By Christian Regalado
Healthcare insurance will be changing for many people starting next year. For those under 65 who are not covered by a group health insurance plan, overall healthcare costs are expected to increase tremendously due to the loss of federal tax credits, rising premium fees, prescription drug costs, and general inflation.
If you get healthcare through healthcare.gov, how much will your premiums increase? That’ll depend on your age and where you live. Those aged 55 to 64 are expected to be the hardest hit. Because of premium increases, the forecast is that many individuals will find their healthcare policies become unaffordable. Many Floridians who purchase health plans through the exchange are projected not to renew their health insurance coverage as premium fees increase.
If you find yourself in these shoes, what can you do? Right now, we’re looking at better-than-a-sharp-stick-in-the-eye options. If you can no longer afford comprehensive coverage, you may want to consider purchasing an accident, hospital indemnity, and/or cancer plan. These plans, while not comprehensive, offer some protection in emergencies and can potentially save you a great deal of money for a reasonable premium. I’m looking more into what will be available in our local market for 2026, and I’ll follow up in future articles.
It’s not just those under 65 who will experience changes in health insurance in 2026. Insurance companies’ Medicare Advantage, PDP, and Supplement plans and premiums for 2026 will become public on October 1. I mentioned in last month’s article that 2026 will be a year of disruption in the Medicare market. We know that most Advantage plans will likely reduce benefits such as dental and vision. Companies offering Medicare Supplement plans are projected to impose meaningful premium increases, and carriers offering prescription drug plans will likely be increasing premiums significantly. A federal test program in six states, thankfully not including Florida, will start requiring prior authorization for Supplement Plans. Avoiding prior authorization is one of the main reasons people enroll in a Medicare Supplement plan.
What is the good news? For those fortunate enough to qualify for a Medicare Supplement or Advantage plan, they will still offer better coverage than individual plans in 2026
Those of us living in South Walton County have a wide range of Advantage plans to choose from including Chronic Special Needs Plans (C-SNPs). These plans allow a special enrollment period for someone recently diagnosed with a chronic or disabling special needs condition such as a cardiovascular disorder, chronic heart failure, diabetes, as well as other chronic conditions to change Advantage plans for stronger coverage. This is important to know if you are enrolled in an Advantage Plan and ever find yourself with a chronic health condition. Regardless, the time to review your current coverage and take any necessary action will be coming. I’ll touch more on this in next month’s article.
Remember: don’t be fooled by 800-number commercials promising better coverage if you qualify. They’re aiming to mine and sell your personal information to other online companies. It’s always been advisable to utilize a local, certified broker to help choose the best options for you, and with increasing complications coming in 2026, that’s all the more important. I am available to speak with you anytime and there is no fee to you for my services. If I can help, please reach out! We can chat over the phone or meet in person. I’m happy to help! Email Christian@evergreenhealthins.com or call (850) 687- 7606.
Stay safe; stay local!
