By Christian Regalado
Enrollment season is upon us, again! At the time of this writing, the government is still shut down while Congress battles over federal tax credits for individuals and families under 65 who get their health insurance coverage through the ACA. The expanded credits that make health insurance accessible for many middle-class families are now technically expired. However, I still see them on the Marketplace when shopping for individual plans. By the time you are reading this article, I am sure something has been decided.
We’re officially in the annual enrollment period for those who shop for health insurance through Healthcare.gov. If you need to make a change for 2026, you have until December 15 to do so. If you would like help navigating your options, I’d be happy to take your call.
On the Medicare side, some Advantage Plan carriers are eliminating their PPO plans that allow out-of-network coverage, others are phasing certain plans out, and nearly all Advantage plans will see at least some changes, including higher costs. By now, you should have received a notice of change or non-renewal of your plan. If your Medicare Advantage plan isn’t renewed in 2026, you must pick another plan by the end of December. The good news is that this allows you a guaranteed issue opportunity should you wish to enroll in a Medicare Supplement plan. There is no underwriting for those who have had their plan terminated.
Should you get another Advantage plan or sign up for a Medicare Supplement plan? Like always, it depends. If premium cost is less of a concern and you don’t like having to stay within a network, a Supplement may be a good choice. Talk to your broker about your different options. Remember, if you go on a Supplement, you will need a separate PDP (prescription drug plan).
One improvement for Medicare Advantage is the availability of the Part B rebate plans. More plans are offering these in our area. These rebate plans use some of the federal funds they receive to pay down part of your Part B premium, which will be $206.50 for most in 2026. The rebate can be as low as $1 and as much as $175 per month. Of course, generally these plans have reduced benefits, and some “extra benefits” such as over-the-counter and dental and vision have been reduced or eliminated. However, locally we currently have some good options, no matter what your financial or medical condition may be. You just have to understand your options. To learn more particulars, talk to your broker since there are a wide range of plans to choose from.
This is a busy time of year, so it’s wise to call your local broker early to schedule a time to review your plan and options. As always, my services are free to you. I’m happy to help, please reach out! We can chat over the phone or meet in person. Email Christian@evergreenhealthins.com or call (850) 687- 7606.
