Open Enrollment 2026: A Season of Massive Change

The term “unprecedented year” has been overused, yet here comes 2026 bringing extreme changes once again. Not only is this another challenging year for Medicare Advantage and Part D plans, but now Affordable Care Act (ACA), Obamacare, and Marketplace plans are being impacted as well. To complete the trifecta, even small group employer policies are facing double-digit premium increases.

The current government shutdown, driven by disagreements over extending the enhanced subsidies known as advanced premium tax credits, has caused widespread confusion in the marketplace. With open enrollment now underway, 2026 final pricing remains uncertain. Most exchanges are proceeding as though the enhanced ACA subsidies will not be extended, and we are doing the same for our planning and recommendations.

The Marketplaces are still strongly encouraging residents to make plan decisions by December 15 to ensure a January 1, 2026 effective date and avoid any potential gaps in coverage. We are closely monitoring the exchanges we serve, including Healthcare.gov, Virginia’s Insurance Marketplace, Maryland Health Connection, and Georgia Access, for updates as they unfold. GetCoveredNJ will continue to follow its standard December 31 and January 31 deadlines, unchanged since 2021.

Our Open Enrollment newsletter is your toolkit for navigating the 2026 enrollment period. We’re here to assist you at no cost, as our services are compensated by the carriers. Open Enrollment begins November 1, with most exchanges requiring selections by December 15 for January 1, 2026 coverage, though some states have later deadlines. This year more than ever, it’s important to review your options carefully, as prices remain in flux and final rates are in limbo until Congress reconvenes and makes a decision. Even if you’re automatically renewed, be sure to review all notices from your carrier or exchange (such as Pennie or GetCoveredNJ) and submit requested documents promptly to avoid any disruptions in coverage.

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If you need to update your application, we can help make those changes and reroute your profile to view all available plans and pricing. Whether you want to switch carriers, compare plan options, or adjust your price point, now is the ideal time to do so. To explore your 2026 options for Pennie, GetCoveredNJ, Healthcare.gov, Maryland Health Connection, Virginia’s Insurance Marketplace, and Georgia Access, you can use the button below without logging into your account..

*Please be advised that Healthsherpa may not be showing accurate subsidy numbers or carrier selections for PA, NJ, or other state-based exchanges. Use this as a baseline until they update their system with the latest data! Healthcare.gov states are not experiencing issues to our knowledge. These are estimates!

If you have Medicare, our dedicated Medicare page offers helpful information, plan resources, and quick quote tools to make comparing options easy. We’ll only reach out if you request assistance. Explore it here: https://doitformeinsurance.com/medicare.

If you decided not to use your applicable Health Insurance Marketplace and instead are enrolled directly with your insurance carrier, your current plan will automatically carry over into 2026 (unless you indicate otherwise or it has been discontinued), as long as your payments are up to date. However, if you’re interested in exploring different options, we’re just a call, text, or email away! You can easily schedule a phone consultation through our Calendar Link, where you can choose a time that works best for discussing your health insurance options for 2026.

Affordable Care Act Alternatives?

In this section, we review Affordable Care Act (ACA) alternatives and what’s changing for 2026. ACA-regulated plans continue to offer the most comprehensive coverage available, particularly for those with pre-existing conditions or chronic health needs. However, affordability and network quality vary greatly by state and county, especially in rural regions where options can be limited. For individuals and families who do not qualify for subsidies or find Marketplace plans unaffordable, there are several viable alternatives worth exploring, each with its own pros and cons.

Short-term medical plans, traditionally used for temporary coverage gaps, have been heavily affected by shifting federal policies over the last decade. Under the second Trump administration, a new executive order has been signed returning authority over short-term medical plans to the individual states. Some states have already reinstated longer-duration coverage, and Florida and Texas have returned to allowing extended short-term medical plans, while Pennsylvania continues to limit them to three months with a one-month renewal pending final guidance. New Jersey still prohibits short-term medical altogether. These plans can be a valuable safety net for healthy individuals who need temporary coverage between jobs, during waiting periods, or while transitioning into ACA coverage, though they should not be viewed as long-term solutions.

Fixed indemnity (fixed benefit) plans remain unaffected by the recent executive orders and can be used as either standalone protection or paired with a high-deductible ACA plan. They pay a set dollar amount per covered service, regardless of what the provider charges, helping reduce exposure to unpredictable costs. While they don’t offer the same guarantees as ACA plans, they can help bridge financial gaps, especially when combined with supplemental or accident coverage.

In addition, we work with associations such as Life-X, Iron Health, and several local unions that provide coverage to members who join their organizations. These programs are typically regulated under ERISA and often function outside of state insurance departments, similar to group or association health plans. Each option varies in pricing, benefits, and eligibility, so it’s important to understand the details before enrolling.

We continue to monitor developments in the ACA and alternative markets to help our clients stay informed and protected. If you receive any offers or materials that seem “too good to be true,” or want to compare one of these alternative options with your current plan, we’re happy to review them and provide honest guidance on what’s legitimate, sustainable, and best aligned with your needs.

During this busy time, we will make every effort to quickly return your call if you leave a voicemail.  Feel free to text or email to schedule a call!  [email protected] or text 267-374-0975.

DoitForMeInsurance and Joe Covell also handles your Dental, Vision, Life, Home, Auto, Group Health, and Business Insurance Needs! Shop everything on our website!

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There are 76 days for most states (beginning Nov 1) to find a 2026 health insurance plan for you and your family! If you still need 2025 coverage you may be able to get it with a Qualified Life Event. Short-term options are available and can begin as soon as tomorrow. Click Here for affordable short-term plans.

Contact us to explore your insurance options or schedule your November phone appointment. Enrollments can be completed by phone, email, or text. If you prefer to enroll on your own, you can select Joseph Covell (National Producer Number 16623825) as your broker on Pennie.com, GetCovered.NJ.gov, MarylandHealthConnection.gov, Virginia’s Insurance Marketplace, Georgia Access, or by entering the same National Producer Number on Healthcare.gov to ensure we can assist you year-round.

Please note that Joe Covell is no longer an employee of Custom Benefit Plans and is not present at the Willow Grove office daily. As an independent contractor, he no longer has access to the [email protected] email or associated phone line. Office appointments are available by request only and are not open for walk-ins. We are proud to serve as a certified Independence Blue Cross #SafeEnrollmentSpace for both over-65 and under-65 communities. For assistance, please email [email protected] or call/text 267-374-0975. If we miss your call, please leave a voicemail or text your name and contact information — you are important to us.

We are not in Financial Planners in the sense that we do not advise, recommend, or sell anything that requires a securities license. We do however work with Indexed and Other Fixed annuity, life, disability, and long term care products. Simply put we don’t work with products that are tied to the market. Since the pandemic we have many clients asking us for life insurance options as well as fixed annuity products that do not lose money when the market underperforms. We work with a team whose vast years of experience allows them to specialize in our clients unique needs.

We are a one-stop-shop for all insurance.  If you would be interested in a no-obligation-to-buy and completely fee-free consultation via phone, zoom, or in-person, feel free to contact us anytime, all of our contact info is at the very bottom! E-mail [email protected] for promptest response.