2027 Open Enrollment in Tennessee: The Complete Guide

The answer up front: Tennessee's marketplace open enrollment for 2027 coverage runs November 1, 2026 through January 15, 2027 at HealthCare.gov. Enroll by December 15, 2026 for coverage starting January 1, 2027. Enroll December 16 through January 15 and coverage starts February 1, 2027. Your first premium must be paid for coverage to take effect.

The deadlines that matter

1. Late October 2026 (before Nov 1): window shopping on HealthCare.gov typically opens a few days early — preview 2027 plans, networks, and prices before you commit.
2. November 1, 2026: open enrollment opens.
3. December 15, 2026: last day to enroll or change plans for coverage starting January 1, 2027. This is the deadline most people should aim for.
4. January 15, 2027: open enrollment closes. Anything enrolled or changed December 16 – January 15 starts February 1, 2027.
5. Pay your first premium. Coverage doesn't start until the insurer receives your first payment. Miss it and the plan can cancel your enrollment.

Before you enroll: the preparation checklist

Gather these before you sit down at HealthCare.gov — having them ready turns a 90-minute ordeal into a 20-minute task:

• Your income estimate for 2027. The single most important number. Your premium tax credit is calculated from your estimated 2027 household income. Estimate carefully: too low and you'll owe money back at tax time; too high and you leave free money on the table. See our subsidy estimation guide.
• Household information. Social Security numbers (or document numbers for lawfully present immigrants), birthdates, and addresses for everyone applying.
• Your current plan details. If you're re-enrolling, know your current insurer, plan name, and premium — you can compare it against 2027 options instead of starting blind. Automatic re-enrollment exists for 2027, but shopping is almost always worth it: plans, networks, and prices change every year.
• Your doctors and medications list. Write down every doctor, specialist, hospital, and prescription you use. During enrollment, check each one against a plan's network and formulary before you pick. Networks change year to year.
• How you want to pay. Have a bank account or card ready for the first premium payment.

What changed for 2027

Five insurers, one exit

Five insurers will sell individual marketplace plans in Tennessee for 2027:

• BlueCross BlueShield of Tennessee (approved rate change ~+10.4%)
• Celtic / Ambetter (~+11% requested)
• Oscar (~+21.4%)
• UnitedHealthcare (~+24.5%)
• Alliant Health Plans (~+23.3%)

The statewide weighted-average approved increase is roughly 15.6–15.9% — the second straight year of double-digit hikes. Cigna is exiting the Tennessee individual marketplace at the end of 2026 and will not offer 2027 plans. If you're currently on a Cigna plan, you must pick a new plan during open enrollment — you will not be automatically moved to equivalent coverage.

The subsidy cliff is back

The enhanced premium tax credits expired December 31, 2025 and were not extended. For 2027, the original pre-2021 rules apply:

• Premium tax credits go to households earning roughly 100%–400% of the federal poverty level (about $15,960–$63,840/year for a single person; $33,000–$132,000 for a family of four, based on confirmed 2026 guidelines).
• There is a hard cliff at 400% FPL — earn one dollar over and your credit drops to zero.
• Cost-sharing reductions still require a silver plan and roughly 100%–250% FPL.

The national numbers show what this means in practice: average post-credit premiums rose 58% in 2026 (from $113 to $178/month), and roughly 3 million people have dropped marketplace coverage since the enhanced credits expired. If your income is anywhere near the 400% line, plan carefully. See our subsidies page.

Tighter verification

HealthCare.gov checks the income and household information you report against federal data. If HealthCare.gov flags a mismatch between what you report and what federal data shows, respond quickly — unresolved mismatches can delay or end your tax credits.

Other 2027 changes worth knowing

• The maximum out-of-pocket for marketplace plans rises to $12,000 individual / $24,000 family (up from $10,600/$21,200 in 2026).
• Automatic re-enrollment is still available for 2027.
• Bronze and catastrophic marketplace plans count as HSA-compatible (since January 1, 2026, under IRS Notice 2026-05). HSAs explained
• Fewer lawfully present immigrants qualify for premium tax credits starting January 1, 2027 (Public Law 119-21). Immigrant guide

If you miss the window

Missing January 15 doesn't always mean waiting until next November:

• Qualifying life event? Losing other coverage, moving to Tennessee, marriage, divorce, a new baby, or aging off a parent's plan at 26 opens a 60-day special enrollment period. You'll need to submit proof. See our special enrollment guide.
• TennCare or CoverKids? No window at all — apply any time at TennCare Connect (tenncareconnect.tn.gov) or 855-259-0701. See our TennCare page and CoverKids page.
• Farm Bureau health plan? Tennessee's medically underwritten non-ACA option enrolls year-round in all 95 counties. It's a fit mainly for healthy buyers who don't qualify for subsidies. See our Farm Bureau health plans page.
• Short-term plan? A temporary bridge — medically underwritten, not ACA-compliant, no tax credits. See our short-term plans page.
• COBRA? If you just left a job with group coverage, you may be able to continue it — expensive, but sometimes the right bridge. See our COBRA guide.

FAQ

What's the real end date of 2027 open enrollment — December 15 or January 15? January 15, 2027. A federal rule tried to move it to December 15, but a court vacated that provision in June 2026 and CMS confirmed the full window stands. December 15 is still an important date — it's the deadline for January 1 coverage — but it is not the end of open enrollment.

I'm on a Cigna marketplace plan now. What happens to me? Cigna is leaving the Tennessee marketplace after 2026, so you must choose a new plan during open enrollment. Don't assume you'll be auto-renewed into anything — start at HealthCare.gov on or after November 1 and pick from the five remaining insurers.

How is my premium tax credit actually calculated? From your estimated 2027 household income, applied against the federal poverty level for your household size. For 2027 the hard cutoff is 400% of FPL. The credit is usually paid directly to your insurer each month (APTC), lowering your bill. Get the income estimate right — the IRS reconciles it at tax time. See our subsidy estimation guide.

I was auto-renewed last year. Should I shop anyway? Yes. With Cigna exiting, ~15.6–15.9% average rate increases, and the subsidy cliff back, last year's plan may be a bad deal this year even if nothing changed in your life. Networks and formularies change too — verify your doctors are still in-network.

Can I enroll by phone instead of online? Yes — HealthCare.gov's call center is 1-800-318-2596 (TTY 1-855-889-4325), open 24/7 except holidays. Free navigator help is also available through GetCoveredTenn at 1-866-475-7879 — in-person in 10 counties (Cheatham, Davidson, Fayette, Robertson, Rutherford, Shelby, Sumner, Tipton, Williamson, Wilson), phone/virtual statewide.

What if my income is just over 400% of the poverty level? Under 2027 rules, you're over the cliff — no premium tax credit at any income above 400% FPL. That's exactly the situation where a Farm Bureau health plan (medically underwritten, typically 30–50% cheaper than unsubsidized marketplace plans) may be worth comparing, if you're healthy enough to qualify. See Farm Bureau health plans and costs.

Sources

• CMS / HealthCare.gov (open enrollment dates November 1, 2026 – January 15, 2027; December 15 deadline for January 1 coverage; first-premium requirement)
• Federal court order, City of Columbus v. Kennedy (June 12, 2026); CMS Deputy Administrator letter (August 2026)
• Tennessee SERFF rate filings via acasignups.net (final approved 2027 rate changes; ~15.6–15.9% statewide weighted average)
• BCBST rate-filing consumer narrative (ratereview.healthcare.gov)
• healthinsurance.org (Cigna exit; Tennessee marketplace overview)
• Commonwealth Fund / benefitsusa.org (enhanced credit expiration; pre-2021 rules and 400% FPL cliff)
• healthcareinsider.com (2027 FPL income bands)
• CMS 2027 marketplace parameters (out-of-pocket maximums; 2028 re-enrollment rule note)
• GetCoveredTenn (Navigator program, 1-866-475-7879)
• KFF (national 2027 proposed median increase context)
• The 2027 plan-year research brief on file at this site (how we verify our facts)

We're also watching: whether Congress acts on H.R. 1834 (a House-passed bill to extend the enhanced credits — the Senate has not taken it up). If it becomes law, the 2027 subsidy math changes entirely, and we'll update this page the same week.