WHAT ARE MY HEALTH PLAN OPTIONS FOR 2026 OCT. 24, 2025 - Insurance News | InsuranceNewsNet

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November 25, 2025 Newswires
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WHAT ARE MY HEALTH PLAN OPTIONS FOR 2026 OCT. 24, 2025

States News Service

The following information was released by the National Association of Insurance Commissioners (NAIC):

It is important to think about your health plan options for 2026. Open enrollment is approaching, changes are coming, and premiums may be higher if you're enrolled in a Health Insurance Marketplace (Marketplace) plan. As you choose a health plan that best fits your needs, the National Association of Insurance Commissioners (NAIC) shares what you should consider.

Health Insurance Marketplace Plans

Under the Affordable Care Act (ACA), Marketplace plans are available. You can shop and apply for coverage at HealthCare.gov. (Some states have their own exchanges, which you can also find on this website.)

Most people who enroll in Marketplace plans qualify for financial assistance, based on income.

However, less help is expected for these plans in 2026.

The ACA's enhanced premium tax credits (subsidies), which make coverage more affordable, are scheduled to end after 2025.

Losing these enhanced credits means your out-of-pocket costs (premiums) could be much higher in 2026.

Depending on your income, you may still qualify for financial help. When you apply, the Marketplace will also check whether you and your family qualify for public programs like Medicaid and the Children's Health Insurance Program (CHIP).

If you already have a Marketplace plan or need one next year, shop around and compare your options. Open enrollment runs from Nov. 1, 2025, through Jan. 15, 2026. (Dates may vary in certain states.) To learn what these plans cover, check here.

Job-Based Coverage

If your employer offers health insurance, you may qualify to enroll, even if you previously declined coverage. Employers typically pay part of the premiums for employees and their dependents.

You may also be eligible for coverage through a family member, such as a spouse's employer-sponsored plan or, if you're under 26, a parent or guardian's plan.

Private Insurance

You can also buy coverage through an insurance agent, broker, or directly from an insurance company. These plans don't qualify for the financial help available through the Marketplace and may not include the same benefits.

Student Health Plans

If you're enrolled in a college or university, you may be eligible for a student health plan. Contact your school's health services department to learn more.

How Should I Choose a Plan?

Assess your needs.

Think about your family's health care needs. Estimate your costs for the year, including copays, prescriptions, and any expected procedures.

Compare plans.

Compare your premiums, out-of-pocket expenses, and benefits under each plan. If you're shopping on the Marketplace, you can compare plans side by side. Decide what you can afford.

Where Can I Get Help?

If you need help understanding your options, contact the department of insurance (DOI) in your state or territory. The DOI can help you find licensed agents or certified assisters who can review your options.

The NAIC Health Insurance Shopping Tool can help you decide which plan is right for you. The Marketplace also offers guidance on choosing a plan.

About the National Association of Insurance Commissioners

As part of our state-based system of insurance regulation in the United States, the National Association of Insurance Commissioners (NAIC) provides expertise, data, and analysis for insurance commissioners to effectively regulate the industry and protect consumers. The U.S. standard-setting organization is governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer reviews, and coordinate regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally.

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