Health Insurance When Money Is Tight: A Tennessee Decision Tree

If your income is low, Tennessee has a specific order to check for coverage: TennCare first, then CoverKids for your kids, then the HealthCare.gov marketplace with financial help. Check them in that order, because each one affects your options in the next.

Step 1: Check TennCare first

TennCare is Tennessee's Medicaid program, and it covers more people than many realize. Tennessee did not expand Medicaid, but TennCare still covers:

• Children — infants (ages 0–1) up to 195% of the federal poverty level, ages 1–5 up to 142%, ages 6–18 up to 133%.
• Parents and caretaker relatives of children under 18 — up to 100% of the federal poverty level (raised in mid-2024). That's $15,960 a year for a single person or $33,000 for a family of four under the 2026 HHS guidelines.
• Pregnant women — up to 250% of the federal poverty level, with 12 months of postpartum coverage and presumptive eligibility (temporary coverage while your application is processed).
• Newborns of enrolled mothers — automatically covered for their first year.

How to apply: tenncareconnect.tn.gov, call 855-259-0701, fax 855-315-0669, mail P.O. Box 305240, Nashville, TN 37230-5240, or apply in person at a local health department.

Step 2: Check CoverKids for your children

If your kids don't qualify for TennCare, CoverKids (Tennessee's CHIP program) covers children under 19 in households up to 250% of the federal poverty level — $54,100 a year for a family of two, $82,500 for a family of four. There is no monthly premium, preventive care is free, and copays are low. The catch: it must be the child's only insurance plan.

Step 3: The marketplace, with financial help

If you don't qualify for TennCare or CoverKids, the HealthCare.gov marketplace is next. Two kinds of financial help exist:

• Premium tax credits — for households between 100% and 400% of the federal poverty level. There is a hard cliff at 400% ($63,840 for a single person, $132,000 for a family of four): one dollar over, and the credit is zero. (The enhanced credits that existed through 2025 expired on December 31, 2025.)
• Cost-sharing reductions — for households between 100% and 250% of the federal poverty level, on Silver plans only. These lower your deductible and copays, not your premium.

Depending on your income, your age, and the plan you pick, some shoppers see $0 or near-$0 premiums after tax credits. That is real — but it is not automatic. Always check window shopping on HealthCare.gov for your specific situation before assuming what you'll pay.

The honest warning: the coverage gap

Tennessee did not expand Medicaid, so most childless adults have no TennCare path at any income — and if your income is below 100% of the federal poverty level, you also don't qualify for marketplace subsidies. This coverage gap is real and affects a lot of Tennesseans. Farm Bureau health plans are not the answer here either: they are medically underwritten, offer no subsidies, and can deny you.

Dental care on a tight budget

TennCare covers dental care for its members. If you're not on TennCare, community health centers, dental schools, and free clinics offer reduced-cost care. Tennessee Dental Authority, an independent dental-care guide, keeps a list of low-cost dental care options in Tennessee.

FAQ

Can I get a marketplace plan for free if my income is low? Some shoppers do see $0 or near-$0 premiums after premium tax credits — it depends on your income, your age, and the plan you choose. The only way to know your actual price is to use window shopping on HealthCare.gov and enter your real information.

I have no income right now. Can I still get coverage? If you have children, a pregnant household member, or are a parent or caretaker relative under 100% FPL, check TennCare. If you are a childless adult with little or no income, you likely fall in the coverage gap — no TennCare and no marketplace subsidies. GetCoveredTenn (1-866-475-7879) can walk you through what's available in your county.

What's the difference between TennCare and the marketplace? TennCare is free or nearly free public coverage with its own eligibility rules. Marketplace plans are private insurance sold through HealthCare.gov, where financial help (tax credits, cost-sharing reductions) can lower what you pay. If you qualify for TennCare, you generally won't qualify for marketplace subsidies.

Can I get a cost-sharing reduction on a Bronze plan? No. Cost-sharing reductions are only available on Silver plans, and only for households between 100% and 250% of the federal poverty level.

Sources

• TennCare eligibility and application channels — tn.gov / TennCare
• 2026 HHS federal poverty guidelines and income thresholds — TN Dept. of Commerce & Insurance guidance
• CoverKids eligibility (CHIP) — tn.gov / TennCare
• Premium tax credit and cost-sharing reduction rules, 400% FPL cliff, enhanced-credit expiration — HealthCare.gov, CMS
• Tennessee Medicaid non-expansion status — TennCare

Related

• How subsidies and costs work and premium tax credits in detail
• When you can enroll and special enrollment periods
• TennCare explained
• How we verify our information

Your next step

1. Check TennCare first. Go to tenncareconnect.tn.gov or call 855-259-0701 and find out whether anyone in your household qualifies — children, parents, and pregnant women have the best odds.
2. Check CoverKids for your kids. If they don't qualify for TennCare, CoverKids covers kids under 19 up to 250% FPL with no monthly premium.
3. Window-shop the marketplace. If neither fits, browse HealthCare.gov anonymously and see what plans and subsidies appear for your income and county.
4. Get free help. Call GetCoveredTenn at 1-866-475-7879 — they cover all 95 counties and can walk you through applications at no charge.