TENNESSEE DEPARTMENT OF COMMERCE AND INSURANCE
Open Enrollment for health insurance coverage on the Federally Facilitated Marketplace began Nov. 1, and Tennesseans have until December 15, 2018, to apply for or re-enroll in coverage for the 2019 calendar year.
According to the the Tennessee Department of Commerce and Insurance, Bright Health is entering the Tennessee market for the first time in 2019 and Celtic Insurance
(appearing on the FFM as “Ambetter of Tennessee”) is returning to the marketplace. BlueCross BlueShield of Tennessee, Cigna, and Oscar Health continue to offer products in Tennessee.
To assist consumers in evaluating their options, TDCI has compiled a list of carrier presentations and coverage areas.
• BlueCross BlueShield of Tennessee: Statewide coverage except for the Memphis and Nashville areas.
• Bright Health: Coverage offered for the Knoxville, Memphis, and Nashville areas.
• Celtic (Ambetter) Insurance: Coverage offered in the Chattanooga and Memphis areas.
• Cigna: Coverage continues in the Nashville, Memphis, and Tri-Cities areas with coverage expansion into the Knoxville area.
• Oscar Health: Coverage continues in the Nashville area with coverage expansion into the Memphis area. (Please note: Oscar plans are available off-marketplace. A technological issue is currently preventing Oscar plans from appearing on healthcare.gov.)
“The expanded healthcare plan options for 2019 give Tennesseans more choices,” TDCI Commissioner Julie Mix McPeak said. “One new carrier is offering coverage in our market, one carrier is returning to Tennessee, and two others have expanded their coverage area. This will mean Tennesseans will see competition in areas of the state, like Chattanooga, Knoxville, and Memphis, where there has been little to none in previous years.”
In addition to expanding coverage options, for the first time in the ACA marketplace era, the Tennessee Department of Commerce and Insurance approved premium rate decreases for two longtime market participants. Though decreases will bring down premium rates, an individual’s out-of-pocket premium costs depends on several factors,
including the amount of Advanced Premium Tax Credit subsidies; therefore, some consumers may experience an increase in out-of-pocket costs for coverage. Consumers should contact licensed insurance agents or company representatives for assistance in considering 2019 plan coverage.
The Department emphasizes the need for consumers to carefully review plan networks. If you like your physician, make sure he/she is included in the plan network and check carrier directories for local hospitals to ensure easy access to ‘in-network’ services, where possible. Several plans provide limited or no out-of-network benefits. All marketplace plans are exclusive provider organizations (EPOs), meaning they do not provide out-of-network benefits, with few exceptions. To avoid unexpected and unpleasant balance bills, check your carrier’s network ahead of visits when practicable.
To assist with enrollment/payment issues or network questions, the Tennessee Department of Commerce and Insurance has posted contact numbers for each of the carriers. Additionally, the Department created an informational video as well as a coverage area map of Tennessee for 2019.
- November 1, 2018: First day to enroll, re-enroll, or change a 2018 insurance plan.
- December 15, 2018: Open Enrollment on the FFM ends.
- January 1, 2019: Coverage starts for those who enroll or change plans by December 15.
Questions about Open Enrollment? Contact the Tennessee Department of Commerce and Insurance at 1-800-342-4029 or 615-741-2218.
To check a license of a professional regulated by the Department, go to http://verify.tn.gov/.