NASHVILLE – The Tennessee Department of Commerce & Insurance (TDCI) reminds consumers that additional savings and increased tax credits are available when they apply or enroll for healthcare coverage on the Federally Facilitated Marketplace (FFM) for the 2021 calendar year during the Special Enrollment Period (SEP) now through Aug. 15, 2021.
According to recently released figures from the Centers for Medicare & Medicaid Services (CMS), over 64,000 uninsured Tennesseans are eligible for tax credits and over 70,000 would be eligible for zero-dollar benchmark Marketplace coverage. Consumers can choose to enroll in plans that cost more or cost less than the benchmark plan, but the amount of their tax credit is based on a percentage of their income and the cost of the benchmark plan’s monthly premium.
Premium tax credit calculations for the Marketplace on HealthCare.gov are now adjusted so that most consumers qualify for more substantial advance payments of premium tax credits. Many Americans who purchase coverage through the Marketplace will see their premiums decrease, on average, by $50 per person per month and $85 per policy per month. An average of four out of five consumers currently enrolled in a plan through HealthCare.gov will be able to find a plan for $10 or less per month with the newly expanded financial assistance under the American Rescue Plan.
Additionally, after advance payments of the premium tax credits, an average of three out of five uninsured adults eligible for coverage on HealthCare.gov may be able to access a zero-premium plan and nearly three out of four may find a plan for $50 or less per month on HealthCare.gov.
Tennessee’s health insurance carriers and coverage areas for 2021 are as follows:
- BlueCross BlueShield of Tennessee: Statewide coverage.
- Bright Health: Coverage in Knoxville, Memphis and Nashville areas.
- Celtic/Ambetter Insurance: Coverage in Nashville, Knoxville, Chattanooga, Jackson, Memphis and Tri-Cities areas as well as select cities in West Middle Tennessee such as Columbia, Dickson and Lawrenceburg.
- Cigna: Coverage in Chattanooga, Jackson, Knoxville, Nashville, Memphis and Tri-Cities areas.
- Oscar Health: Coverage in Nashville and Memphis areas.
- UnitedHealthcare: Coverage in Chattanooga, Jackson, Memphis and Nashville areas as well as select cities in West Middle Tennessee such as Columbia, Dickson and Lawrenceburg.
To aid consumers in understanding their coverage choices, TDCI has posted a video outlining Tennessee’s insurance coverage areas.
Current enrollees should review their application, make any changes needed to their current information, submit their application and select a plan, or reselect their current plan, to receive the increased advance payments of premium tax credits for 2021 Marketplace coverage. Consumers who take action in April and confirm updated savings on the plan of their choice will start receiving the savings and lower costs starting with their May 1 premiums.
Consumers who want to enroll in coverage and see if they qualify for more affordable premiums can visit HealthCare.gov or CuidadoDeSalud.gov to view 2021 plans and prices and, if eligible, enroll in a plan that best meets their needs.
If desired, consumers may instead choose to make a new plan selection but should consider how much they have already paid toward the deductible when deciding whether or not a change in plan makes sense. When a consumer changes plans, the amount they’ve already paid towards meeting their prior plan’s deductible and annual limit on cost sharing may be reset to zero, and they would need to start overpaying out of pocket expenses to meet their new deductible and to reach the annual limit on cost sharing on their new plan.
If they have made significant payments toward their current plan’s annual limit on cost sharing, consumers should check with their insurance company to see how it might impact them and what options are available to keep credit toward what they have already paid
In order to use this SEP, current enrollees will need to step through their application and make any changes if needed to their current information and submit their application in order to receive an updated eligibility result that provides the SEP before continuing on to enrollment.
This SEP opportunity will not involve any new application questions or require consumers or enrollment partners to provide any new information not otherwise required to determine eligibility and enroll in coverage. In addition, consumers will not need to provide any documentation of a qualifying event (e.g., loss of a job or birth of a child), which is typically required for SEP eligibility.
As always, consumers found eligible for Medicaid or CHIP will be transferred to their state Medicaid and CHIP agencies for enrollment in those programs.
Before enrolling in a plan, TDCI reminds consumers to remember the following tips:
- Carefully review plans when shopping on the exchange during the SEP. Review a policy to ensure it provides the coverage for services you are seeking. While it may be tempting to enroll in a plan with the lowest premium, consumers should take into account other potential costs such as co-pays and deductibles.
- Ask questions and contact the carriers about their plans. Consumers can learn more details about individual plans, get contact numbers for carriers and view a statewide map of insurance carriers’ coverage areas at TDCI’s website.
- Research premiums, deductibles, co-pays and cost-sharing along with reviewing each insurance carrier’s networks for their most accessible and/ or preferred providers and hospitals. To avoid unexpected or ‘balance bills’, always visit in-network providers.
Additionally, consumers can call the Marketplace Call Center at 1-800-318- 2596, which provides assistance in over 150 languages. TTY users should call 1-855-889-4325. Consumers can also find a local assister or agent/broker in their area. Eligible consumers can apply through HealthCare.gov through Aug. 15, 2021, to gain access to the Special Enrollment Period to change or update their plan choices.