Expect health insurance prices to rise next year, brokers and experts say

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Expect health insurance prices to rise next year brokers and.jpeg

Production prescriptions and annoying medical costs are some insurance companies and employers now. Patients may start paying their price next year.

Health insurance will grow more expensive in many market corners in 2026, and coverage may shrink. Patients can be left to pay more for your doctor’s visits and deal with prescription cover changes.

The price increases may be particularly blatant in the individual coverage markets, as insurance companies also expect that the federal government will end some support that helps people buy coverage.

“We are in a period of uncertainty in every health insurance market at the present time, something that we have not seen very long ago,” said Larry Levitte, CEO of KFF, who is studying health care.

What hits insurance companies

In group calls to discuss modern profit reports, insurance companies have canceled a list of increasing costs: more people receive care. Expensive emergency room visits increase, as well as mental health treatments.

Insurance companies also say that more health customers drop coverage in the individual market. This leaves a higher concentration than patients who generate claims.

Registration in the insurance markets in the sponsorship law at reasonable prices in the past few years. David Windley, an analyst at Jeffrey, pointed out that the campaign campaign against fraud and tightening the verification of the eligibility that was diluted during the Covid-19 pandemic makes it difficult for some to remain covered.

He said that people who use a little care “disappear.”

The prescribed medications are another challenge, especially diabetes and folk obesity treatments, especially the GLP-1. These include OzemPIC, Mounjaro, Wegovy and Zepbound.

“The pharmacy gives me a headache, and does not intend to pun,” said Feni Dapol, the administrative director of the employee benefits consultant.

There are more expensive medications

Insurance brokers say new genetic treatments that can come at one time more than $ 2 million have an effect. These medications, which target rare diseases, and some newer cancer treatments are part of the reason that Sun Life Financial covered 47 claims last year and cost more than $ 3 million.

The Financial Services Company covers high -cost claims for employers who pay their medical bills. Jin Coleer, head of health and risk solutions, said that Sun Life may have had no expensive claim a decade ago and perhaps a “handful at best” five years ago.

Some of these medications are rarely used, but they cause high total costs. That provokes insurance installments.

“It adds to the medical (cost growth) in a way that we have not seen in the past,” Coller said.

Market pain in expectations

The high prices will be more clear in the individual coverage markets of the Care Law at reasonable prices. Insurance companies there raise installments of about 20 % in 2026, according to KFF, which was the analysis of state regulatory files.

But consumers in the actual height may see much greater. The enhanced tax credits that help people buy coverage at the end of the year may end, unless the congress renews it.

If they go, the costs of customer coverage may increase by 75 % or more, according to KFF.

The employer Sherley Modelin is worried about the high market prices. It cannot provide coverage for about 20 3D design and manufacturing employees in Bouatian, Virginia, so they return them 350 dollars per month for the coverage they buy.

Modlin knows that its payment covers only a slice of its workers. She is concerned about high prices, some may push for a job in a largest company that provides benefits.

She said: “My employees may not want to go to work in a large company, but when they think about how to pay them to pay their bills, they sometimes have to make sacrifices.”

Employers may transfer costs

The costs are also growing in the largest market for the coverage sponsored by the employer, says the benefits advisor, Mercer. Employees may not feel so much because companies generally pay most of the bonus.

But they may notice coverage changes.

About half of the big employers included in Mercer said earlier this year that they could turn more costs to their employees. This may mean higher discounts or people must push more before they reach the maximum out of the pocket to cover them.

Narcotics coverage changes are possible

For prescriptions, patients may see hats on expensive obesity treatments or borders on those who can take them.

Dapole said that some plans may also start using separate discounts for their pharmaceutical and medical advantages or make patients pay more for medical prescriptions.

Emily Bremer, head of the Independent Insurance Agency, which is based in St. Louis, noted that the coverage changes may differ throughout the country.

She said that employers are not excited to reduce benefits, so people may not see dramatic described coverage changes next year. But this may not last.

“If there is something that does not give the costs of pharmacy, it will take it closer to what we would like to think,” Bremer said.

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The Ministry of Health and Science in Associated Press is receiving support from the educational sciences and media group of the Howard Hughes Institute. AP is the only responsible for all content.

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2025-08-23 20:36:00

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