Private Health Plans for the Self-Employed in Tennessee

I am an independent, licensed health insurance broker, and I am licensed in Tennessee. If you are self-employed, a 1099 contractor, or a freelancer, this page covers the options that sit outside the Marketplace — what is actually available in Tennessee, what the trade-offs are, and when a private plan is the wrong answer. There is no fee for my help. The insurance company pays the broker, not you.

Tennessee has allowed Farm Bureau health plans, which are not regulated as insurance, since 1993.

Tennessee at a glance for the self-employed

Tennesseans shop on HealthCare.gov. Six carriers sold plans for 2026. Cigna is leaving, so five remain for 2027: Blue Cross Blue Shield of Tennessee, Oscar, Ambetter, UnitedHealthcare and Alliant Health Plans. About 569,000 people picked a plan for 2026, down 11%.

• 2027 rates. Carriers proposed an average increase of about 13% for 2027, from about 10% at BlueCross BlueShield of Tennessee to about 29% at UnitedHealthcare.
• Farm Bureau plans have deep roots here. Tennessee Farm Bureau has offered health plans for decades. They are membership plans that are not regulated as insurance and are medically underwritten, so they can cost less for healthy people and can decline or exclude conditions.
• No Medicaid expansion. About 89,000 Tennesseans are in the coverage gap. Since 2024, low-income parents of minor children can qualify for TennCare.
• Subsidies were large. In 2026 the average Tennessee enrollee got about $772 a month in subsidies and paid about $141. Above the 400% line, you pay the full price.

The 400% line matters more here than most people expect. For 2027 the credit stops above $63,840 for one person and $132,000 for a family of four, and there is no phase-out. See the full 2027 income limits.

Your private options in Tennessee

• Short-term plans. Tennessee allows short-term coverage for up to 36 months including renewals. That length makes them tempting, but they usually exclude pre-existing conditions and often leave out prescriptions and maternity, so read the benefit summary line by line.
• Tennessee Farm Bureau health plans. A long-standing option here. They require membership, ask health questions and are not regulated as insurance.
• Medically underwritten private plans. Health questions up front, often lower premiums for healthy applicants, broad PPO networks, and applications accepted any month.
• Supplemental coverage. Accident, critical-illness and hospital plans can soften a high deductible. How it works.

When private is the right call in Tennessee, and when it is not

With five carriers on HealthCare.gov for 2027 and proposed 2027 increases averaging about 13%, a healthy Tennessee freelancer or business owner over the subsidy line often saves real money with a private plan.

Stay with HealthCare.gov if you have an ongoing condition, are pregnant or planning to be, take expensive prescriptions, or qualify for a meaningful tax credit. If that is you, I will say so.

The tax piece

Most self-employed people can deduct their health insurance premiums, which also lowers the income that counts toward a subsidy. How it works for 1099 workers.

Tennessee questions I hear a lot

Which carriers sell Marketplace plans in Tennessee for 2027?

Five: Blue Cross Blue Shield of Tennessee, Oscar, Ambetter, UnitedHealthcare and Alliant Health Plans. Cigna is leaving at the end of 2026.

What are Tennessee Farm Bureau health plans?

Membership-based plans that Tennessee Farm Bureau has offered for decades. They are medically underwritten and not regulated as insurance, so approval is not guaranteed and conditions can be excluded.

Did Tennessee expand Medicaid?

No. About 89,000 Tennesseans are in the coverage gap. Since 2024, low-income parents of minor children can qualify for TennCare.

What if I earn more than 400% of the poverty level in Tennessee?

You pay the full Marketplace price. For healthy applicants, a private medically underwritten plan or a Farm Bureau plan is often cheaper. I compare the options at no cost.

Posey Health Solutions · National Producer Number 20609967 · licensed in Tennessee and 30 other states. This page is general information, not advice about a specific plan, and it is not tax advice. Plan availability, carrier participation, and duration limits vary by county, carrier, and plan year, and the rules can change.