2027 marketplace changes in Tennessee

Which insurance companies are leaving the Tennessee marketplace in 2027

Who is leaving, what's left in your county, and what to do before the deadline. Last checked October 5, 2026.

The short answer

One insurance company is leaving the Tennessee marketplace for 2027.

Cigna (confirmed). Cigna is leaving the individual market in Tennessee on January 1, 2027, on and off the marketplace, as part of the nationwide exit it announced in April 2026. In 2026 it sold marketplace plans in 65 of Tennessee's 95 counties. source

Altogether, 65 of Tennessee's 95 counties lose at least one marketplace insurer.

A Johnson City example, and the PPO question

Suppose you're a hairstylist renting a chair in Johnson City and chose a Cigna EPO because it included your doctors. Washington County will still offer coverage from three insurers, but their networks differ. A Johnson City physician might participate with one and not another. Contact your doctors about their accepted 2027 plans, then enroll before December 15 for coverage beginning January 1.

Cigna offered EPO coverage in Tennessee, and the state's marketplace didn't have any PPO plans in 2026. So this departure isn't removing an existing marketplace PPO. If you're healthy, don't qualify for the tax credit and need coverage with a network beyond Tennessee, I can help you find a nationwide private PPO. These plans ask health questions before accepting applicants.

What's left in your county

These are the 65 Tennessee counties where at least one marketplace insurer is leaving. For each one you can see who's leaving, how many marketplace insurers are left, and which ones.

The Tennessee marketplace had no PPO plans in 2026, so none of the exits takes a PPO away; you just have fewer HMO, EPO and similar plans to pick from.

See every county that loses an insurer

County	Insurer leaving	Insurers left	Who's left (2026 plans)	Marketplace PPO after
Anderson	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Benton	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Bledsoe	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Blount	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Bradley	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Campbell	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Carroll	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Carter	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Cheatham	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Chester	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Claiborne	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Cocke	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Crockett	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Davidson	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Decatur	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Dyer	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Fayette	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Franklin	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Gibson	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Grainger	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Greene	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Grundy	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Hamblen	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Hamilton	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Hancock	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Hardeman	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Hardin	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Hawkins	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Haywood	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Henderson	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Henry	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Jefferson	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Johnson	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Knox	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Lake	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Lauderdale	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Loudon	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Madison	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Marion	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
McMinn	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
McNairy	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Meigs	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Monroe	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Montgomery	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Morgan	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Obion	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Polk	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Rhea	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Roane	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Robertson	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Rutherford	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Scott	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Sequatchie	Cigna	4	Alliant Health Plans, Inc.; Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Sevier	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Shelby	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Sullivan	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Sumner	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Tipton	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Trousdale	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Unicoi	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Union	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Washington	Cigna	3	Ambetter (Centene); BlueCross BlueShield of Tennessee; UnitedHealthcare	No
Weakley	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Williamson	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No
Wilson	Cigna	4	Ambetter (Centene); BlueCross BlueShield of Tennessee; Oscar; UnitedHealthcare	No

County data: CMS 2026 marketplace plan data source. Insurers are counted by company, and the table uses each company's 2026 service area, so a company that enters or expands for 2027 isn't counted yet. I'll update it when the 2027 plan list publishes in late October.

What happens to your plan

Your coverage doesn't end immediately just because the insurer is leaving. The existing policy continues through December 31, 2026, and you're entitled to written notice beforehand. Federal requirements call for at least 90 calendar days of notice when an insurer discontinues a plan, or at least 180 calendar days when it withdraws completely from a state's individual market. Haven't received anything yet? Contact your insurer and request the notice.

Here's where people often misunderstand the process. Under federal regulation 45 CFR 155.335, the marketplace may place you with another insurer when your current company has no remaining marketplace plan. That's permission, not a guarantee. State law and the regulator's instructions govern the transfer. Without specific direction, the marketplace chooses a "similar" plan. The regulation doesn't require anyone to verify that your doctors or medications are covered.

Purchased your coverage directly from the insurer rather than through the marketplace? Its automatic re-enrollment provisions don't apply to your policy. You'll have to select replacement coverage on your own.

HealthCare.gov opens enrollment November 1. You should receive 2 notices by that point, one from your insurer and another from the marketplace. The marketplace notice identifies any replacement plan you'll be placed in if you haven't acted by December 15. HealthCare.gov also warns that automatic re-enrollment doesn't happen in every situation.

Choose your replacement no later than December 15 to begin coverage January 1. Enrolling from December 16 through January 15 gives you a February 1 effective date. If your previous policy ends December 31, that means going without coverage for January.

You might still qualify to enroll after the regular window closes. HealthCare.gov recognizes discontinued coverage as a qualifying event, and federal regulations allow 60 days before and 60 days after your old plan's termination to select replacement coverage. I wouldn't rely on that as your first choice. Make sure you're eligible before planning around those dates.

What to do now

The way I'd approach this depends on your particular situation and where things stand for you. Whichever route makes sense, the next step is the same: let's talk on the phone before the deadline.

Scenario 1 of 2

Your income qualifies you for help with the premium

When your household qualifies for a premium tax credit, marketplace coverage is generally the more affordable route because you can't apply that credit anywhere else. Still, don't accept an automatic plan selection without checking it. Compare every remaining insurer in your county before December 15, and verify your prescriptions and doctors against the new plan's network. Your old plan's network doesn't determine what the new one covers.

Next step: Share your estimated income, medication list and doctors with me. I'll help you choose a Tennessee marketplace policy that fits before enrollment closes.

Talk it through with Sam → Call 813-999-0101

Scenario 2 of 2

You pay full price and you're healthy

If your income puts you outside the tax credit range, you're responsible for the entire marketplace premium, with your choices limited to the insurers serving your county. That's when I'd also consider private coverage. Medically underwritten plans use nationwide PPO networks, and their pricing reflects your health. Healthy applicants may pay less than the marketplace's unsubsidized rate. There are tradeoffs: insurers ask medical questions and can reject an application or exclude a preexisting condition. We'll review those details together before you decide.

Next step: Give me a call, and I'll compare a nationwide PPO quote for your household with the marketplace coverage offered in your Tennessee county.

Talk it through with Sam → Call 813-999-0101

You can still get a nationwide PPO in Tennessee

Regardless of which insurers remain on your county's marketplace, I can help you obtain a nationwide PPO in Tennessee. The Tennessee marketplace had no PPO plans in 2026, so none of the exits takes a PPO away; you just have fewer HMO, EPO and similar plans to pick from.

For healthy people paying the entire marketplace premium, it's worth comparing private, medically underwritten PPO coverage. These plans offer networks extending nationwide. I carry health insurance licenses in 36 states, including Tennessee.

Questions about insurers leaving Tennessee

Straight answers, no sales pitch.

Which insurance companies are leaving the Tennessee marketplace in 2027?

Cigna (confirmed). Altogether, 65 of Tennessee's 95 counties lose at least one marketplace insurer.

If my insurance company leaves, will I be moved to a new plan automatically?

Possibly, but there's no guarantee. Federal rules permit the marketplace to assign a comparable plan from another insurer when state law and regulators allow it. HealthCare.gov specifically cautions that automatic re-enrollment isn't always available. And if your current coverage was purchased outside the marketplace, that process won't apply. My advice is to choose your replacement yourself.

What's the deadline to pick a new Tennessee plan for 2027?

To start coverage January 1 through HealthCare.gov, enroll by December 15. You have until January 15 before open enrollment ends, but selecting a plan after December 15 means it won't take effect until February 1.

Can I still get a PPO in Tennessee?

Yes. I can help you find a nationwide PPO available in Tennessee. The Tennessee marketplace had no PPO plans in 2026, so none of the exits takes a PPO away; you just have fewer HMO, EPO and similar plans to pick from.

Sources

Cigna sold individual marketplace plans in 65 of 95 Tennessee counties in 2026 (CMS 2026 plan data, counted by company) source
Cigna is leaving the individual market in Tennessee on January 1, 2027, on and off the marketplace, as part of the nationwide exit it announced in April 2026. source
After the confirmed and reported exits, 65 of 95 Tennessee counties lose at least one marketplace insurer and 0 are left with one, counting the 2026 plans of the companies that stay (CMS 2026 plan data) source
Tennessee marketplace PPO plans in 2026: 0 of 95 counties; after the confirmed exits: 0 (CMS 2026 plan data) source
HealthCare.gov says that by November 1 you should get 2 letters, one from your current insurance company and one from the Marketplace, and that in some cases you won't be automatically re-enrolled source
45 CFR 155.335(j)(3): when no plans from the same insurer are available, the Exchange "may enroll the enrollee in a QHP issued by a different issuer, to the extent permitted by applicable State law", as the state regulator directs or, if it does not, "in a similar QHP from a different issuer, as determined by the Exchange" source
HealthCare.gov open enrollment starts November 1; enroll by December 15 for coverage that starts January 1, or December 16 to January 15 for coverage that starts February 1 source
45 CFR 155.420: losing coverage is a triggering event, the loss date is the last day of the old plan's coverage, and the person has 60 days before and 60 days after it to pick a new plan source
HealthCare.gov lists "Your individual plan or your Marketplace plan is discontinued (no longer exists)" as a qualifying event for a special enrollment period source
45 CFR 147.106: an insurer that drops a product must give written notice at least 90 calendar days before coverage ends; one that leaves a state's individual market entirely must give at least 180 calendar days notice and cannot return to that market for 5 years source
Cigna sold 2026 Tennessee marketplace plans in 65 counties; after it goes, 24 of them keep 3 marketplace companies and 41 keep 4, and none is left with just one (CMS 2026 plan data, counted by company) source
The 24 Tennessee counties that drop to 3 marketplace companies are all in East Tennessee, among them Knox, Sullivan, Washington, Carter, Sevier, Hamblen, Greene and Blount (CMS 2026 plan data, counted by company) source
Davidson, Shelby, Hamilton, Montgomery, Rutherford, Williamson and Madison counties each had 5 marketplace companies in 2026, Cigna among them, and keep 4 (CMS 2026 plan data, counted by company) source
Cigna's 2026 Tennessee marketplace plans were EPO plans (CMS 2026 plan data) source
Putnam, Cumberland, Maury and Coffee counties had no Cigna marketplace plans in 2026 (CMS 2026 plan data) source

Last checked October 5, 2026. I update this page when the 2027 plan list publishes in late October.

Got a letter? Bring it to the call.

Call me with your county, the people who need coverage and the details of your notice. I'll compare the remaining Tennessee marketplace plans with a nationwide PPO quote and help you decide before enrollment ends. I'm licensed in 36 states, and we can handle everything by phone.

Book a free call → Call 813-999-0101 Send a message