Marketplace Premium Change Notifications: What They Mean & How to Respond
Marketplace premiums are jumping for 2026. If you received a rate increase notification, don't auto-renew without comparing options. We verify your doctors, compare ACA vs private PPO plans, and show total annual costs before the January 15 deadline.
Marketplace Premium Change Notifications: What They Mean & How to Respond
Fast take: If you received a Marketplace premium change notification, your 2026 rate is likely increasing—sometimes significantly. Don't auto-renew without comparing options. We'll verify your doctors, compare ACA plans vs. private PPOs, and show total annual costs before you commit.
Got a premium increase notice?
We'll compare your current plan against new Marketplace options and private PPOs—and verify your doctors stay in-network.
Get Free Quotes Book a CallWhat your notification means
Premium increase
✓ Your monthly cost is going up for 2026
✓ Increase can range from 10-30%+ depending on your state
✓ Driven by medical inflation, drug costs, and policy changes
Plan changes
✓ Network may have changed—verify your doctors
✓ Deductibles and out-of-pocket maximums may be higher
✓ Prescription formulary tiers may have shifted
Why premiums are jumping for 2026
- Medical inflation: Hospital and provider costs continue rising faster than general inflation
- Specialty drugs: GLP-1 medications and other high-cost drugs are pushing claims higher
- Subsidy uncertainty: Enhanced ACA subsidies may expire, raising net costs for middle-income families
- Carrier adjustments: Insurers are repricing based on 2024-2025 utilization patterns
What to do right now
1) Don't auto-renew blindly
If you do nothing, your current plan will automatically renew at the higher 2026 rate. You have until January 15 to switch plans during Open Enrollment.
2) Verify your provider network
Marketplace plans frequently change networks. Your current doctors may no longer be in-network for 2026—check before you commit.
3) Compare total annual cost
Don't just look at premium changes. Factor in:
- New deductible amounts
- Copays and coinsurance changes
- Out-of-pocket maximum increases
- Expected usage based on your health needs
4) Check alternative options
If your Marketplace premium is jumping significantly and you don't qualify for strong subsidies, private PPO options may offer:
- Lower total annual costs for healthy applicants
- Broader nationwide PPO networks
- Fewer referral requirements and restrictions
How to decide in minutes
Stay on Marketplace if...
✓ You qualify for strong income-based subsidies
✓ Your doctors are still in-network for 2026
✓ A different Marketplace plan offers better value
✓ You're comfortable with HMO/EPO restrictions
Consider Private PPO if...
✓ Your premium jumped 20%+ and subsidies are minimal
✓ You want nationwide PPO access and flexibility
✓ You travel frequently or need specialists
✓ You prefer direct access without referrals
How RKA handles premium increase notifications
- Network verification: We confirm your doctors are in-network for 2026—before you commit
- Side-by-side comparison: Current plan vs. new Marketplace options vs. private PPOs
- Total cost projection: Annual costs including premiums, deductibles, and expected usage
- Fast enrollment: We'll switch you to the best option before the January 15 deadline
Don't pay more without comparing options
We'll verify your doctors, compare all available plans, and show clear annual costs—before January 15.
Get Free Quotes Book a CallFAQ
Can I switch plans after getting a premium increase notice?
Yes—during Open Enrollment (through January 15), you can switch to any Marketplace plan or explore private PPO options if eligible.
Will my doctors still be covered in 2026?
Not necessarily. Networks change annually. We verify your specific providers before you commit to any plan.
Are private PPOs always more expensive than Marketplace?
No. If you don't qualify for subsidies, private PPOs can offer lower total costs with broader networks—especially for healthy applicants.
For education only; eligibility and benefits vary by carrier and state. Always review official plan documents.
Extended Open Enrollment 2026: Final Days Before January 15 Deadline | RKA
Open Enrollment 2026 closes January 15. Enroll by Dec 15 for Jan 1 coverage, or by Jan 15 for Feb 1 coverage. Don't auto-renew into higher 2026 rates—compare ACA Marketplace plans vs private PPOs and verify your doctors are covered.
Extended Open Enrollment 2026: Final Days to Lock Coverage – Deadline January 15
Fast take: Open Enrollment 2026 runs through January 15 in most states. If you enroll by December 15, coverage starts January 1. Enroll by January 15, coverage starts February 1. This is your last window to compare ACA Marketplace plans vs. private PPOs and secure your 2026 rate.
Need help choosing the best plan before Jan 15?
We'll verify your doctors and prescriptions, compare ACA vs. PPO options, and show clear costs—no pressure, just answers.
Get Free Quotes Book a CallKey dates to remember
Open Enrollment Window
Nov 1, 2025 → Jan 15, 2026
(most states)
Enroll by Dec 15
Coverage starts Jan 1, 2026
Enroll by Jan 15
Coverage starts Feb 1, 2026
What to do before the deadline
1) Verify your providers
Marketplace networks can be narrow—HMO/EPO-heavy with referral requirements. Private PPOs often offer broader access. We'll confirm your doctors are in-network before you enroll.
2) Compare total annual cost
Don't just look at premiums. Factor in deductibles, copays, coinsurance, and out-of-pocket maximums with your expected usage patterns.
3) Check subsidy eligibility
Income-based tax credits can dramatically lower Marketplace premiums. We'll estimate your 2026 subsidy eligibility and show net costs.
4) Consider private PPO alternatives
If you don't qualify for subsidies or need nationwide PPO access, private medically underwritten PPOs may offer lower total costs and fewer restrictions.
How to decide in minutes
Pick an HMO or POS if…
✓ You want lower premiums and you're comfortable staying within a local network.
✓ You prefer having one doctor coordinate all care and provide referrals.
✓ You rarely travel or need specialists outside your area.
Pick a PPO or EPO if…
✓ You want the freedom to see specialists without referrals and value a larger network.
✓ You travel often or need access to doctors across multiple states.
✓ You're willing to pay higher premiums to avoid network restrictions or referrals.
How RKA helps with last-minute enrollment
- Fast comparisons: ACA vs. PPO side-by-side with your providers
- Network verification: We confirm your doctors before you commit
- Clean enrollment: We'll hit the deadline and set your correct effective date
Quick FAQs
What if I miss the January 15 deadline?
You'll need a Qualifying Life Event for a Special Enrollment Period, or you'll wait until next Open Enrollment. Private PPOs may still be available year-round if eligible.
Can I change plans if I already enrolled?
During Open Enrollment, you can switch plans. After January 15, changes require an SEP.
Will my 2025 plan auto-renew?
Yes, but you may pay more in 2026. Many insurers raised rates significantly—review before auto-renewal hits.
For education only; eligibility and benefits vary by carrier and state. Always review official plan documents.