Open enrollment for 2026 is just around the corner, affecting anyone with an individual Affordable Care Act (ACA, also called “Obamacare”) plan, as well as people covered under Medicare. While the impact looks different for each group, every member needs to review their coverage before making decisions for the next year.
For those under the ACA, an annual review is critical. You’ll need to check your provider network, rates, insurance premiums, and your premium tax credit or cost-share benefits. Both are based directly on your taxable income.
How Your 2025 Income Impacts 2026 ACA Coverage
ACA premiums are calculated from your current year’s income. In August 2025, your income for the year isn’t finalized yet, since the year isn’t over. Still, your 2025 premium will be tied to that income, and that estimate becomes the basis for planning your 2026 coverage.
That means any expected changes in your job, healthcare needs, or family situation should be part of your review. Predicting those changes now can help you choose the right ACA plan for 2026.
Why Annual Reviews Are Essential
Since open enrollment decisions are based on estimates, small shifts in income or needs can change your subsidies, premiums, or which doctors remain in your network. That’s why it’s important to review your coverage every year. Ideally, you should work with an experienced agent who can walk you through your options.
Contact MBhealth for Open Enrollment Help
Open enrollment is always a busy season, but reviewing your coverage is one of the most important steps you can take to protect your health and finances.
Call MBhealth at (314) 544-5400 or visit mbhealth.com to schedule your review today.
About Mike Butz
Mike Butz has spent his career helping individuals, families, and small businesses navigate the often-confusing world of health insurance. A certified advisor for Medicare and the Healthcare Marketplace, he also provides guidance on life, disability, and long-term care insurance.
