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The government is making big changes that may increase your cost for a Marketplace health plan.
We can help you prepare now so you’re ready on November 1!
This year, you’ll see the greatest number of federal government changes to your health insurance since the start of the Affordable Care Act. If you buy insurance through the Health Insurance Marketplace (HealthCare.gov) and get a subsidy (tax credit), you may get much less of this financial help from the government. This could mean a big increase in your monthly insurance cost starting in January. As part of the government’s “One Big Beautiful Bill Act,” enrollment requirements are also becoming stricter for everyone. All of these changes will apply to every insurance company in Florida, so it’s critical to have expert help now.
Don’t worry – we can guide you through the changes. We’re here to help you find a plan that fits your needs and budget so you can have peace of mind and protect your family from high or unexpected health care costs. There’s no cost or obligation for this expert guidance.
It’s more important than ever to have health insurance. We want to be sure you’re up to date and know where to find help and guidance during this Open Enrollment Period from November 1, 2025 – January 15, 2026.
Many people may get less financial help in 2026:
Unless Congress renews the enhanced subsidies, they will expire at the end of 2025. If this happens, monthly insurance costs will be much higher for almost all Floridians who buy health insurance on the Marketplace. For some, their monthly costs will more than double, and they may need to look at a different health insurance plan for next year.
For example, a 40-year-old in Volusia County making $22,590 could see his/her payment go from $0 per month in 2025 to $85 in 2026 for the same plan.
These numbers are Florida Health Care Plans estimates for a 40-year-old
in the lowest cost Florida Health Care Plans plan in Volusia County. This
estimate is for illustrative purposes only. Other insurers may vary. The
2025 150% Federal Poverty Level was used to calculate the income level.
This assumes the person is making $23,475 in 2026 and does not make a
change to their plan.
Here are a few more government changes you’ll see in November:
- More steps and information may be required when you enroll so you can keep your subsidy. So being prepared is a top priority this year.You must have filed your taxes and reconciled them using IRS form 8962 for any year that you’ve received a subsidy up to 2024 to get a subsidy for 2026. Starting in 2026, anyone who underestimates their annual income and gets more of a subsidy than they should have must repay 100% of the extra amount.
- There will be fewer opportunities to enroll in health insurance outside of the fall Open Enrollment Period. Those who don’t enroll during this time may have to wait until the next Open Enrollment before getting coverage.
Because of these changes, many people will need help enrolling or renewing this year, and Florida Health Care Plans is providing expert guidance at no additional cost. The enrollment and renewal processes are different and will likely take longer than before, so it’s important to have a plan for November 1.
We’re here to guide you through the changes
When you’re with Florida Health Care Plans, you’re never alone. Our agents are licensed and specially trained to explain all the government changes and help find the best plan for your family’s needs. With the enhanced subsidies set to expire at the end of the year, and market changes causing premiums to increase across the country, you may want to find a plan with a lower monthly cost. An agent can help. And there’s never an extra cost to work with them.
We have a wide range of plans to fit many budgets, and our agents know how to help you get the most financial help you can qualify for. Plus, all our plans include personalized care programs, special discounts, and more at $0 extra cost.
Having the right health insurance gives you security and peace of mind that you’re not alone in paying for your medical care and prescription drug needs. If you have a FHCP agent, contact them to set up your appointment. If not, you can find an agent near you, connect with an agent at a local Florida Health Care Plans in person or through a virtual chat, or call us at 386-676-7110.
What to do before you meet with your agent:
Step 1: Be sure you’ve filed your 2024 income taxes and reconcile your tax credit using IRS Form 8962. You must file your taxes for any year you received a subsidy in order to get a subsidy for the upcoming year. The Marketplace will look at your 2024 tax return to determine your 2026 subsidy.
Step 2: Gather the documents that are required to enroll and get a tax credit this year:
- Name, address, Social Security Number, date of birth for everyone covered by your plan, including Immigration status, Citizenship confirmation, and Adoption, foster care placement, or court order confirmation
- The name of your agent, broker, or other professional helping you with enrollment this year
- Information about how you file your taxes (filing separately or jointly, names of dependents)
- Employer and Household income information for everyone in your household (Required – you can no longer self-attest to your income.)
- Your current health insurance information
- Any job-based health insurance your employer has offered, including Health Reimbursement Arrangements (HRAs)
We're here for you
Schedule an appointment now. This year, more than ever, you may need guidance to help choose the right insurance plan and get the most subsidy you can qualify for.
Frequently asked questions
Changes to Enrollment and Financial Help
Who makes the rules for health insurance?
Centers for Medicare & Medicaid Services (CMS), which is part of the federal government, determines who is eligible for financial assistance, how much they qualify for, what they must provide to prove they are eligible, and when they can enroll. The changes they make affect all insurance companies.
Do these changes affect all insurers in Florida?
Yes. The federal government oversees the Health Insurance Marketplace (HealthCare.gov), and they determine who qualifies for financial assistance and how much, what paperwork is required to enroll or renew, and when people can enroll. The changes they’re making, including the possible expiration of the enhanced tax credits, will apply to every insurance company in Florida.
How much will my premium increase for 2026?
Monthly premiums for the upcoming year are released on November 1, and because of the changes in the market and some of the new guidelines, premiums are expected to go up across the country. Setting up an appointment with a licensed FHCP agent is one of the best ways to learn how your monthly costs could change. Even if you typically don’t work with an agent and choose to purchase insurance on your own, consulting with an agent is free and will be helpful when making choices about your health care coverage this year.
Will all subsidies (tax credits) go away in 2025?
No, the subsidies for plans sold on the Health Insurance Marketplace are not going away totally. Unless Congress removes the enhanced subsidies, they will expire at the end of 2025. That means, in January 2026, they will go back to their pre-2021 American Rescue Plan Act (ARP) amounts. Subsidies have always been available for plans that are sold on the Marketplace. The 2021 American Rescue Plan Act increased the amount of financial help that some people received, and it allowed others over a certain annual income to get subsidies for the first time. These enhanced subsidy levels were planned to be in place for two years, but The Inflation Reduction Act later extended them for another two years. The enhanced subsidies are set to expire at the end of 2025, and unless Congress acts, they will return to the pre-2021 American Rescue Plan Act amounts. With this change, millions of Americans would lose some portion or all of their financial help, making their monthly insurance costs more expensive.
Marketplace Rules and Filing Your Taxes
Why does the Marketplace need me to file my taxes?
You must file your taxes every year that you received a subsidy. When you enroll in or renew your insurance and apply for financial help, you estimate how much money you’ll make that year. When the year is over, you’ll need to confirm whether your estimate was correct. You do this by filing your taxes and comparing your actual income to what you predicted. This is referred to as IRS form 8962. If you got more of a subsidy than you should have, you’ll have to pay back some of the financial assistance. On the other hand, if you got less of a subsidy than you should have, you could get some money back. The Marketplace will look at your taxes up to 2024 when you apply for a subsidy for plan year 2026.
My income fluctuates. What do these changes mean for me?
When you enroll in or renew your insurance and apply for financial help, you estimate how much money you’ll make that year. When the year is over, you’ll need to confirm whether your estimate was correct. You do this by filing your taxes and comparing your actual income to what you predicted. If you got more of a subsidy than you should have, you’ll have to repay 100% of the extra amount. In the past, there was a limit on what you’d have to repay. So, if your income fluctuates, you will need to update your eligibility in your Florida Health Care Plans account during the year to avoid owing anything back.
I want to keep my current plan for next year. Can you just keep me in that plan?
If your current plan is still being offered next year:
If you don’t qualify for a subsidy, the answer is yes.
If you qualify for a subsidy, you can passively renew, but your subsidy amount may change, and you could have a higher monthly cost. Specifically, those whose subsidy covers 100% of their monthly premium (so they pay $0 per month for their premium), will be assessed $5 per month until they verify their income. So, after November 1, to avoid having to pay $5 per month, you should work with an agent to validate your income and renew your coverage by December 15.
When, How, and Why to Enroll
What can FHCP do to help me find more affordable coverage?
When you’re with FHCP, you’re never alone. Our agents are licensed and specially trained to explain all the changes and find the best plan for your family’s needs. And there’s never an extra cost to work with them. We have a wide range of plans to fit many budgets, and our agents know how to help you get the most subsidy you can qualify for. Plus, all our plans include personalized care programs, special discounts, and more at $0 extra cost. We’ll do everything we can to help you find a plan that fits your needs and your budget.
I usually buy insurance myself on the Marketplace and don’t work with an agent. How do I find an agent if I need help?
We have knowledgeable agents standing by to answer your questions at no extra cost and there’s no obligation to buy a plan from them. Our agents are licensed and specially trained to explain all the changes and find the best plan for your family’s needs. Having this expert guidance at no extra cost is a perk of working with FHCP. It’s easy to find an agent near you, connect with an agent at a local Florida Health Care Plans in person or through a virtual chat, or call us at 386-676-7110.
Why is health insurance important?
No one plans to get sick or hurt, but most people will need medical care at some point. Having insurance means you won’t have to pay expensive medical bills on your own, whether you have a simple stomach bug or a serious accident or illness. For example, without health insurance, here are some common out-of-pocket costs:
- Average ER visit at a Florida hospital: $3,100
- To fix a broken leg: $7,500
- Average three-day hospital stay: $30,000
- Cost of comprehensive cancer care: More than $100,000
A recent report shows that 40% of adults in the United States have some type of health care debt.1 Medical debt shows up on your credit report, and medical bills contribute to nearly 70% of bankruptcies in the U.S.2 Having health insurance helps protect you and your loved ones from potentially huge health care expenses.
Health insurance is more than just a financial safety net — it can be a tool for getting healthier. Many insurance plans offer added personalized services, like help managing ongoing health conditions, for no extra cost. This can help you get the quality care you need for the least out of your pocket. Plus, with insurance, your checkups, vaccinations, yearly bloodwork, and annual cancer screenings are covered at no extra cost.
When can I enroll in a new health plan?
The annual Open Enrollment Period is a time when individuals and families can enroll in a health insurance plan or renew their current plan for the upcoming year. In 2025, Open Enrollment runs from November 1 through January 15. Those who enroll by December 15 will have coverage starting on January 1. Those who enroll between December 16 and January 15 will have coverage starting February 1.
If it’s outside of the Open Enrollment Period, you would have to have a qualifying life event, which includes situations like losing your existing health insurance, getting married, having a baby, or moving to a new ZIP code. If you miss Open Enrollment and do not qualify for a Special Enrollment Period, you may have to wait until the next Open Enrollment to get coverage. A FHCP agent can help determine if your life change qualifies you for an SEP.
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More examples of 2026 monthly costs and additional resources:
- Protect yourself from fraud and scams
- Information on documents you may need to enroll or renew
Disclaimer
The information provided on this website is for educational and informational purposes only. The content is intended to provide general knowledge and understanding of various topics and should not be considered or relied upon as legal or tax advice. If you are seeking legal or tax advice, you should consult with a qualified attorney or tax professional who is licensed to practice in your jurisdiction. You should not make any decisions based solely on the information provided on this website without first consulting with a qualified professional. The website's owners, authors, affiliates, subsidiaries, and contributors are not responsible for any errors or omissions in the content, and do not guarantee the accuracy, completeness, or timeliness of the information. The website's content is subject to change without notice and may not reflect the most up-to-date information.
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