Ranked 10 of 17 states · median $773/mo · CMS PY2026
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A 40-year-old accountant in Tennessee pays a median $773/month for a Silver plan before subsidies — 10th of 17 on cost. The cheapest plan in the state is $646 from Ambetter of Tennessee in Fayette. On cheapest Silver at age 27, Tennessee ranks 16 of 17 for this occupation.
Screen-based work skews younger and healthier, which is exactly the profile a high-deductible plan is built for. The risk is real — you carry the first several thousand dollars yourself — so the tables below show what a healthy buyer pays across the age curve, not just at 40.
Occupational context: Sedentary strain: eye strain, repetitive stress, and Q1 stress load.
None of that changes your price. ACA plans in Tennessee are community rated — premium varies by age, ZIP code, tobacco use and household size only. Your occupation cannot be used to rate you, decline you, or exclude a condition. What it changes is which plan design is the right bet.
Premium is set by rating area, so a accountant in one Tennessee county can pay materially more than one an hour away. Six counties from across the state, cheapest Silver plan for a 40-year-old:
| County | Cheapest Silver @40 | Issuer | Deductible | Carriers |
|---|---|---|---|---|
| Crockett | $701 | BlueCross BlueShield of Tennessee | $8,100 | 5 |
| Henry | $701 | BlueCross BlueShield of Tennessee | $8,100 | 5 |
| Davidson | $751 | Oscar | $6,000 | 5 |
| Wilson | $751 | Oscar | $6,000 | 5 |
| Macon | $776 | BlueCross BlueShield of Tennessee | $8,100 | 3 |
| White | $776 | BlueCross BlueShield of Tennessee | $8,100 | 3 |
The spread across just these six is $76/month — $908 a year for the same metal tier. Statewide the range runs $646 to $1,001. Coverage by County publishes all 95 Tennessee counties individually.
| Tennessee — the age curve | 2026 |
|---|---|
| Cheapest Silver @27 | $530 |
| Cheapest Silver @40 | $646 |
| Cheapest Silver @60 | $1,372 |
| Cheapest Bronze @40 | $466 — BlueCross BlueShield of Tennessee |
| Bronze deductible | $10,600 |
| Lowest deductible in state | $500 |
A 27-year-old accountant in Tennessee starts at $530; the same plan class at 60 starts at $1,372 — roughly 2.6× as much. If a Bronze plan here is HSA-qualified, the deduction plus low claim volume usually beats Silver on total annual cost. Confirm HSA eligibility on the plan document, not the metal tier.
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. 5,239 plan records across 95 Tennessee counties. Full-price filed rates before premium tax credits — verify at enrollment.
Cheaper for the same coverage: South Dakota ($725), Oklahoma ($731), Kansas ($765). More expensive: Mississippi ($773), Florida ($789), Utah ($805).
Side-by-side: Tennessee vs Oklahoma · Tennessee vs Kansas · Tennessee vs Mississippi · Tennessee vs Florida
Cross-state numbers are useful for understanding whether Tennessee is treating you well, not for arbitrage. You cannot buy an out-of-state exchange plan. If you are a accountant weighing a relocation for other reasons, the premium difference is a real line item worth putting in the decision.
Expense categories that typically apply to this trade: Software, licensing, CPE credits, home office. Premiums are generally deductible above the line under IRC §162(l) when no employer plan is available to you or your spouse — a question for your CPA, not your agent.
If your household income is above the subsidy range, ACA is not automatically the answer. There are other categories of coverage that may fit, and they work very differently. That is a conversation, not a web page.
The BLS median wage for Accountants and Auditors in Tennessee is $75,500 a year (May 2024). Starting pay — the 10th percentile — is about $50,400. The middle half earn $61,960 to $92,140, and the top 10% more than $125,280. BLS counts about 26,890 people doing this work for an employer in Tennessee. The self-employed are not in the BLS survey, so this is the going rate for the work, not your own number.
The cheapest Silver plan for a 40-year-old in Tennessee is $646 per month from Ambetter of Tennessee, with a state median of $773. Both figures are full price before premium tax credits; most buyers pay less after subsidies.
No. Tennessee exchange plans are guaranteed issue and community rated, so a accountant pays exactly what anyone else of the same age in the same ZIP pays. Occupation is not on the application as a rating factor.
No. Only EPO plans were filed for 2026.
Tennessee ranks 10 of 17 states covered here, at a median $773 per month. Indiana is cheapest at $558 and Nebraska is most expensive at $875.
Above the cliff. At this income a single-person household receives no premium tax credit for 2027 and pays the full premium.
This occupation is above the cliff in all 23 states reported.
What this figure is. It is the median annual wage BLS reports for Accountants and Auditors (SOC 13-2011) in Tennessee. BLS surveys wage and salary workers and excludes the self-employed, so it is a benchmark for the occupation in this state — not the income of a self-employed accountant. Premium tax credit eligibility is set by household modified adjusted gross income and household size, not by occupation, so treat this as a reference point rather than a determination of what you qualify for.
Why the cliff is back. The enhanced premium tax credits expired on 31 December 2025. For plan year 2027 the 400% FPL limit applies again, so household income above $63,840 ends premium tax credit eligibility outright.
This page compares states. For Tennessee specifically — county-by-county carriers, plan data and enrollment help — I publish that on Coverage by County, including a page written for Accountants in Tennessee and a blog covering deductibles, subsidies and special enrollment.
Tennessee loses a carrier this cycle: Cigna is out of the ACA individual market from January 1, 2027, leaving 5 filing here. For Accountants that is a forced decision, and a better one made in November than in January.
Rate filings for 2027 point to roughly a 15% median increase nationally, from −1% at one end to 54% at the other. Tennessee has finalised: insurers were approved for an average 15.6% increase for 2027. Your own premium still turns on your plan and county.
Enrollment opens November 1, 2026. Treat December 15 as the deadline: it guarantees January 1 cover on every marketplace, Tennessee included. Conflicting end dates get quoted because a 2025 rule shortened the window and a court vacated it in June 2026, appeal pending — enrol by the 15th and the argument is irrelevant to you.
There is still no PPO on the Tennessee marketplace — not in any of its 95 counties. Every plan is an EPO, which for an accountant working across a wide area is the binding constraint, not price.
You already know you are changing plans — Cigna is leaving. The only real question is whether you pick the replacement or the marketplace picks it for you, and that is a much easier decision made now than in the second week of December.
Enter a ZIP and a licensed agent will tell you three things:
Two Accountants on opposite sides of Tennessee can be quoted very different premiums for the same plan. Your ZIP is what decides it.
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