Health Coverage in Memphis
Memphis is in Shelby County, Rating Area 6. For 2026, 5 carriers filed 65 marketplace plans there: Ambetter of Tennessee, BlueCross BlueShield of Tennessee, Cigna Healthcare, Oscar Insurance Company, UnitedHealthcare. Tennessee uses healthcare.gov, and every marketplace plan is guaranteed issue — your health history does not change your price or whether you can buy.
Every one of the 65 plans is an EPO. There is no PPO filed in Shelby County, so outside a genuine emergency a plan pays only inside its own network. Check that the hospitals and doctors below are in a plan’s directory before you enrol, not after.
What Plans Cost in Memphis
The figure a premium tax credit is calculated from is the benchmark — the second-cheapest Silver plan. In Shelby County a 40-year-old pays $654 a month for it at full price, and a family of four $2,092 a month — $25,104 a year before any credit.
| Tier | Premium / month | Deductible | Carrier |
|---|---|---|---|
| Expanded Bronze | $482 | $9,000 | Oscar Insurance Company |
| Bronze | $466 | $10,600 | BlueCross BlueShield of Tennessee |
| Silver | $646 | $6,000 | Ambetter of Tennessee |
| Gold | $636 | $2,000 | Oscar Insurance Company |
Source: CMS Plan Year 2026 Qualified Health Plan Landscape file. Full-price filed rates before premium tax credits; not a quote or an offer of coverage. Verify current rates at enrollment.
Hospitals in Memphis
Medicare’s hospital directory lists 5 acute-care or critical-access hospitals in Memphis:
- Baptist Memorial Hospital — acute care hospital, emergency department, CMS overall rating 3 of 5
- Delta Specialty Hospital — acute care hospital, emergency department
- Methodist Hospitals of Memphis — acute care hospital, emergency department, CMS overall rating 3 of 5
- Regional One Health — acute care hospital, emergency department, CMS overall rating 1 of 5
- St. Francis Hospital — acute care hospital, emergency department, CMS overall rating 1 of 5
That list says where the hospitals are, not which plans cover them. Network participation differs between plans from the same carrier, and it changes year to year, so check each hospital against the plan’s own provider directory before you choose. A licensed agent can run that check across every plan filed in Shelby County.
Source: CMS Hospital General Information (Care Compare). Ratings are CMS’s overall star rating where one is published.
What a Doctor Visit and an ER Visit Cost
For care that is not an emergency, the gap between tiers shows up in what a visit costs, not only in the premium. Across the plans filed in Shelby County for 2026:
- Silver (24 plans): a primary-care visit is most often a $40 copay (8 plans); an emergency-room visit is most often 40% coinsurance after the deductible (11 plans).
- Bronze (4 plans): a primary-care visit is most often no charge once the deductible is met (3 plans); an emergency-room visit is most often a $750 copay after the deductible (2 plans).
- Gold (16 plans): a primary-care visit is most often a $30 copay (7 plans); an emergency-room visit is most often 25% coinsurance after the deductible (7 plans).
Urgent-care charges vary by plan and are not in the federal landscape file, so check a plan’s Summary of Benefits and Coverage before you rely on one.
Subsidy Eligibility in Memphis
Premium tax credits are set by household income against the federal poverty level. For a single adult in 2026 they run from about $15,650 up to $62,600; for a family of four the upper limit is $128,600. Above 400% of poverty the credit stops completely — the enhanced rules that removed that cap expired on 31 December 2025, and above the line there is no cap on repaying a credit you turn out not to have earned.
Tennessee has not expanded Medicaid, which leaves a gap at the bottom of the scale: an adult earning below the poverty line can be too poor for a marketplace subsidy and still not qualify for TennCare. If your income is near or below $15,650 as a single adult, check that before assuming you have no options.
Where you live does change the size of the credit, because it is calculated from the local benchmark: $654 a month in Shelby County for a 40-year-old.
More in Tennessee
- Health insurance in Shelby County
- Health insurance in Tennessee
- Tennessee plan comparison
- How much health insurance costs in Tennessee