Many of your clients will be paying more for their health insurance in 2026. Some will be paying a lot more. The price hikes can put a strain on client satisfaction, but you can help by showing your clients how to squeeze as much value as possible from their 2026 health insurance coverage.
The Impact of Insurance Price Hikes
People who rely on the ACA marketplace for health insurance are seeing higher prices for two reasons. First, insurers have raised health insurance premiums for plans sold on the marketplace. Second, many people are losing enhanced premium tax credits, meaning they’ll have to pay the full premium themselves without any assistance.
According to the Center on Budget and Policy Priorities, before the expiration of the enhanced premium subsidies, 93% of marketplace enrollees, or more than 20 million people, received premium tax credits to help them pay for ACA plans. Without these subsidies, average costs are expected to more than double. For example, a family of four that used to pay $11,050 a year might pay $23,909 a year.
CNBC says everyone who received premium subsidies will be impacted by higher costs, but certain demographics will be most affected, including early retirees and middle-income households.
For many households, this type of price hike is a major financial blow. Your clients may be worried about their costs, and they may be struggling to afford care due to higher deductibles and copays in addition to premiums. Faced with high costs, policyholders need to get as much value from their plans as possible.
Don’t Leave Benefits on the Table
High deductibles and copays may keep people from getting care, but many types of care are available with no out-of-pocket costs.
According to Healthcare.gov, many types of preventive care, including screenings and vaccines, are available with no costs. Make sure your clients know about these benefits and use them as needed.
Consider Supplementing High-Deductible Plans
According to KFF, the average deductible for a Bronze level ACA plan is $7,476 for plan year 2026.
Some of your clients may have chosen high-deductible plans as a way of lowering the monthly premium, especially if they are relatively young and healthy and hope not to need care. However, if they experience an unexpected health issue, the high deductible may become a financial burden.
A Health Savings Account could help your clients. As of 2026, anyone enrolled in an ACA Bronze level or Catastrophic plan is eligible to enroll in an HSA, which provides a tax-advantaged way to pay for eligible healthcare costs.
Your clients may also be interested in an accidental injury or critical illness insurance policy. These insurance policies typically pay a lump-sum benefit in the event of a qualifying medical condition, such as a heart attack or cancer diagnosis for a critical illness policy or a broken limb or burn for an accidental injury policy.
Appeal Claim Denials
Did you know that more than 80% of prior authorization appeals are successful? That’s according to the American Medical Association.
KFF says ACA insurers offering qualified health plans on HealthCare.gov denied an average of 20% of all claims in 2023, but fewer than 1% of all denied claims were upheld.
If your clients think a claim has been denied unfairly, encourage them to appeal the decision. The appeal may not be successful, but it’s possible that it will be.
Help Your Clients Find Other Resources
If your clients are struggling with costs, you can show your value by helping them find resources to help. For example, if they’re dealing with a job loss or other change in income, they may qualify for Medicaid. In Texas, people can apply for Medicaid benefits through YourTexasBenefits.
Another option is to seek discounts directly from drug manufacturers for high-priced prescriptions. Many drug manufacturers offer discount programs to help people afford their medications. If your clients are having trouble affording a prescription, encourage them to go to the manufacturer’s website to see if a discount is available. They could also ask their doctor about switching to a generic alternative.
Being There for Your Clients
Rising prices can be stressful for your clients. It’s a difficult situation, but it’s also your opportunity to shine. Check in on your clients, see how they’re doing, offer tips on how to save money and make the most of their health plans, and make sure they know you are available if they have any questions or need help.
Through PTT Financial, agents can access contracts for health, life, and ancillary insurance products, as well as training opportunities and support to help you grow your business. Learn more.