Healthcare Costs Continue to Drive Insurance Premium Increases
September 10th, 2026
Researchers found that healthcare spending attributes to approximately 91% of the increase in average premiums between 2011 and 2024. The findings imply that the cost of medical care—including healthcare goods and services—remains a primary factor that is influencing what individuals pay for health coverage. During the time period studied, average insurance premiums increased 78.4%, while healthcare spending increased 84.2%.
This study evaluated privately insured coverage across large-group employer plans, small-group plans, and individual health insurance exchanges—including the ACA Marketplace. They found the same broad relationship across markets: increases in the underlying cost of healthcare are a major driver of premium increases.
The affordability of health insurance is influenced by more than the price of the insurance policy itself. Rising hospital, physician, prescription drug, and other healthcare costs ultimately contribute to higher premiums. When financial assistance is decreased at the same time, consumers can feel the impact directly.
Consumers should carefully review their coverage options, availability of premium tax credits, provider networks, deductibles, and total potential out-of-pocket costs when selecting a health plan. As a broker I help individuals compare these options during the Open Enrollment period from Nov 1 - Dec 15, or during the year under special life change circumstances. Please feel free to reach out if you have questions or to discuss your individual Marketplace options.
Source: Fierce Healthcare — "Increases in healthcare spending largest driver behind premium growth: Yale study", Paige Minemyer, published September 9, 2026.
Important Disclaimer: This article is for general educational and informational purposes only and is not insurance, Medicare, financial, tax, or legal advice. Medicare plan benefits, costs, coverage, and availability may change and vary by plan, location, and individual circumstances. This information is not a guarantee of future plan costs or benefits. Always review your current plan materials, including your Annual Notice of Change (ANOC), and verify current information before making enrollment or coverage decisions.
Medicare and GLP-1 Weight-Loss Drugs: What Beneficiaries Need to Know in 2026
August 18th, 2026
Highlights in this article surround the federal government's efforts to make GLP-1 medications—such as Wegovy, Zepbound, Ozempic, and others—more available to people with Medicare and Medicaid, distinctly when they're being used to treat obesity.
The key differences:
- Medicare: A new temporary program, the Medicare GLP-1 Bridge, began July 1, 2026 and has been extended through December 31, 2027.
- Medicaid: The BALANCE Model is moving forward, with participating states able to expand coverage for GLP-1s used for obesity.
- Medicare BALANCE: CMS has indefinitely delayed implementing BALANCE for Medicare Part D because not enough Part D insurers were willing to participate.
The BALANCE Model was originally planned to begin in Medicare in 2027. It would have negotiated lower GLP-1 prices and widened coverage for obesity, while also providing lifestyle-support programs.
However, CMS announced in April 2026 that it would not be implementing BALANCE in Medicare in 2027 because there was not enough participation received from Medicare Part D insurers. Therefore, CMS lengthened the GLP-1 Bridge program to continue through 2027.
It is important for Beneficiaries to know that Medicare is not permanently covering weight-loss drugs. Rather, Medicare has created a temporary pathway through the end of 2027, while the longer-term BALANCE approach for Medicare has been put on hold. KFF recognizes 2028 and beyond as the major uncertainty for beneficiaries who become highly dependent on the Bridge program for obesity treatment.
Do you have questions about how these changes may affect your Medicare coverage? As a Medicare broker, I can help you understand your options, compare plans, and determine what will work best for your individual needs and budget. Please feel free to reach out to discuss your Medicare options.
Source: Kaiser Family Foundation (KFF) — “What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge,” Meredith Freed, Juliette Cubanski, and Elizabeth Williams, published May 11, 2026.
Important Disclaimer: This article is for general educational and informational purposes only and is not insurance, Medicare, financial, tax, or legal advice. Medicare plan benefits, costs, coverage, and availability may change and vary by plan, location, and individual circumstances. This information is not a guarantee of future plan costs or benefits. Always review your current plan materials, including your Annual Notice of Change (ANOC), and verify current information before making enrollment or coverage decisions.
Medicare Part D Changes Could Make Reviewing Your Coverage More Important Than Ever
August 4th, 2026
The Centers for Medicare & Medicaid Services (CMS) is ending temporary subsidies that helped steady premiums for many stand-alone Medicare Part D prescription drug plans. As these subsidies come to an end, some Medicare beneficiaries could see higher monthly premium costs or other changes to their prescription drug coverage in the upcoming 2027 plan year.
While this may not affect everyone, it could be vital for a vast majority of beneficiaries who have stand alone Medicare Part D plans. Premiums, deductibles, copays, covered medications (formularies), and pharmacy networks may all be different when the next plan year begins.
Reviewing your coverage during Medicare's Annual Enrollment Period (AEP), which runs from October 15 through December 7, is so important. Even if you're happy with your current plan, comparing your options each year can help you be prepared, and to know you are receiving the coverage that best fits your healthcare needs and overall budget.
As an independent Medicare broker, I help beneficiaries compare their available plan options at no additional cost. Together, we can review your prescriptions, pharmacies, and healthcare needs to decide whether your current coverage is still the best fit.
If you'd like to schedule a Medicare plan review before or during AEP, feel free to reach out. By completing an annual review, you can have peace of mind and it may help you avoid unexpected costs in the year ahead.
Source: Kaiser Family Foundation (KFF) — "CMS's Decision to End Temporary Subsidies to Medicare's Stand-Alone Drug Plans Could Mean Larger Premium Increases for Some Beneficiaries Next Year", Juliette Cubanski, published July 29, 2026.
Important Disclaimer: This article is for general educational and informational purposes only and is not insurance, Medicare, financial, tax, or legal advice. Medicare plan benefits, costs, coverage, and availability may change and vary by plan, location, and individual circumstances. This information is not a guarantee of future plan costs or benefits. Always review your current plan materials, including your Annual Notice of Change (ANOC), and verify current information before making enrollment or coverage decisions.