Get ready for higher health insurance premiums next year

Expect to pay more for health coverage next year — possibly a lot more — whether you get your health insurance from an employer or on a health care exchange.

As open enrollment season approaches, employers say they are facing the stiffest increase in health costs in more than a decade — almost 9% on average. But some project double-digit increases, even after they take steps to hold down costs, according to a large survey of employers conducted by Mercer, a benefits consultant. The reasons include higher labor costs for health care workers, higher charges from doctors and hospitals, and more demand for care and costly new drugs, such as those for weight loss.

Experts say workers should expect to share some of the burden through higher premiums and out-of-pocket expenses for coverage next year. But the impact will vary depending on where you work.

“It’s not clear how much of that cost they will pass along to employees, rather than eat it,” said Cynthia Cox, a health insurance expert at KFF, a health care research group. Larger employers may be better able to shield workers from some costs, she said, while smaller firms may have less flexibility.

With costs rising, it’s important to compare plans offered during your employer’s open-enrollment period — typically, a period of a few weeks in the fall — to make sure you are on the best plan for you and your family.

“Inertia is a powerful force,” said Louise Norris, a health policy analyst at Healthinsurance.org, an information and referral site. “But it’s always a good idea to evaluate your coverage during open enrollment.”

Make sure, for instance, that your doctor and your preferred pharmacy are still on your plan and that medications you take are still on the plan’s approved list, or formulary. “Don’t assume anything will stay the same,” Norris said.

Employers may offer plans that have lower monthly premiums — the amount deducted from your paycheck — in exchange for paying more when you need care. The plans typically have higher deductibles — the amount you pay before insurance covers your treatment — or copayments, which you pay at the doctor’s office. High-deductible plans may come with employer contributions to a special health savings account, or HSA — say, $1,000 — which you can use to help pay for out-of-pocket costs. If you don’t need the money right away, you can invest it and take the HSA with you if you change jobs.

How much can I contribute to an HSA in 2026?

If you have health coverage just for yourself in a plan that qualifies, you can make up to $4,400 in pretax contributions next year (including any employer contributions). If you have family coverage, you can contribute $8,750. People 55 and older can put away an extra $1,000.

Is a higher deductible risky?

It’s important to consider your family’s health needs before choosing a high-deductible plan, experts say. The minimum annual deductible for family coverage in an HSA-eligible plan is $3,400 for 2026. That means you’ll need to cover the full cost of care, other than preventive services such as cancer screenings and other tests, with your HSA balance or other funds until you meet the limit.

Norris said it would be wise to calculate what you’d pay in a worst-case scenario, in which you have to meet not just your deductible, but also your plan’s out-of-pocket maximum cost. A lengthy hospitalization or a cancer diagnosis can mean staggering bills. Health plans may cover just 80% of costs after you meet your deductible. They’ll cover 100% only after you meet the plan maximum.

Are there other employer options for health services?

Cox suggested contacting your employer’s human resources department to ask about programs that might help lower your costs. “There may be other benefits you didn’t realize existed,” she said. Employers, for instance, increasingly offer free telemedicine options with round-the-clock virtual access to doctors. And employee assistance programs may provide up to 10 free or low-cost mental health visits.

Caitlin Donovan, senior director at the Patient Advocate Foundation, a nonprofit that provides help and financial aid to people with debilitating diseases, suggested checking to see if moving off a spouse’s employer plan and onto one from your own employer may save you money. Some employers may charge extra to cover a spouse, she said, if the spouse has insurance available through a job.

Can I save money with a ‘narrow network’ health plan?

While shopping around for medical care based on price is usually impractical, Donovan said, it can make sense for some services. There may be variability in pricing, for instance, for imaging tests like X-rays and MRIs, depending on whether the test is done at a hospital or a free-standing clinic.

What’s happening with Affordable Care Act plans?

Plans available under the Affordable Care Act, also known as Obamacare, could see drastic premium increases because the expanded tax credits that have lowered costs for millions of Americans are scheduled to end. Unless the Republican-controlled Congress votes to extend them, the enhanced credits will expire at the end of the year. That could lead to out-of-pocket premiums paid by marketplace enrollees rising by an average of at least 75%, a KFF analysis estimated.

KFF has updated its tax credit calculator so that people enrolled in marketplace plans can see how their premium payments may change if the enhanced credits expire. Open enrollment on HealthCare.gov, the federal marketplace, begins Nov. 1.

KFF calculated some examples using a benchmark marketplace plan, showing that a 35-year-old couple making $30,000 a year would see their annual premium go from zero to $1,107, while a 49-year-old couple that earns $90,000 and has a 19-year-old child would see their annual premium rise to almost $9,000, from $6,246.