Worried about health insurance for 2026? Read this

Originally published November 20; updated December 11, 2025 

If you buy your own health insurance, or had planned to for next year, you might have seen news stories and social media posts about insurance costs going up.

And not just a little. A lot.

You also might have heard that extra government funds will no longer be available to help people afford health insurance.

And all of this may have left you feeling confused and worried, especially with deadlines coming up soon.

You may even think you should just try to go without health insurance to save money.

But University of Michigan Health experts have some important, timely advice: Don’t make any decisions until you have explored all your options.

There is still money available to help some people with their costs. And if you can't find a plan that's affordable, you may be allowed to buy a "catastrophic" plan so that you at least have coverage if you get seriously sick or injured.

Whatever you do, the experts say, don’t go without coverage if you are able to afford an available plan. And get help finding the best option for you. Deadlines are fast approaching, unless you qualify for certain programs or special enrollment periods.

“For 15 years, people who don’t get health insurance from an employer, and don’t qualify for Medicaid, Medicare or other plans, have had the option to buy their own coverage under the Affordable Care Act, or ACA,” explained A. Mark Fendrick, M.D., director of the U-M Center for Value Based Insurance Design and a professor at the U-M Medical School.

“This year, there’s uncertainty about who exactly will get help from the federal government to reduce the cost of coverage, and how much they will get, which has raised a lot of worry,” he added. “But what we know from the days before the ACA is: Being uninsured is hazardous to your physical and mental health, and could dramatically impact your financial health.

“Before you decide that it is just too expensive to enroll in a health plan, it’s worth checking out the options and considering cutting costs in other areas of your budget to afford health insurance,” he said, “because one unexpected illness, injury or operation could spell financial ruin if you don’t have coverage.”

Alena Hill and her team of Michigan Medicine Patient Financial Counselors have heard a lot of worry in recent weeks since the enrollment period began.

They run a toll-free helpline that anyone in Michigan can call – whether or not they’ve received care at U-M Health – to talk through their options.

They can be reached at 877-326-9155 or [email protected] between 8 a.m. and 4 p.m. on weekdays.

“We want to help people, and we hope they’ll call us, or our partners at the Washtenaw Health Project, or other unbiased trained counselors near them,” said Hill.

She also notes that there are also trained counselors at UM Health-Sparrow at (517) 364-6060, and UM Health-West at (616) 252-7110, which are part of the U-M Health regional network.

For people who live outside Michigan, she notes that counselors who are listed as “assisters” in the Find Local Help section on healthcare.gov are not paid by health insurance companies; they offer independent advice.

That site also lists insurance brokers, who get paid based on how many people enroll through them.

10 key things to know about 2026 health insurance

1. Act soon.

If you want your coverage to begin January 1, you have until the end of December 15 to commit to a plan and pay your first bill. 

If you don’t do it by then, you can still sign up and pay by the end of January 15 and have coverage starting February 1. (Some states have different deadlines.)

If you miss the enrollment deadline, you may qualify to enroll later in 2026 if you lose a job; get married, divorced or widowed; move to another state; turn 26 and have to leave your parents' plan, or have or adopt a child. These are called Special Enrollment Periods; see the link for other reasons people can qualify for them

The extra subsidies that some people have qualified for since the start of the COVID-19 pandemic will all but certainly expire December 31. Congress and the president are deliberating options for what to do once they expire.

If you've been waiting to see what happens with the extra subsidies, you should enroll in the best plan you can afford by December 15 or January 15, apply for an affordability exemption (see information below) in order to buy a catastrophic plan if you're over 30 and your least-expensive plan is unaffordable, or go without insurance.

2. Don’t assume anything.

The healthcare.gov insurance marketplace has five tiers of coverage: catastrophic, bronze, silver, gold and platinum.

Because of weird quirks in the way health insurance on the individual market is priced, you may actually pay less for a higher-level plan than a lower-level plan, especially gold vs. silver.

At every level, consider total costs, Hill says.

Don’t stop at what it will cost you each month (called a premium). You should also look at the deductible (how much you’ll have to pay for care before your insurance kicks in) and the co-pay and co-insurance amounts you’ll pay when you get care.

Also, check the network of hospitals and providers that are considered “in network” and the list of medications a plan will cover, especially if you have a doctor you like or a prescription you rely on.

Here’s the list of ACA plans that U-M Health’s hospitals, health centers and providers in southeast Michigan will accept in 2026. Here’s the list of all plans accepted at UM Health-Sparrow.

If you currently have insurance that you bought on the Healthcare.gov site or a state marketplace, you may be tempted to just automatically let the system re-enroll you for next year.

But don’t assume that the plan you have now will be the best one for next year. It may not even be offered, or another plan may be better for you or less expensive in monthly premiums, deductibles and co-pays.

3. Know what's available for veterans.

Check to see if you might be eligible for Veterans Health benefits – the criteria have expanded recently. Even if you didn’t qualify before, you might now.

4. Your exact income really counts this year.

That’s because federal help with insurance costs will no longer be offered for people with incomes over 400% of the federal poverty level.

But people with incomes below this cutoff will get at least some help with the cost of their insurance. 

There’s a calculator here that will help you understand where your income falls based on how many people live with you, and there’s a list of what kinds of income counts.

The income levels that the calculator shows for each household size are the 100%, 200%, 300% and 400% of poverty for that state.

Before you decide that it is just too expensive to enroll in a health plan, it’s worth checking out the options and considering cutting costs in other areas of your budget to afford health insurance, because one unexpected illness, injury or operation could spell financial ruin if you don’t have coverage." 

– A. Mark Fendrick, M.D.

If your income is just over the 400% line, even by a dollar, you may want to consider whether there are ways to reduce your income slightly in order to qualify for help. You could ask a tax professional if there are ways to place some of your earnings in tax-advantaged accounts that would reduce the type of income that counts for insurance purposes. Or you can contact insurance brokers and companies directly to see if you might be able to buy a plan directly for less than it would cost you on the healthcare.gov site.

5. If your income is between 200% and 399% of the federal poverty level, you will get some help with insurance costs.

People and households in this bracket of income will receive some sort of help with the cost of self-purchased health insurance, as they did before the pandemic. But extra help with costs that they could receive in 2025 will expire on New Year’s Eve.

Remember, in order to have coverage on January 1, you need to sign up and pay your first payment by December 15. To have coverage on February 1, you need to sign up and pay by January 15. 

6. If you have a low income, you will not face the high monthly costs that you might have heard about on the news. And Medicaid changes aren’t happening soon.

If your income is under 200% of poverty, you will definitely qualify for government help with the cost of your coverage.

If your income is below 138% of poverty for your state, you may qualify for Medicaid or a Medicaid expansion plan such as the Healthy Michigan Plan.

You may have heard that changes are coming to Medicaid plans, to require people to confirm twice a year that they still have a low income and that they are working, volunteering, going to school or caregiving in order to keep their benefits. These changes aren’t taking effect immediately.

However, if you qualify for Medicaid, it’s really important to make sure to update your phone number, email address and street address on file so that you won’t miss notifications about changes coming later.

Also, even if you make too much money to qualify for Medicaid, your children may qualify for the MIChild program (or its equivalent in other states) which is free to the family. Children in Michigan families that make up to 217% of poverty are eligible.

If you live in the 10 states that have not expanded Medicaid and your income is under the federal poverty level but too high to qualify for your state’s Medicaid program, you are not eligible for government help with the cost of buying insurance.

7. Your age counts, too.

Insurance plans that people buy directly under the Affordable Care Act aren’t allowed to charge people more based on their health or disability status. But they are allowed to charge more based on age.

So if you’re in your 50s or early 60s, you may have the biggest rise in insurance costs. Make sure to talk with a trained and unbiased advisor to find the best option for you.

If you're under age 30, you can automatically choose a Catastrophic plan on the healthcare.gov site if that's the level of coverage you want, to cover some preventive care and "worst case scenarios." Learn more about your options under 30.

If you are under 26, you may be able to remain on your parents' job-related insurance until you turn 26; if you're on a parent's Marketplace plan and you will turn 26 during the calendar year, you can stay on it until the end of the calendar year. Learn more about enrolling in a healthcare.gov plan under a Special Enrollment Period for people turning 26.

8. If nothing else, you can consider a catastrophic plan. 

These are stripped-down, bare-bones plans that have low monthly premiums but very high deductibles (meaning that you would have to bear the cost of health care you receive until it reaches thousands of dollars).

You can only get these plans if you’re under age 30, or don’t qualify for any government assistance with your health insurance costs, or your insurance will cost more than 8% of your total income even if you do get help.

If you are over age 30, you can only buy a Catastrophic plan if you fill out and mail a form to the federal government, and they approve an exemption for you. Learn more about doing this here.  There are different forms to fill out depending on your circumstances. One form is for people going through a financial hardship like homelessness, eviction, bankruptcy or foreclosure. The other is for people who can't afford the plans available to them because they will cost more than 8% of their household income. The forms, and instructions for filling them out, are available here.

These are not the best insurance choice for most people; if you qualify for any federal help with your insurance costs, you’re better off choosing a higher-tier plan.

But if you don’t, or you truly can’t afford one of the plans available to you, catastrophic plans offer a way to get coverage for worst-case scenarios like major accidents or illnesses.

Plus, under the Affordable Care Act, they must cover 10 types of essential care, three primary care visits and the cost of certain preventive care before you’ve met your deductible.

If you get a Catastrophic plan, be sure to stash as much money as you can in a Health Savings Account. See below for more on those.

If you end up facing medical bills you can’t afford next year, hospitals and health systems usually offer financial help, but they usually have a requirement that you have the coverage you qualify for, and that you’re below income limits.

For instance, U-M Health’s information is here.

9. If you get a plan with a high deductible, open a Health Savings Account.

Every Bronze and Catastrophic plan is eligible for these, and some other higher-level plans may also be HSA-eligible; check the plan’s details.

An HSA makes it possible for you to put cash into a special account that doesn’t charge taxes when you take the money out and spend it on health expenses that your plan doesn’t cover, such as your costs up until you meet your deductible. You can keep the account from year to year, and let money build up if you don’t use it.

10. If you’re an immigrant, check to see if your immigration status makes you ineligible for coverage.

There have been recent court cases and federal policy changes that limit which immigrants can buy insurance on Healthcare.gov.

People who used to be eligible, including the “Dreamers” covered under the DACA program, may no longer be. See this page for information about eligibility and where to get care.

Keep in mind that community health clinics, federally qualified health centers, and hospitals and health systems may offer free or reduced-cost care for people in these situations. The Washtenaw Health Project also has options.

No matter what, Fendrick and Hill say it’s important to get help navigating this especially complicated year.

Hill’s team is available 877-326-9155 or [email protected] between 8 a.m. and 4 p.m. on weekdays. UM Health-Sparrow’s team is at (517) 364-6060, and UM Health-West’s team is at (616) 252-7110.

Sign up for Health Lab newsletters today. Get medical tips from top experts and learn about new scientific discoveries every week.

Sign up for the Health Lab Podcast. Add us wherever you listen to your favorite shows.