Your Health Insurance Premium Went Up at Renewal. Now What?

Why a renewal bill can go up

An insurance company sets its rates for the coming year at renewal. Many things can move the number. The company may be paying out more in claims across the whole plan. The plan's benefits may have changed. Some plans price by age, so getting older can nudge the bill up. None of these has to do with how often you personally went to the doctor.

If your plan comes through a job, there is one more reason. Your employer decides how much of the monthly cost it pays. When the employer pays less, the amount taken from your paycheck rises even if the plan itself stayed the same.

Read the renewal notice before you do anything

The notice usually shows more than the new payment. Look for the deductible, which is what you pay for care before the plan starts sharing costs. Look for the copays, the flat amounts for a visit or a prescription, and the out-of-pocket maximum, the most you could pay for covered care in a plan year. Then check whether your doctors are still in the network and whether your medications are still on the plan's drug list.

Write down the date the new rates start and the last day you can make a change. Those dates are usually printed on the notice. If you cannot find them, call the number on your insurance card and ask.

Staying put is a real choice

A bigger bill does not automatically mean you should leave. If your doctors are in the network and your medications are covered, keeping the plan you know may be the sensible move. A new plan can mean new rules and a new network.

Staying can still be a decision you make on purpose. Compare the new total for the year, not only the monthly payment, with one or two other plans before you click renew.

If your plan came through the Marketplace

Florida uses HealthCare.gov for Marketplace plans. Open enrollment, which usually runs from the fall into January, is the usual time to switch Marketplace plans, and outside it you generally need a special enrollment period after a life event. Canceling a plan by choice, or losing it because you stopped paying, generally does not open a special enrollment period, so you would wait for the next open enrollment. If your payment jumped because your help with monthly costs changed, update your application at HealthCare.gov. Premium tax credits are available only through the Marketplace.

We offer private plans only and cannot enroll anyone in a Marketplace plan, so if you want a Marketplace plan, start at HealthCare.gov.

Looking at a private plan

A private plan is one more option to put beside your renewal. You can apply any time of year, so you do not have to wait for a yearly window. The plans we offer are private plans, not ACA Marketplace plans, and they have exclusions and limitations. An advisor explains the details.

Your current plan keeps its terms until renewal, and a new plan has its own terms, network and drug list, so compare them side by side. Our plans are for people under 65.

Please do not cancel your current plan until the new one is active. If you cancel first and the new plan does not start when you expect, you could end up with no plan at all.