Same plan. Same deductible. Same doctors. Higher bill. Renewal increases are automatic, which is exactly why so many people pay them, and the letter is written to make accepting it feel like the only option. It is not.
A renewal is an offer, not an obligation. Privately underwritten PPO plans can generally be applied for any month of the year, which means you can shop this the week the letter arrives rather than waiting for an enrollment season that may be ten months away.
This is the exact sequence we run. No portal maze, no call-center roulette, no quote and vanish.
Sometimes it is only the premium. Sometimes the deductible moved, or the network narrowed, or a drug tier shifted. Carriers are not required to make that obvious. Find out what you are really being offered.
Your current carrier will not tell you that a different carrier is cheaper for your household. An independent licensed producer will, because we are not selling one company's product.
A cheaper premium that drops your specialist is not a saving. Before anything moves, we verify the physicians you actually use against the network on the plan you are considering.
Sometimes the honest answer is that your current plan is still the best thing available to you. That is a fine outcome. What is not fine is paying more every year without ever having checked.
A renewal increase usually has more than one cause, and they are not equally within your control. This separates the ones worth acting on from the ones worth understanding and accepting.
| The cause | Can you do anything about it? | What to do |
|---|---|---|
| The enhanced tax credits expired | Not directly, but your eligibility depends on your income, which you may have some control over. | Establish exactly where your projected income sits against 400% of the federal poverty level. Nationally the average premium paid after credits rose 58%, from $113 to $178 a month.[1] |
| Market-wide rate increases | No. This affects everyone in your rating area. | For 2026, insurers filed a median 18% increase across 312 filings, with about 40% seeking 20% or more.[3] Reshopping is the response, not appealing. |
| You got a year older | No. | Age is a filed rating factor. It moves every year and there is nothing to be done about it. |
| Your income changed | Yes, and this is the big one. | Crossing 400% of the poverty level removes the credit entirely rather than reducing it. If you are near the line, retirement contributions and the self-employed health insurance deduction can move your modified AGI.[6] |
| You were auto-renewed | Yes. Absolutely. | Auto-renewal frequently rolls you into a plan that is no longer competitive in your area. Actively reshopping every year is the single most reliable saving available to you. |
| Your plan changed underneath you | Partly. | Deductibles and networks change at renewal even when the name of the plan does not. Average deductibles rose 37% to $3,786.[1] Read what actually changed before you compare premiums. |
| Where the real money usually is | Two places: getting the income projection right, and refusing to auto-renew. | Everything else on this list is either fixed or market-wide. These two are yours, and together they are worth more than any amount of complaining about the increase. |
This table describes how these options generally work, with regulatory points cited to the sources below. It is not a quote, it is not specific to any one company, and rules vary by state and by plan. Confirm the details against the actual plan documents and your own plan administrator.
The enhanced premium tax credits expired going into 2026. Whatever route you take, these are the conditions you are taking it in.
Households earning above 400% of the federal poverty level were roughly 7% of 2025 marketplace enrollment but nearly 48% of the decline going into 2026.[1] The band right at the edge, between 400% and 500% of poverty, lost 44% of its sign-ups — over 321,000 people.[1]
If your renewal increase felt disproportionate, that is very likely because you crossed or sit near that line. The credit does not taper there, it stops: $62,600 for one person and $128,600 for a family of four for 2026 coverage, moving to $63,840 and $132,000 for 2027.[4]
Three things. Confirm what actually changed in the plan rather than just the premium. Re-run the income projection for next year rather than reusing this year’s. Then compare the market properly instead of accepting the auto-renewal. That review is free and it takes about twenty minutes.
Premiums rise for reasons that have nothing to do with you specifically. Medical costs go up, the pool you are in gets more expensive, and the plan you bought three years ago is no longer the plan the carrier is actively competing on. Loyalty is not rewarded in this market. The people paying the least are almost always the ones who checked recently.
Where we quote a 30 to 50 percent saving, that is measured against an unsubsidized benchmark Silver or Gold marketplace plan for the same household, not against a number we picked because it sounds good. And the honest caveat that most agents leave out: if you qualify for a subsidy, a private plan will probably cost you more, and we will tell you that rather than take the sale.
One call. Licensed producer, not a call center. If your current plan is still the better deal, I will tell you that.
A captive agent has one company's shelf. An independent licensed producer compares across carriers and gets paid the same either way, which removes the reason to steer you. That is the whole structural argument, and it is why the comparison is worth having even in the years when the answer is stay where you are.
Nothing. There is no fee for the review, the comparison, or the enrollment. Carriers compensate licensed producers, so the conversation costs you your time and nothing else. If the review says your current plan is still the best option for your household, you will have spent twenty minutes and gained the only thing worth having here, which is knowing.
Figures and rules on this page last verified against the primary sources on August 13, 2026
Scotty Jaymes Insurance is a private, independent insurance agency. We are not affiliated with, endorsed by, or connected to any government agency, the federal Medicare or Medicaid programs, or any state or federal health insurance marketplace including Healthcare.gov. Regulatory summaries are general information, current as at the verification date shown, and are not legal or tax advice. Rules change and vary by state and by plan. Plan availability, benefits and pricing vary by state and by applicant.
Renewal increases are usually driven by rising medical costs, changes in the risk pool you are rated in, and the plan you hold no longer being the one the carrier competes on. It is rarely about you individually, which also means it is rarely something you have to accept.
Privately underwritten PPO plans can generally be applied for any month of the year, so yes in most cases. Marketplace plans typically require open enrollment or a qualifying life event. Which route applies depends on what you currently hold and what you are moving to.
Only if we check first, which we do before anything moves. The plans we place run nationwide PPO networks with no referral requirement, but no network includes every provider. Verifying your specific physicians is a step, not an assumption.
It depends entirely on your household, state, and health. Where we quote 30 to 50 percent, it is measured against an unsubsidized benchmark Silver or Gold marketplace plan for the same household. If you qualify for a subsidy, a private plan will probably cost you more, and we will say so.
No. There is no fee to you for the review, the comparison, or the enrollment. Carriers compensate licensed producers, so my time costs you nothing whether you move or stay.
Then that is what we will tell you. Staying put after an honest comparison is a legitimate result, and it is a better position than staying put because nobody ever ran the numbers.
Under-65 coverage only. We do not sell Medicare.