And… We are Back.
I trust all our readers have had a great spring after that long winter. We are starting to see some changes with Medicare and much more for folks under 65 on ACA/ Marketplace plans.
Medicare Part B- The standard premium could rise to $206.50 per month in 2026, up from $185 this year. That 11.6% increase would be the largest single- year jump in about a decade, according to the latest annual Medicare trustees report.
Medicare Supplement Plans - Premiums are increasing this year more than ever. We are seeing this with all the companies. Especially Plan "G", the most popular plan.
Are there Options? – YES! Consider changing to a Plan "N". It has the same basic benefits as "G" – Except a modest copay for primary, specialists and ER. No coverage for "Excess Charges"; the doctor may bill for beyond Medicare approved rate. Savings of some 10%– 25%. https://www.medicareoptionsforyou.com/medicare-supplement-premium-increase.html
Medicare Advantage Plans – We have FIVE Star plans available year round. Also "C-Snp’s - Chronic Disease Special Needs Plans" if you have been diagnosed with diabetes or heart disease. https://www.medicareoptionsforyou.com/alignment-c-snp.html
For 2026, Advantage plans will be focused more on medical benefits rather than the "Extras" such as dental, vision, OTC and the like.
For 2026, Advantage plans will be focused more on medical benefits rather than the "Extras" such as dental, vision, OTC and the like.
Medicare Prescription Drug Plans- "Part D" - The out of pocket maximum is increasing just $100 dollars to $2100 for 2026. Otherwise, the same as this current year.
BIG Changes to ACA/ Marketplace/ ObamaCare subsidies and your net premium. Unless Congress acts, the "enhanced premium tax credits (PTC)" enacted by President Biden in 2021 will expire. This means PTC’s will decrease and your premiums will increase dramatically. The Kaiser Foundation estimates for western NC is excess of 300%.
In addition, the "400% Cliff" will return. If you have an income of more than 400% of the federal poverty line - $60,250 for a single person, $82,800 for a couple $125,000 for a family of 4, then NO subsidy is available. You would pay the full cost of your insurance.
The Marketplace may require more verification of your income estimate for 2026 to be eligible for these premium discounts. The only good news is we will still have until January 15, 2026 to enroll or change your plan.
In addition, the "400% Cliff" will return. If you have an income of more than 400% of the federal poverty line - $60,250 for a single person, $82,800 for a couple $125,000 for a family of 4, then NO subsidy is available. You would pay the full cost of your insurance.
The Marketplace may require more verification of your income estimate for 2026 to be eligible for these premium discounts. The only good news is we will still have until January 15, 2026 to enroll or change your plan.
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Health Insurance 2026- Click here to find out more about what's ahead for 2026.
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On a POSITIVE note, Trout Insurance is sponsoring WNC Strong. This local organization administered by Mountain BizWorks is working to support small businesses in WNC that are still feeling the effects of Hurricane Helene. We have seeded this with $2,500. Please click the link and we’ll add $20 more for each response. No donation is required on your part for this effort.
https://www.troutinsurance.com/wnc-strong.html
https://www.troutinsurance.com/wnc-strong.html
We are looking forward to a busy enrollment season and will be at your service!
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“We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or call 1.800.Medicare to get information on all of your options.”
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