Healthcare coverage isn’t “set it and forget it”. Needs, costs, and options shift every
year. As we approach 2026, individual market insurers are requesting the largest health
insurance increases in over 5 years. The reason behind it … inflation, tariffs and the
expiring tax credits at the marketplace. Read more here Full Article
A proactive review ensures you are not overspending on services you don’t use. A
review can also identify if you are underinsured or missing out on better alternatives.
Options like health-sharing plans, high-deductible plans paired with HSAs, or
independent brokers can sometimes save you thousands.
Get help navigating options: If you are not sure where to start, working with a trusted
advisor can help you identify ways to reduce costs while staying protected. If you are
not sure your adviser is exploring the ever-changing options, look for a new advisor.
Check to see if cost saving services such as telemedicine are included with health
coverage options you are exploring. Experts report that telemedicine can provide better
and more affordable access for many.
Be sure you understand your TRUE out of pocket costs. What will you be responsible
for if you or a family member gets sick? Will it be affordable?
Lending Tree reports that 55% or Americans have been burdened with medical debt.
Don’t be a statistic … it’s time to explore what options are available.
Significant shifts in health insurance policies—from marketplace rules to employer and
Medicare changes—will directly affect millions of Americans. Whether you’re shopping
on the ACA exchanges, relying on employer coverage, or enrolled in Medicare, here’s
what you need to know to stay informed and prepared.
Here are some of the Key Shifts to watch for as 2026 health care choices are made:
1) At the ACA Marketplace:
Premiums Are Rising:
• Insurers across the Affordable Care Act (ACA) marketplaces are proposing a
median premium increase of 18% to 20% for 2026 – making this the steepest
rise since 2018.
• Congress has said they are not extending the enhanced subsidies. For
those losing subsidies, premiums could surge by up to 75% for many enrollees.
Without other options, many could be at risk of losing coverage.
Stricter Marketplace Enrollment and Subsidy –
Several major changes have been introduced for 2026
• No Automatic Renewal of subsidized plans: Enrollees must actively confirm
eligibility.
• Tighter Income Eligibility Checks, elimination of special enrollment for those
under 150% Federal Poverty Level (FPL) and more verification steps will slow
and complicate the enrollment process.
2) Employer-Sponsored Plan Changes –
• Large Employers are preparing to pass along up to 10% increases in health
insurance costs to workers in 2026.
3) Medicare Cost Increases –
• Medicare Part B premiums will jump about 11.6% to 206.50 /month, with the
deductible rising to $288.
• Part D premiums remain capped at up to $38.99, but deductibles may rise to
$615. and the annual out-of-pocket maximum will increase to $2,100
• Prescription Payment Plan (MPPP) are preparing to pass along up to 10%
increases in health insurance
Be Proactive Now:
Whether you pay for your own health insurance, get it through an employer-sponsored
plan, or provide it for your employees, it’s time to do a serious review of what your
options are.
Sticking with the same thing you’ve always had at a time when plans and prices are
changing isn’t the best solution. A proactive review can help you manage rising costs
and provide you access to benefits tailored to your individual needs.
Written by Susan Hunter, dedicated to helping businesses, individuals and families navigate healthcare with confidence.
Essential Healthcare Solutions
