Ranked 10 of 17 states · median $773/mo · CMS PY2026
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A 40-year-old truck driver 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.
Coverage that only works where you sleep is not coverage if you spend the week elsewhere. The binding question is whether the plan pays out of area at all, and beyond emergencies many HMOs simply do not. States below are ordered by network reach, with the no-PPO states flagged.
Occupational context: Elevated rates of obesity, sleep apnea, and back injury; DOT physical required every 24 months.
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 truck driver 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 |
|---|---|---|---|---|
| Maury | $779 | Oscar | $6,000 | 4 |
| Lauderdale | $646 | Ambetter of Tennessee | $6,000 | 5 |
| Cocke | $669 | Ambetter of Tennessee | $6,000 | 4 |
| Morgan | $669 | Ambetter of Tennessee | $6,000 | 4 |
| Hancock | $678 | BlueCross BlueShield of Tennessee | $8,100 | 4 |
| Bradley | $698 | Ambetter of Tennessee | $6,000 | 5 |
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 truck driver 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
Read the comparison as context, not as a shopping list. Your county of residence determines what you can buy, and for a truck driver that is fixed unless you relocate. Where it is actionable is a move already in progress — that is a qualifying life event, and you have 60 days on either side of it.
Self-employed Truck Drivers in Tennessee typically deduct: Truck payment, fuel, maintenance, per diem, insurance. 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 BLS median wage for Heavy and Tractor-Trailer Truck Drivers in Tennessee is $55,610 a year (May 2024). Starting pay — the 10th percentile — is about $38,380. The middle half earn $46,130 to $70,600, and the top 10% more than $80,000. BLS counts about 63,130 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.
Below the cliff. At this income a single-person household remains eligible for a premium tax credit in 2027.
This occupation is below the cliff in all 23 states reported.
What this figure is. It is the median annual wage BLS reports for Heavy and Tractor-Trailer Truck Drivers (SOC 53-3032) 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 truck driver. 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 Truck Drivers 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 truck driver on a Cigna plan is moving, and doing nothing just means the marketplace chooses the replacement.
Nobody can tell you your 2027 Tennessee premium yet. Filings nationally cluster around a 15% median increase, with the full spread running −1% to 54% — and until this state signs off, a specific local number is invention.
Mark November 1, 2026 to open and December 15 to act. That second date guarantees cover from January 1 in Tennessee regardless of how the current litigation over the enrollment window resolves.
There is still no PPO on the Tennessee marketplace — not in any of its 95 counties. Every plan is an EPO, which for a truck driver 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 Truck Drivers 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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