As the fall open enrollment period approaches, Floridians who buy their own health insurance through the Health Insurance Marketplace (HealthCare.gov) should expect big changes to how they enroll and how much they pay each month. The government is making the greatest number of changes to health insurance since the start of the Affordable Care Act (ACA), and these changes will affect every insurance company in Florida.

What’s changing?

Unless Congress extends the enhanced premium tax credits – extra financial help that was added for Marketplace plans in 2021 – they will expire after 2025. If this happens, most people who receive a subsidy (tax credit) may get less of this government financial help for 2026. This could mean a big increase in their monthly insurance cost starting in January 2026. For example, a 40-year-old in Miami-Dade County making $22,590 a year could see his payment go from $0 in 2025 to $81 in 2026 for the same health plan.¹

In addition, enrollment requirements are becoming more strict for everyone. More steps and information may be required to qualify for a subsidy. Also, there will be fewer opportunities to enroll in health insurance outside of the fall open enrollment period. The enhanced subsidies expiring and other insurance market changes are expected to cause monthly insurance premiums to increase across the country. 

A new educational webpage offers more details on what’s changing and how to prepare for open enrollment: FloridaBlue.com/StayCovered.

More people may need guidance and support

Because of these changes, many people may need help enrolling or renewing during this fall’s Open Enrollment, which starts on November 1. Even those who don’t normally work with an agent for their insurance may want expert guidance to be sure they have the right insurance coverage for next year and get the most financial help they can qualify for.

The value of having health insurance

With the rising cost of medical care and prescription drugs, it’s more important than ever to have health insurance. Having the right plan gives individuals and families security and peace of mind that they’re not alone in paying for medical care and prescription drugs. With most plans, annual checkups, vaccinations, yearly bloodwork and cancer screenings are covered at no extra cost. Plus, insurance pays part of the medical bills when people on the plan get hurt or sick. 

Support and guidance is available and free

Setting up an appointment with a licensed Florida Blue agent is one of the best ways individuals and families can learn how their monthly costs could change and what steps and documentation will be required. And there’s never an extra cost to work with them. 

Anyone can connect with a local licensed Florida Blue agent, visit a local Florida Blue Center in-person or through chat, or call Florida Blue 1-800-876-2227 for personalized support and guidance.

¹These numbers are Florida Blue estimates for a 40-year-old in the lowest cost Florida Blue silver plan in Miami-Dade 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