Harris: Open Enrollment Season: What You Need to Know 

By Charlestien Harris, Retired Financial Coach at Southern Bancorp

We’ve often emphasized the importance of financial planning for your overall financial well-being. One topic that tends to be overlooked is reviewing your health insurance policies. If you’re not keeping up with the changes happening in healthcare, you may be making decisions based on outdated information – potentially affecting both you and your family.

The general open enrollment period is now underway. For Medicare and Medicare Advantage plans, it runs from October 15 through December 7, 2025. For federal health insurance plans, it begins November 1, 2025, with deadlines that vary by state. 

Below are some of the most important changes to be aware of as the new coverage period approaches:

Key Changes to Know

1. Potential Premium Increases
   One of the most notable changes is the expected rise in premiums. Health insurers have already filed for median premium increases of at least 18 percent for 2026. For Medicare recipients, Medicare Part B premiums are also projected to increase. Rising healthcare costs are a major factor behind these hikes.
2. Higher Out-of-Pocket Costs
   The maximum out-of-pocket limit for ACA plans has increased. Additionally, some enhanced subsidies are set to expire at the end of 2025, which could lead to higher premiums and out-of-pocket expenses for many participants.
3. No More Repayment Cap
   The cap on how much you may have to repay the IRS for excess premium tax credits under ACA plans has been lifted. If your income changes unexpectedly, you may owe more at tax time.
4. End of Year-Round Enrollment Flexibility
   The year-round enrollment option for individuals with incomes below 150% of the federal poverty level is ending. All ACA enrollees – regardless of income – must now enroll or re-enroll during the standard open enrollment period (November 1–January 15) unless they experience a qualifying life event.
5. Changes to Medicare Advantage Plans
   While you may see lower premiums, this could come with reduced coverage or limited service areas. Insurers may no longer cover as many services as they did in previous plans.
6. Possible Change in Preferred Physician
   Many of us prefer to stick with a trusted doctor, but your new plan may restrict who you can see or where they’re located – especially if they’re out-of-network. Review your plan carefully to avoid surprises.
7. Increase in Medicare Part D Prescription Drug Cap
   The annual out-of-pocket cap for Medicare Part D prescription drugs will increase to $2,100. Rising drug costs are being passed on to consumers, and this trend extends beyond healthcare.

Tips to Help Manage Healthcare Costs

1. Prioritize Preventive Care
   Take advantage of free or reduced-cost preventive services such as annual check-ups, health screenings, community health fairs, and vaccinations. These can help you maintain good health and avoid costly issues down the road.
2. Choose the Right Health Plan
   Evaluate your health needs – and those of your family – to select a plan that fits best. A well-matched plan can significantly reduce your overall healthcare costs.
3. Utilize a Health Savings Account (HSA)
   If eligible, contribute to an HSA. These accounts allow you to save pre-tax dollars, which grow tax-free and can be used for qualified medical expenses. It’s a smart way to prepare for future healthcare costs.
4. Stay Within Your Network
   Using in-network providers typically costs less. If you go out-of-network, be prepared for higher out-of-pocket expenses.

Paying for healthcare is already expensive, but with careful planning, you can take steps to reduce costs. Be sure to read your policies thoroughly to ensure they cover what you need and fit your budget. The changes mentioned above can significantly impact your financial planning, so stay informed and prepare in advance.

For more information on this and other financial topics, feel free to email me at charlestienharris77@gmail.com or write to me at P.O. Box 1825, Clarksdale, MS 38614.

Until next week – stay financially fit!

Charlestien Harris is our financial contributor, a retired financial expert with Southern Bancorp Community Partners.