Ranked 10 of 17 states · median $773/mo · CMS PY2026
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A 40-year-old real estate investor 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 counties covered, Tennessee ranks 4 of 17 for this occupation.
Once your work crosses county and state lines, network geography stops being a detail and becomes the whole decision. An HMO contracted in one metro leaves you paying cash 200 miles down the road, and a handful of states filed no PPO at all for 2026. These rankings lead with reach.
Occupational context: Property-inspection fall and exposure risk.
This is background for choosing a plan, not for pricing one. Since 2014 every Tennessee exchange plan has been guaranteed issue and community rated: same age, same ZIP, same tobacco status means the same filed premium whether you are a real estate investor or an accountant. Occupation changes the shopping criteria, nothing else.
Premium is set by rating area, so a real estate investor 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 |
|---|---|---|---|---|
| Smith | $776 | BlueCross BlueShield of Tennessee | $8,100 | 3 |
| Giles | $779 | Oscar | $6,000 | 4 |
| Marshall | $779 | Oscar | $6,000 | 4 |
| Haywood | $646 | Ambetter of Tennessee | $6,000 | 5 |
| Claiborne | $669 | Ambetter of Tennessee | $6,000 | 4 |
| Monroe | $669 | Ambetter of Tennessee | $6,000 | 4 |
The spread across just these six is $133/month — $1,595 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 reach | 2026 |
|---|---|
| Counties in the state | 95 |
| Counties with only one carrier | 0 (0%) |
| Plan types available | EPO |
| PPO available on exchange | No |
| Carriers filing in the state | 6 |
| Cheapest Silver @40 | $646 — Fayette |
Tennessee has no PPO plans on the exchange at all. For a real estate investor covering distance, that single fact outweighs premium: 0 of 95 counties here are served by one carrier, so an HMO bought in one metro may leave you out of network for the rest of your route.
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 real estate investor weighing a relocation for other reasons, the premium difference is a real line item worth putting in the decision.
Self-employed Real Estate Investors in Tennessee typically deduct: Travel, property costs, legal and accounting fees. Health premiums sit separately, above the line under IRC §162(l), and only when neither you nor a spouse could have joined an employer plan — eligibility disqualifies you even if you declined the coverage.
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 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 real estate investor 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.
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 Real Estate Investors in Tennessee and a blog covering deductibles, subsidies and special enrollment.
The biggest change here is a carrier walking away. Cigna leaves the ACA individual market on January 1, 2027 — one of the 6 carriers writing in Tennessee today. Every real estate investor on a Cigna plan is moving, and doing nothing just means the marketplace chooses the replacement.
On price the only honest number today is national: the Peterson-KFF read of 2027 filings puts the median proposed rise near 15%, spanning −1% to 54%. Final Tennessee rates are not approved, so any precise 2027 figure quoted for this state is guesswork.
The window opens November 1, 2026, and December 15 is the date worth writing down — it is what secures January 1 cover in Tennessee and everywhere else. You will find later dates quoted; they stem from a 2025 rule that was vacated in June 2026 and is under appeal.
There is still no PPO on the Tennessee marketplace — not in any of its 95 counties. Every plan is an EPO, which for a real estate investor 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:
Coverage for Real Estate Investors 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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