Open Enrollment Starts Next Week: Let’s Review Your Coverage Before It Renews
It’s the end of October, which means Open Enrollment begins next week!
If you haven’t scheduled your November appointment yet, please get on my calendar. With potential premium increases and changes to available plans, this is an important year to review your coverage carefully.
My goal is to help you understand your options and choose coverage that fits your healthcare needs and budget.
Send Me Your Updated Information
Before I can prepare accurate quotes, I need to know what has changed since we last reviewed your insurance.
Please send me updates about:
- Your expected household income for the coming year
- Family members who need coverage
- Changes to your healthcare needs
- New doctors or specialists
- Current prescriptions and medication changes
Having this information ahead of time helps me narrow down your options and prepare quotes that reflect your actual situation.
What Could Higher Premiums Mean for You?
The preliminary information I’ve been discussing points to potential Marketplace premium increases of around 16% on average.
That does not mean everyone’s premium will increase by 16%.
Some plans could have smaller increases, while others could have larger ones. Your actual cost will depend on the plans available in your area, your household information, and any premium tax credit you qualify for.
Until I review your specific quotes, I won’t know exactly what those changes mean for you.
That’s why it’s important to compare your options before your coverage renews.
Don’t Assume Your Tax Credit Will Stay the Same
Your premium tax credit is another important piece of the picture.
The additional pandemic-era savings ended on December 31, 2025. Regular premium tax credits may still be available to eligible households, but we need to review your eligibility and updated costs. HealthCare.gov explains premium savings.
A tax credit may help offset part of your premium, but we won’t know your actual monthly cost until we update your information and review the available plans.
Your Monthly Premium Is Only Part of the Cost
When we compare plans, we also need to look at:
- Deductibles
- Copays and coinsurance
- Out-of-pocket maximums
- Doctor and hospital networks
- Prescription coverage
A plan with a lower monthly premium may leave you paying more when you need care.
Likewise, a plan that worked well this year may have different benefits, prescription coverage, or network arrangements next year.
We need to look at the whole picture.
Could Coverage Outside the Marketplace Make Sense?
Depending on your circumstances, it may be worth comparing options outside the Marketplace.
However, those options need a careful review. ACA-compliant plans purchased outside the Marketplace do not qualify for Marketplace premium tax credits. Other types of coverage may have medical underwriting, exclusions, or more limited benefits.
Being healthy today is only one part of that decision. We also need to understand what a policy would cover if your health changes.
I’m also interested in reviewing the Antidote Health options mentioned in my recent updates. Before making recommendations, I’ll need to evaluate the available benefits, networks, and prescription coverage.
Ages 55–64: Please Make Coverage a Priority
As I mentioned last week, I especially encourage people between the ages of 55 and 64 to review their health insurance before deciding to go without coverage.
I know premiums can be expensive. But an unexpected illness or hospitalization without insurance can create a much larger financial burden.
If affordability is a concern, let’s talk through your options before you make that decision.
Don’t Let Automatic Renewal Make the Decision for You
Automatic renewal may be convenient, but it doesn’t replace a personal review of your coverage.
If your current plan is being discontinued or your carrier is leaving your area, pay close attention to every notice you receive. Any replacement plan should be checked against your doctors, medications, healthcare needs, and budget.
Even if your plan remains available, its costs and benefits may change.
Please don’t assume that keeping the same plan means keeping the same coverage or price.
Make December 15 Your Deadline
Open Enrollment begins November 1.
For coverage beginning January 1, plan to complete your enrollment by December 15. Scheduling your appointment in November gives us more time to review your options and address questions.
If you miss a deadline or receive a notice about a plan you didn’t choose, contact me promptly so we can determine what options are available for your situation.
Let’s Prepare Together
Here’s what you can do now:
- Schedule your November appointment.
- Send me your updated household, income, doctor, and medication information.
- Watch for emails and notices about your current coverage.
- Be ready to compare your options before December 15.
I know these changes can feel frustrating. Once the quotes are available, we’ll work through them together and find the best fit we can for your needs and budget.
Schedule a consultation at:
https://calendly.com/jkappconsulting
