tennessee residents who do not have health insurance should take a closer look at Pivot Health’s short term health insurance. It provides you the comprehensive medical coverage to meet your benefit and budget needs.

Pivot Health: offering you choices and flexibility to meet your needs over time.