With the year ending, it is an important time to review your current and future employer-based health insurance coverage to see how your financial responsibilities might be changing in 2026.
You also may want to use the review to potentially adjust your healthcare by ensuring you get as much care as possible done in 2025 or by delaying care until after the new year, depending on whether and how your coverage is changing.
Shawn Stack, a policy director for the Healthcare Financial Management Association, provided a checklist of suggested details to review, comparing this year’s coverage to next year’s.
Do any of the following change?
- Covered services
- Covered medications
- Premiums
- Deductibles
- Co-pays
- Out-of-pocket maximums
- Network status of your preferred physicians and other care providers
Also, provide your new insurance information to your providers so that there are no mix-ups about your coverage.
If you’re considering waiting until January before getting planned care, make sure you take a look at how changes could affect payment.
“Most health plans reset deductibles, co-pays, and out-of-pocket maximums with the beginning of that new benefit year. So, if you delay until next year, be prepared for those costs to start over,” Stack said.
And in the case where you have hit your deductible or maximum out-of-pocket for the current year, that means you likely will be better off getting any needed care before Jan. 1, capturing that guaranteed benefit.
“On the other hand, if your new plan, the plan that you’re going into, is less expensive and has better coverage, wait until after Jan. 1 to minimize your out-of-pocket expenses under your new plan,” Stack said. “But keep in mind that [you should] talk to your physician and make sure delaying that care is not detrimental to your health.”