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INDIVIDUAL & FAMILY PLANS

Coverage for you and your family

Open Enrollment has ended, but if you’ve had certain life changes, you might still be able to sign up for a plan during a special enrollment period. We're here to let you know what to expect before and after you enroll.

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Parents with newborn baby | BCBS of Tennessee
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Do I qualify for a special enrollment period?
You may be able to get an SEP if

If you’ve had a baby, adopted a child or had a dependent placed in your care by a court order, your SEP period starts on the date of birth or placement and lasts 60 days. You’ll need to provide acceptable documentation to enroll in a plan.

What counts as acceptable proof?

A birth certificate or court order.

When will my new plan start?

Your plan will start on one of these dates, depending on when you apply/enroll:

  • On the baby’s date of birth
  • The first day of the month following application received date
  • The first day of the month after you enroll, if you enroll between the 1st and 15th of the month
  • The first day of the second month after you enroll, if you enroll between the 16th and the end of the month

Your SEP period starts on the date of your marriage and lasts 60 days. You’ll need to provide acceptable documentation to enroll in a plan.

What counts as acceptable proof?

A marriage certificate.

You must also show proof that at least one spouse had the minimum essential coverage for at least one day in the last 60 days with one of these documents:

  • Termination of Coverage Letter from Prior Health Insurance Carrier
  • COBRA Notice & Election Form from Prior Health Insurance Carrier/Employer
  • COBRA Notice of Exhaustion of Benefits Letter from Employer on Company Letterhead (stating the reason for loss of coverage and date of termination)
  • Notice of Loss of Medicaid Coverage

When will my new plan start?

Coverage begins: The first day of the month after you enroll.

When you lose your minimum essential health health coverage (for example, due to loss of a job), your SEP starts 60 days before loss of coverage and lasts 60 days after loss of coverage. You’ll need to provide acceptable documentation to enroll in a new plan.

What counts as acceptable proof?

  • Termination of Coverage Letter from Prior Health Insurance Carrier
  • COBRA Notice & Election Form from Prior Health Insurance Carrier/Employer
  • COBRA Notice of Exhaustion of Benefits Letter from Employer on Company Letterhead (stating the reason for loss of coverage and date of termination)
  • Notice of Loss of Medicaid Coverage
  • Death Certificate
  • Court Order

When will my new plan start?

Coverage begins:

Your plan will start on one of these dates, depending on when you apply/enroll:

  • The first day of the month after loss of coverage, if you enroll on or before you lose coverage
  • The first day of the month after you enroll, if you enroll after you lose coverage
  • The first day of the month after you enroll, if you enroll between the 1st and 15th of the month
  • The first day of the second month after you enroll, if you enroll between the 16th and the end of the month

When you lose your health coverage because of divorce, legal separation or death of another plan member, your SEP lasts 60 days after loss of coverage. You’ll need to provide acceptable documentation to enroll in a new plan.

What counts as acceptable proof?

  • A court order
  • Divorce decree
  • Death certificate

When will my new plan start?

Coverage begins:

Your plan will start on one of these dates, depending on when you apply/enroll:

  • The first day of the month after you enroll
  • The first day of the month after you enroll, if you enroll between the 1st and 15th of the month
  • The first day of the second month after you enroll, if you enroll between the 16th and the end of the month.

If you’ve moved, or are planning to move, outside your plan’s service area, your SEP starts 60 days before your planned move and lasts 60 days after your move. You’ll need to provide acceptable documentation displaying your new address to enroll in a new plan.

What counts as acceptable proof?

  • State of Tennessee Automobile Registration
  • Utility Bill
  • Mortgage Statement
  • Drivers License (issued within the past 60 days)
  • Rental Agreement
  • Current Employer Verification (paycheck statement)
  • IRS Tax Reporting W-2 Form
  • Current College Tuition Bill
  • Offer of Employment at a Tennessee Employer

You must also show proof of enrollment in minimum essential coverage for at least one day in the last 60 days prior to permanent move with one of these documents:

  • Termination of Coverage Letter from Prior Health Insurance Carrier
  • COBRA Notice & Election Form from Prior Health Insurance Carrier/Employer
  • COBRA Notice of Exhaustion of Benefits Letter from Employer on Company Letterhead (stating the reason for loss of coverage and date of termination)
  • Notice of Loss of Medicaid Coverage

When will my new plan start?

Coverage begins:

Your plan will start on one of these dates, depending on when you apply/enroll:

  • The first day of the month after your move, if you enroll on or before your move
  • The first day of the month after you enroll, if you enroll after your move
  • The first day of the month after you enroll, if you enroll between the 1st and 15th of the month
  • The first day of the second month after you enroll, if you enroll between the 16th and the end of the month.

Your SEP period starts on the date you gain access to an Individual Coverage Health Reimbursement Account (ICHRA) or are provided a Qualified Small Employer Health Reimbursement Account (QSEHRA). If the date of the employer notice is at least 90 days prior to the start of the HRA, you can enroll 60 days prior to the start of the HRA. If the date of the employer notice is less than 90 days prior to the start of the HRA, you have up to 60 days after the start of the HRA to enroll. You’ll need to provide acceptable documentation to enroll in a new plan.

What counts as acceptable proof?

Employer Notification

When will my new plan start?

Coverage begins:

Your plan will start on one of these dates, depending on when you apply/enroll:

  • The first day of the month of HRA eligibility, if the eligibility is the first day of the month
  • The first day of the month after HRA eligibility if you enroll before HRA eligibility date
  • The first day of the month after you enroll, if you enroll on or after HRA eligibility date.
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We offer three levels of plans

Whether you'd rather pay less each month or prefer having more control of your overall costs, it helps to think about how you and your insurance will split expenses when looking for a plan.
Let's get started and find the plan that's right for you.

How do I know if I'm eligible for financial help?

The Affordable Care Act (ACA) is a law that was passed in March 2010 to make health insurance affordable and available to more people. If you qualify for an ACA plan, you'll get financial help to lower your monthly payment and health care costs through a tax credit. You might be eligible for a tax credit based on your annual income and the size of your family.

Who's eligible for a tax credit?

Family Size Income Ranges
Individual $12,760 - $51,040
Family of 2 $17,240 - $68,960
Family of 3 $21,720 - $86,880
Family of 4 $26,200 - $104,800
Family of 5 $30,680 - $122,720
Family of 6 $35,160 - $140,640
What are the out-of-pocket costs for each plan?

Out-of-pocket costs are the expenses for your health care that your insurance doesn't cover. This can include things like deductibles, coinsurance, copayments and other services.

See the out-of-pocket costs for each of our plan levels.

Plan level Through the
Marketplace		 Through
BlueCross		 Deductible Member
Coinsurance		 Out-of-Pocket Maximum Works
with HSA?
Individual Family Individual Family
B07 Bronze B07 check mark check mark $5,950 $11,900 50% $6,900 $13,800 check mark
B08 Bronze B08 check mark check mark $8,550 $17,100 50% $8,550 $17,100  
B10 Bronze B10 check mark check mark $6,600 $13,200 50% $8,150 $16,300  
B11 Bronze B11 check mark check mark $6,400 $12,800 50% $8,550 $17,100  
S01 Silver S01 check mark check mark $750 $1,500 50% $7,800 $15,600  
S04 Silver S04 check mark check mark $3,500 $7,000 50% $7,900 $15,800  
S20 Silver S20   check mark $5,600 $11,200 50% $7,000 $14,000  
S21 Silver S21 check mark check mark $4,000 $8,000 50% $8,000 $16,000  
S21 Silver S21 check mark check mark $3,900 $7,800 50% $8,000 $16,000  
S22 Silver S22   check mark $3,500 $7,000 50% $8,000 $16,000  
G06 Gold G06 check mark check mark $2,750 $5,500 20% $6,350 $12,700  
G07 Gold G07 check mark check mark $1,000 $2,000 45% $6,000 $12,000  

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What are the prescription costs for each plan?

Here's how the prescription costs break down based upon your plan level.

Plan level Copay and Coinsurance Ranges
Generics Preferred Brand Drugs Non-Preferred Brand Drugs
B07 Bronze B07 Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
B08 Bronze B08 Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
B10 Bronze B10 Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
$10 Preventive Rx Copay $35 Preventive Rx Copay $60 Preventive Rx Copay
B11 Bronze B11 Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
$10 Preventive Rx Copay $35 Preventive Rx Copay $60 Preventive Rx Copay
S01 Silver S01 Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
$10 Preventive Rx Copay $35 Preventive Rx Copay $60 Preventive Rx Copay
S04 Silver S04 Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
$10 Preventive Rx Copay $35 Preventive Rx Copay $60 Preventive Rx Copay
S20 Silver S20 Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
$10 Preventive Rx Copay $35 Preventive Rx Copay $60 Preventive Rx Copay
S21 Silver S21 Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
$10 Preventive Rx Copay $35 Preventive Rx Copay $60 Preventive Rx Copay
S22 Silver S22 Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
$10 Preventive Rx Copay $35 Preventive Rx Copay $60 Preventive Rx Copay
G06 Gold G06 $8 Copay $35 Copay $60 Copay
G07 Gold G07 Deductible/Coinsurance Deductible/Coinsurance Deductible/Coinsurance
$10 Preventive Rx Copay $35 Preventive Rx Copay $60 Preventive Rx Copay

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What does "deductible/coinsurance" mean?

Deductible: The amount you pay each year before your health plan begins paying.

Coinsurance: The percentage of costs for care that you'll pay - usually after you've paid your deductible.
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'Man with young girl helping her ride her bike | BCBS of Tennessee'

Ready to shop for a plan?
Here’s how.

There are two ways to shop for a plan – with or without qualifying for financial help. You can always contact us to talk about which option will work for you.

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Plans with financial help

See if you’re eligible for financial help when buying one of our plans on the Marketplace.

90 percent

Nine out of 10 qualify for individual and family plans with financial help

family size

Financial help is based on your income and the size of your family

see if you qualify

Plans without financial help

Even if you don’t qualify for financial help, we have health insurance plans that have what you’re looking for and fit your budget too.

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