Ranked 10 of 17 states · median $773/mo · CMS PY2026
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A 40-year-old nurse practitioner 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 median Silver premium, Tennessee ranks 10 of 17 for this occupation.
Patient-facing and standing work means steady, predictable utilization — regular visits, prescriptions, physical therapy. Copay structure and network breadth drive real annual cost more than the headline premium, so these pages rank states on median premium and carrier count together.
Occupational context: Needlestick and infectious exposure; standing strain.
Two things get confused here constantly. Risk exposure decides what coverage you should buy. It does not decide what you are charged — Tennessee carriers rate on age, ZIP, tobacco and family size, full stop. A nurse practitioner with a bad back and a healthy 40-year-old office worker in the same county see the same number.
Premium is set by rating area, so a nurse practitioner 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 |
|---|---|---|---|---|
| Sevier | $669 | Ambetter of Tennessee | $6,000 | 4 |
| Sullivan | $678 | BlueCross BlueShield of Tennessee | $8,100 | 4 |
| Hamilton | $698 | Ambetter of Tennessee | $6,000 | 5 |
| Benton | $701 | BlueCross BlueShield of Tennessee | $8,100 | 5 |
| Hardeman | $701 | BlueCross BlueShield of Tennessee | $8,100 | 5 |
| Obion | $701 | BlueCross BlueShield of Tennessee | $8,100 | 5 |
The spread across just these six is $32/month — $385 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 — network and cost | 2026 |
|---|---|
| Median Silver premium @40 | $773 |
| Cheapest Silver @40 | $646 — Ambetter of Tennessee (Fayette) |
| Most expensive Silver @40 | $1,001 |
| Carriers filing in the state | 6 — Alliant Health Plans, Ambetter of Tennessee, BlueCross BlueShield of Tennessee, Cigna Healthcare |
| Plan types available | EPO |
| Counties with only one carrier | 0 of 95 |
Tennessee has 6 carriers filing and 0 of 95 counties served by a single issuer. For a nurse practitioner with an established provider relationship, that carrier count is the number that decides whether you keep your doctor.
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
This only matters if you can actually choose — you buy in the state where you live, not where you work. If you are a nurse practitioner who moved this year, that move is a qualifying life event and opens a special enrollment period.
Deduction categories that generally fit this trade: Malpractice insurance, licensing, DEA registration, CE. Note the ordering problem with health premiums: the §162(l) deduction lowers your AGI, and your AGI is what sets your premium tax credit, so the two calculate against each other. That is a CPA conversation and worth having before you enroll, not after.
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 Nurse Practitioners in Tennessee is $108,420 a year (May 2024). Starting pay — the 10th percentile — is about $61,530. The middle half earn $98,920 to $126,010, and the top 10% more than $133,120. BLS counts about 14,300 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. Under the ACA, carriers cannot rate, decline, or exclude based on occupation or health history. Rates vary only by age, ZIP code, tobacco use and household size.
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 22 states reported.
What this figure is. It is the median annual wage BLS reports for Nurse Practitioners (SOC 29-1171) 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 nurse practitioner. 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 Nurse Practitioners in Tennessee and a blog covering deductibles, subsidies and special enrollment.
One of Tennessee’s 6 carriers is leaving. Cigna exits the individual market entirely on January 1, 2027, so if you are a nurse practitioner covered by them the question is not whether you switch but whether you choose the switch yourself.
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.
One thing 2027 will not fix: no PPO is sold anywhere in Tennessee. All 95 counties offer EPO plans only, so care outside the network is effectively emergency-only. If your work as a nurse practitioner crosses county lines, weigh that above the premium.
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:
Coverage for Nurse Practitioners is priced county by county across Tennessee. Enter your ZIP and a licensed agent will show you what is on the table.
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