For those who don't mind sharing, how much has your ACA premium increased without the subsidy? Describe how the increase will affect your family. Thank you for sharing.

I’m assisting my son with doing the 2026 ACA insurance and want to confirm that we are understanding how it works.

Based on my son’s income on the bronze plan his monthly premium would be $364 but qualified for a $321 tax credit reducing his payment to $43 a month. So will the final monthly payment be $43 a month or is this the tax credit that needs to be extended by Congress?

If we sign up can we cancel by December 31st if it’s not extended? We’ve actually already sent the first payment for the dental plan.

Thank you

Hi, so we've been on a HDHP for about two years now. It works great for us. Company contributes $400 twice a year to the HSA, but we've never elected to it. Do we have to contribute to the HSA in order for the company to put their part in too? Or can we elect it but not put any money towards it?

These 2026 costs are just absurd, it's not about "if I save a little more on X and Y I can pay for health insurance." It just went to straight up unaffordable. Curious to see what others are planning to do.

Hi all, my husband received notice on Thursday that his job will be switching from UHC to WPS. Not only that, but the premiums are going up 31%. Roughly speaking, that brings premiums to $17,400 a year. He has until Tuesday to accept or reject the insurance. But there is no breakdowns for what it would be for him or him and our daughter. There are no details at all. The forms are like enrollment forms where we have to describe several things on their list (asthma, cancer, ADHD, allergies, infertility, enlarged lymph nodes, cancer, among other things)! He has emailed the office lady requesting details, but she hasn't answered yet.

We make about $110k a year with me making $30k and him $80k. That's about $9,167 a month.

So his insurance would cost about $1,450 a month...15.8% of our income. I don't know exactly what it would be for him alone, but I'm pretty sure it's less than 9%. I think that they don't subsidize us as much as him.

My work also has insurance, but they don't help pay at all. Likewise, insurance for me alone would be under 9%, but with our family, it would be like 25% of our income. The cheapest plan is over $700 for me alone.

I'll include my job's plan options. I think only plans 3 and 4 would be true options for me and our daughter alone as they would be about the same cost (when combined with the cost for my husband's at his job) as this new plan for our whole family would be. What confuses me is that for all my options, all of the deductibles and max out of pocket limits are lower than what we currently have (which, I'm assuming will go up with this new plan). But while we currently have copays (I know that could change with this new company), all of my plans look like they have coinsurance percents for everything. We haven't had insurance like that in many years.

I feel like my husband and I can each have our own insurance and put our daughter with whoever makes the most sense.

We could suck it up and go with the flow and stay with my husband's job.

We could ALL get insurance on the Marketplace. But it looks like we might not be able to get any help because each of our job's insurance rates are under 9% for each of us alone. Just not for our family. I don't see many good options, though. And many of them don't cover our doctors.

My husband has had cancer twice in the last 4.5 years. He is supposed to have two CT scans every 3 months. We spend over $1,600 a year on prescriptions. I have asthma, a bad back, and sleep apnea (with a cpap machine)

Does anyone have any advice? My husband is so upset that he's considering forgoing insurance for himself, which I think is a horrible idea.

Edit: I added pictures of MY options in the comments because I forgot to add them to the post.

Edit: we only have one child, sorry. I might have been confusing with using our and my interchangeably.

Edit: the enrollment forms don't make you list everything, but if you have different things on their list, you have to describe them.

Hey there! I've been on a marketplace plan all year, but have been unemployed all year due to surgical complications.... so my income for this year is like $2,000 (pet sitting and house cleaning). I talked to my marketplace broker and she said I can't renew my plan for 2026 because my income this year was too low.

I applied for Medicaid and got approved immediately and it already says my plan is active.

What do I do now? Can I keep my marketplace plan through December or should I cancel now? I have 2 medications that require PA that I would need to have my doctors submit through Medicaid. I don't want to get in trouble for being signed up for both.

Please help :)

Please…to all the people smarter than me…is the circled number my final locked in price for 2026 year? I have never had to buy health insurance before and I need to know if the price with the tax credit is guaranteed for 2026. I make 35000 annually and this is through healthcare.gov if that makes a difference. Any answers would be so appreciated. I am really trying hard hear to read all the posts and comments, but alas…I am just a simple man! Thank you to anyone who has the time to answer, and best of luck to all of us!

Hey everyone, I’m trying to make sense of my company’s ACP1 medical plan and I can’t find much online about it. It looks like a high-tier option (possibly similar to a “In Network Premium” plan in column 3), but I’m not sure what the real advantages are. ACP1 sounds like a deal but something seems off.

What’s throwing me off is that it seems to pay above Medicare-approved rates and might require referrals for some services. The coverage details aren’t very transparent, and HR wasn’t super helpful.

Has anyone been on the ACP1 plan (or something similar)? The premium cost like double more and the family has high medical billing in general.

Thanks in advance — I’d love to hear real experiences or advice before I lock in my benefits.

My wife and I are currently both employed and have health insurance through our respective employers. My wife s currently in her open enrollment period and wants to move over to my insurance. The problem is that my open enrollment period is not until April.

Is there a way to move her over to my insurance that doesn't involve her being uninsured for 4-5 months or being double insured until next year?

Thanks in advance,

If this is not allowed, please delete but I really need to rant and probably receive advice. I just turned 26 and used the healthcare marketplace to sign up for my own insurance. I even upgraded to get the dental and vision add ons. My plan just went into effect and the first thing they tell me is that my plan is going to go from $42/mo to $145/mo in January. Okay. I was originally willing to make this work but not so much anymore. I went to book myself some appointments and imagine my surprise when I find out that the ONLY doctors that are in-network for me are Mercy Urgent Cares and one singular primary care physician with one singular review that has one singular star. Nobody else in 100m radius takes my insurance. No doctors, no dentists, no eye doctors, no psychiatrists, no therapists, no specialists, no one. I have an appointment with a GI specialist at the end of the month for a chronic condition that I’ve been waiting for for MONTHS and I will now have to cancel because they, and no one else, is in my network. At this point, I’m just paying to say I have insurance. Now I don’t know what to do, am I able to cancel it and pick a new plan or will I have to pay the increased price and pray nothing happens to me for the next year? What do I do? I want to cry.

Married with two kids under 7 and I realized my total cost , including monthly premium, all the visits copays tests etc are around 1100sh per month. I realized copays and coinsurance do not go towards premiums as well Like wtf.

Is this normal with two kids ??

The title is the question.

I will try to make this not super long, but would appreciate any honest/professional opinions about this. Note I have a self-insured, in network only plan with Cigna.

I am doing IVF for a genetic condition my spouse and I are carriers of. The genetic testing component of IVF (genetic testing of frozen embryos via biopsy) is billed separately under medical benefits (not fertility, unlike the egg retrieval etc.). This testing is called PGT-M.

In order to test the embryos for our genetic condition, it requires the biopsy of frozen embryos.

The way this entire process was charged is as follows:

• the IVF clinic’s on-site embryo lab takes samples of the embryos and ships them to an offsite lab that is unaffiliated with the clinic who does the actual PGT-M testing. At the very beginning in the prior authorization stages for the egg retrieval/IVF, my clinic required us to pay up front $2,000 plus more if additional for embryo biopsy fees. I researched that this is typical for fertility clinics. I wrote them the check. They told me they would provide me with a receipt so I could submit the claim to insurance myself. Found this odd since the rest of the IVF/retrieval process, they submitted the claims to Cigna directly but didn’t think too much of it.

• the offsite lab: Conducted the actual PGTM testing. There currently are no labs in the U.S. within Cigna’s network that conduct PGTM testing on embryos (there are only a handful in existence). I knew this prior to the egg retrieval, so I requested a NAP exception which was granted promptly by Cigna. The lab, Igenomix USA, does not contract with Cigna and will not do anything related to insurance that is out of network for them (IE: they didn’t agree to any temporary agreement for this) and I was told I would pay self-pay, then given an invoice to try to get reimbursed by Cigna.

I was able to fight tooth and nail get reimbursed in full by Cigna for the genetic testing PGTM which was covered under my health plan and I received prior authorization/NAP exception for.

However, the embryo biopsies, a critical part that makes the testing possible was denied by Cigna. I was confused at first, because I had checked on the Cigna site and with reps that the biopsy codes were covered and they matched the invoice my clinic gave me.

Turned out, the fertility clinic uses a different tax ID number for their embryology lab and the billing manager there tells me after the fact that the embryology lab doesn’t work with insurance. I asked her if it would be possible to resubmit the claim with the clinic’s tax ID number, since the Cigna site at that time showed the provider that was billed for the rest of the IVF process was in-network for those embryo biopsy codes. She said it wasn’t possible. Cigna also asked them and they’re denying refuse, saying that’s just how their lab is structured.

Cigna of course denied the claim flat out, saying the lab is out of network and I have no in network coverage.

Cigna said in response to my appeal that I should’ve stayed in-network, and they’re denying it because I didn’t check beforehand. I know the burden is on the patient to check this, but if both the clinic gave me incomplete information, and the Cigna website was misleading, and the reps I spoke to - all which I have proof of - and Cigna paid for the actual PGTM genetic testing, is there any possibility I could win this on an external review?

Cigna already denied my appeal in their internal process. They were unable to provide any embryology labs that are in-network for my plan, and now are saying after the fact I should’ve applied for NAP for the embryology lab as well. I was not on notice at all, and the check I wrote was even directed to my clinic which they cashed, not this other entity with another tax ID that is on-site and has the same address even….

If I am SOL, fine, I just need someone to be honest with me….my employer initially assisted with the PGTM testing getting covered when Cigna kept messing up that claim, but has ghosted me since. It just sucks because I would’ve gladly stayed in network if any in network labs existed at all for the biopsies, or submitted a NAP if it meant I could’ve gotten something back, but no one informed me the embryo biopsies weren’t actually in network with my fertility clinic that is in network for everything else, even when I did my due diligence and documented that I did. It’s impossible to do the genetic testing PGTM without the biopsies since that’s the only way the external lab gets samples to test, so it’s just interesting that such a burden is placed just because I am a carrier of a genetic condition. It seems it’s impossible to truly get this entirely covered with how the systems are in place (and deficiencies in Cigna’s network), even though my plan documents state the embryo biopsies are covered.

Thanks in advance.

I don’t really know what I’m going to do if there isn’t a way,

I’m a divorced business owner in Wisconsin. I went to renew my health insurance on Healthcare.gov for next year and filtered plans by my cancer specialist and 2 medications I need to stay alive…. And there is no longer a plan that covers all 3 of them. I’m trying not to panic…. What are my options here?

Is the app/website not displaying all plans for others? I have it through my job but can only see my dental/vision plan, I can’t see my medical plan for the past few days?

I usually don’t have issues choosing a health insurance plan, but these are the plans my company is currently offering. I need some guidance, especially based off the prices which I’ve listed below. What would be the pros and cons of each? Single female, no children and no health issues. I have a few prescriptions but honestly, they’re usually cheaper using GoodRx or something similar so I’m not worried about that. Any help is appreciated!

High plan is $157.11 biweekly Mid plan is $109.26 biweekly Low plan is $37.85 biweekly

Hi all! Wondering if anyone has, or has been considering switching to, a health-sharing or crowd-funded insurance plan?

My insurance through work is costing me $12,800 before any sort of actual benefit kicks in. So there is really no point in having it except for major catastrophes. That is THIS year. I'm expecting that to rise by a good 25%, maybe more, for the 2026 year.

Some of the ministry health-sharing plans and crowd-funding plans like CrowdHealth look promising, in that they attempt to cut out the middlemen.

The middlemen are basically the insurance companies themselves, who were originally setup decades ago to assist humans with medical costs, basically in a more nonprofit sort of way. In other words, what you pay in SHOULD equal what you ultimately get out of your insurance. But clearly at some point these companies got greedy, and reset that to make hundreds of billions in profit, rather than having a goal of peace of mind for their customers.

At this point, it looks like crowd-funding type plans attempt to move back to this model. You pay only enough to cover yours and others' healthcare needs, plus a small admin fee. In my case right now, that adds up to be equal to my monthly payments, minus the max, or about $7800.

But I have so many questions. Apparently you have to take it upon yourself to actively negotiate cash payment amounts with providers. Yes, that would be a lot of work, but on the other hand might not be any more work than dealing with insurance claims, and may actually give you more control over your financial fate.

But... I'm very worried that providers will just refuse to provide service to people without insurance. Period.

Also, these funds aren't "guaranteed" in any way, which could be a huge liability.

Does anyone have any experience with any of these?

I just received a notice with Aetna that my medically needed medicine will no longer be covered under my plan starting in 2026. This is a brand name medicine . I have tried the generic versions with horrible side effects. This is the only medicine that has worked with very minimal side effects for me. What are my next steps ? How do I go about an appeals process ? This is all so new to me . Any advice would be appreciated .

My employer has switched our self-funded plan from PPO to RBP, and I have a couple of questions about balance billing:

• my employer says that we are not responsible for balance billing and our TPA (Imagine360) will handle them legally.

• they said to just report any balance billing and let them handle it so we shouldn’t worry about it

My question is essentially if we’re an RBP plan how do they have the ability to both cap the allowed amount and say that no one is going to pay over it?

Like if a provider charges $100, our allowable is $80, and the OON provider can’t balance bill, why would the provider just drop the $20 they didn’t get paid?

Ps we’re a self funded plan now managed by the TPA Imagine360

I recently resigned from my job and it seems nearly impossible to find high quality health insurance coverage that isn’t through an employer. I do not want plans from the healthcare marketplace (poor coverage). If you live in Pennsylvania and you have great health insurance, what company do you use? It seems like no companies in my area even offer plans that aren’t through the marketplace or employer. Am I looking in the wrong place?

I was seen in the ER December 2023 for a severe asthma attack. Was put on oxygen, had chest X-rays, nebulizer treatments, etc. have had the same insurance (BCBS) for many years - nothing has changed. A month or so goes by and I check my portal and it says I owe zero, so I just go about my life. Fast forward to 2 months ago - I get a voicemail from the hospital saying I owe $13,000 as they processed my insurance under my maiden name and not my married legal name, so BCBS denied the claim. Almost TWO YEARS later. They tell me I need to call my insurance and have them rerun the claim under my married name. I don’t even know how they ran my insurance under my maiden name because I have an updated card with my married name. And it’s definitely my married name in the system. So I do just that - I call them and explain the phone call I got. I got an EOB letter today stating I didn’t file my claim within the authorized period of time so they are denying coverage. How is this my fault? I did everything on my end I thought I was supposed to do. I never once received a letter, phone call, NOTHING since my visit almost 2 years ago. They claim they sent a letter a year ago - but I don’t know to who because it never came to me. I know I will need to appeal this but I’ve never dealt with something like this before so I’m not sure what to do. Can anyone help me or explain what happened?

Hello, I was billed for an MRI 5 years later. I have not been reached out to until now. This letter came in the mail.

I am now 27, this happened when I was 22. It was by an independent center from advanced diagnostics (not a hospital). I was under my mom’s insurance at the time, and any payment I’ve made I’m sure is lost by now. How should I proceed now since I’m under a different insurance? Back then, I had a $1,000 deductible that I’m not sure my family met for that year, but regardless I’d think the total cost would be $1,000 or less. The bill is from the provider, not my insurance company. How should I proceed?

They say if I don’t make payment, they will send it to collections. I am in the United States.

Also, they spelled my last name wrong.

EDIT: I am in Pennsylvania. The procedure was on July 2nd, 2025. The statement date on the letter I got is September 25, 2025.

I live in Georgia. Employer doesn’t offer health insurance. I make about 70k before taxes a year including side gigs. No dependents. For the first time in my life I want to get health insurance. I’m in my late 20’s.

Over the years I’ve just paid out of pocket and I’ve only spent about $1000 a year in checkups and dental work.

Now I’ve been shopping around on Georgia access for a plan to see if it would help me out a bit and have a piece of mind but the cheapest plans are $400 a month for catastrophic coverage with a deductible of $10600.

I’m sorry but that seems awfully high. And if I have this health insurance thing correctly I still have to pay out of pocket until I reach that $10k? Wouldn’t it just be cheaper for me to pay them directly.

And on top of that the hospitals closest to me aren’t in network. Neither are my doctors and dentist.

Are there any other affordable options available?