The 2026 health insurance enrollment period in the United States has officially begun. From October 15th to December 7th, individuals who wish to join Medicare (commonly known as the “red and blue card”) must complete the enrollment process. Existing Covered California customers in California can also start updating their plans. However, regardless of the insurance option chosen, healthcare costs for Americans are expected to rise in 2026.
During the year-end period, most Americans are required to select or renew their health insurance within a fixed enrollment period. Medicare, the “red and blue card,” is a federal insurance program for individuals aged 65 and older, disabled individuals, or those with specific medical conditions. Covered California, on the other hand, is the largest state health insurance marketplace in the U.S., offering low-cost health insurance plans to individuals who are unable to obtain insurance through employment under the Affordable Care Act.
The enrollment period for the 2026 red and blue card runs from October 15th to December 7th. Beneficiaries of the “Part D prescription drug plan” need to take note of some upcoming changes.
In 2026, the annual out-of-pocket limit for prescription drugs covered under the Part D plan will be raised to $2,100. If a beneficiary’s medication is not covered by the plan, the full cost will need to be paid out of pocket. Some Part D plans will also charge higher monthly premiums next year.
Additionally, some major insurance companies participating in the red and blue card program may withdraw from certain regions or reduce certain benefits. Policyholders will need to compare options and choose a plan accordingly. Insurance service companies analyze that rising healthcare costs and an aging population are contributing factors to the increase in premiums.
Overall, major policy changes are expected in the 2025 red and blue card program. Insurance professionals advise all applicants to carefully review the details of various plans.
The increase in premiums in 2026 will mainly affect individuals covered under the Affordable Care Act (ACA), as a subsidy program is set to be reduced.
ACA premiums and subsidy amounts are linked to household size and annual income for tax filers. Within specific income ranges, the lower the income, the higher the government subsidy, leading to lower monthly premiums for beneficiaries.
In 2021, the federal government passed the Enhanced Premium Tax Credits program, providing additional financial assistance to certain individuals. However, this additional subsidy program is set to end on December 31st. As a result, government subsidies for 2026 ACA enrollees will be reduced.
Using California as an example, Covered California announced the insurance plans and rates for 2026 in August, indicating an average rate increase of 10.3% adjusted based on enrollment. With some beneficiaries losing the benefit of enhanced premium tax credits, it is estimated that premiums for 1.7 million California enrollees will increase by an average of 66%.
As per usual practice, existing Covered California policyholders can renew their plans from October 15th to December 31st. New customers will have to wait until November 1st to apply for the 2026 health insurance plans, with the enrollment period ending on January 31st next year.
Individuals who wish to have health insurance starting from January 1st must renew or purchase new insurance by December 31st. Those who miss the deadline will not be able to participate in the 2026 enrollment.
Covered California offers health insurance plans in bronze, silver, gold, and platinum tiers, with higher tiers having higher monthly premiums. Each year, there may be slight adjustments to the out-of-pocket costs and monthly premiums for different plans.
Hence, Covered California advises existing customers to check and update their income and contact information when renewing. It is important to compare different plans and choose the insurance plan that best fits individual needs and budgets.