Open enrollment increases for 2026

[Burhead]

My company is switching from Meritan health/Aetna to Highmark

Plan on I'm on now:
2025 Aetna PPO - $268.74 ($722.22 for family)
2026 Highmark PPO - $295.61 ($924.44 family)
2026 Highmark PPO HPN (In-network only, certain zip codes) - $266.05 ($839.50 family)

2025 CDHPs (Aenta)
3500 - $75 ($488.58 family)
2000 - $175.03 ($627.11 family)

Highmark CDHPs (Both plans deductibles increased by $250 & OOPM by $500)
3750 - $72.62 ($548.05 family) ($3750 deductible/$7500 OOPM, 30% co-insurance after deductible)
2250 - $169.46 ($682.16 family)
2250 HPN - $152.51 ($621.44 family) ($2250 deductible/$4500 OOPM/20% co-insurance after deductible)

Dental and vision premiums are staying the same $6.60 ($18.86 family) for vision. $20.48 ($73.19 for family) or $32.14 ($117.36 family) for dental depending on the plan selection.

I won't know until Nov 3rd if I'm eligible for the in-network only plans.

PPO
Preventive - 100% (Same)
Deductible - $1,000 (Staying same)
Coinsurance - 25% after deductible (same)
Out of Pocket Max - $3,500 (Same)
Telemed through Cirrus - $0 copay (New, was $40 on Aenta)
Doc Visit - $40 copay (same)
Specialist - $50 copay (same)
Emergency Room - $400 copay waived if admitted (Same)
Urgent care - $50 (same)

Prescription through Express Scripts (same)
Generic - $10 (retail) - $25 (mail)
Preferred - $50 (retail) - $125 (mail)
Non-preferred - $75 (retail) - $200 (mail)
Specialty - $150

Some operations (bariatric, hip/knee surgery, spinal, or CAR T-cell therapy) must be performed now through Carrum Health with Highmark and its covered 100% no deductible. All other operations are optional through Carrum Health but Highmark won't cover 100% of the cost, it goes to cost sharing after I meet the deductible.

They also stopped the company contribution to HSAs this year.

All this is for single person. Honestly I don't know what I'm going to do. I'm actually thinking about just dropping it altogether only way I'd keep it is if I can get the in-network only PPO plan. I'm 33 and never go to the doctor and I'm not any prescriptions so I'm giving away free money. I'm worth more with the life insurance honestly haha plus insurance is a scam anyways.

 

[McDad]

My company is switching from Meritan health/Aetna to Highmark

Plan on I'm on now:
2025 Aetna PPO - $268.74 ($722.22 for family)
2026 Highmark PPO - $295.61 ($924.44 family)
2026 Highmark PPO HPN (In-network only, certain zip codes) - $266.05 ($839.50 family)

2025 CDHPs (Aenta)
3500 - $75 ($488.58 family)
2000 - $175.03 ($627.11 family)

Highmark CDHPs (Both plans deductibles increased by $250 & OOPM by $500)
3750 - $72.62 ($548.05 family) ($3750 deductible/$7500 OOPM, 30% co-insurance after deductible)
2250 - $169.46 ($682.16 family)
2250 HPN - $152.51 ($621.44 family) ($2250 deductible/$4500 OOPM/20% co-insurance after deductible)

Dental and vision premiums are staying the same $6.60 ($18.86 family) for vision. $20.48 ($73.19 for family) or $32.14 ($117.36 family) for dental depending on the plan selection.

I won't know until Nov 3rd if I'm eligible for the in-network only plans.

PPO
Preventive - 100% (Same)
Deductible - $1,000 (Staying same)
Coinsurance - 25% after deductible (same)
Out of Pocket Max - $3,500 (Same)
Telemed through Cirrus - $0 copay (New, was $40 on Aenta)
Doc Visit - $40 copay (same)
Specialist - $50 copay (same)
Emergency Room - $400 copay waived if admitted (Same)
Urgent care - $50 (same)

Prescription through Express Scripts (same)
Generic - $10 (retail) - $25 (mail)
Preferred - $50 (retail) - $125 (mail)
Non-preferred - $75 (retail) - $200 (mail)
Specialty - $150

Some operations (bariatric, hip/knee surgery, spinal, or CAR T-cell therapy) must be performed now through Carrum Health with Highmark and its covered 100% no deductible. All other operations are optional through Carrum Health but Highmark won't cover 100% of the cost, it goes to cost sharing after I meet the deductible.

They also stopped the company contribution to HSAs this year.

All this is for single person. Honestly I don't know what I'm going to do. I'm actually thinking about just dropping it altogether only way I'd keep it is if I can get the in-network only PPO plan. I'm 33 and never go to the doctor and I'm not any prescriptions so I'm giving away free money. I'm worth more with the life insurance honestly haha plus insurance is a scam anyways.

If you go without, I'd recommend a "catastrophic plan" if they're still available .

 

[Burhead]

If you go without, I'd recommend a "catastrophic plan" if they're still available .

I’ll have to look into that maybe. I don’t know it gets depressing seeing how everything keeps going up. I don’t know how people are making it.

 

[BigOrangeMojo]

Find a catastropic plan and pop the savings towards a larger emergency fund that will cover the out of pocket max....

 

[McDad]

I’ll have to look into that maybe. I don’t know it gets depressing seeing how everything keeps going up. I don’t know how people are making it.

Do you have an HSA option through work?

 

[Burhead]

Do you have an HSA option through work?

Only if I enroll in one of the high deductible plans. They had been offering company match but for 2026 they are stopping that.

 

[BigOrangeMojo]

You might not do any better than the 3K CDHP. Especially if you have a HSA option.

If possible, try to max out HSA.....

 

[Burhead]

You might not do any better than the 3K CDHP. Especially if you have a HSA option.

If possible, try to max out HSA.....

I’ve never really looked into one before but I might this year. Appreciate the advice.

 

[MHS Rebel]

Dang. I'm on Medicare.
It's $185 for Part B and that is paid by a retirement Stipend.
My Plan G Medigap is $146. All co-pays are minimal like 20/30.
Annual physical (Medicare mandate) is free
Dental and Eye is $70 combined.
Prescription Part D is $0 - (yes zero) After ~2500 rest of year is 0 deductible. We have paid zero for drugs since about June.
Long Term Care is $45/mo
In total, I am paying out of pocket about 1/3 of what Ins was when I was working.
Same for wife.

Medical - United Healthcare
Dental - Delta
Prescription - Wellcare
Eye - VSP
LTD - NY Life.

 

[NorthDallas40]

Only if I enroll in one of the high deductible plans. They had been offering company match but for 2026 they are stopping that.

Even without company match your HSA contributions are tax deductible and if you go with the catastrophic plan you’ll need the reserve cash if you need care

 

[BigOrangeMojo]

HSA has triple tax benefits. What you contribute is pretax, it grows tax free, and any withdrawals are tax free if used for medical expenses....

 

[K-town Vol Fan]

My company is switching from Meritan health/Aetna to Highmark

Plan on I'm on now:
2025 Aetna PPO - $268.74 ($722.22 for family)
2026 Highmark PPO - $295.61 ($924.44 family)
2026 Highmark PPO HPN (In-network only, certain zip codes) - $266.05 ($839.50 family)

2025 CDHPs (Aenta)
3500 - $75 ($488.58 family)
2000 - $175.03 ($627.11 family)

Highmark CDHPs (Both plans deductibles increased by $250 & OOPM by $500)
3750 - $72.62 ($548.05 family) ($3750 deductible/$7500 OOPM, 30% co-insurance after deductible)
2250 - $169.46 ($682.16 family)
2250 HPN - $152.51 ($621.44 family) ($2250 deductible/$4500 OOPM/20% co-insurance after deductible)

Dental and vision premiums are staying the same $6.60 ($18.86 family) for vision. $20.48 ($73.19 for family) or $32.14 ($117.36 family) for dental depending on the plan selection.

I won't know until Nov 3rd if I'm eligible for the in-network only plans.

PPO
Preventive - 100% (Same)
Deductible - $1,000 (Staying same)
Coinsurance - 25% after deductible (same)
Out of Pocket Max - $3,500 (Same)
Telemed through Cirrus - $0 copay (New, was $40 on Aenta)
Doc Visit - $40 copay (same)
Specialist - $50 copay (same)
Emergency Room - $400 copay waived if admitted (Same)
Urgent care - $50 (same)

Prescription through Express Scripts (same)
Generic - $10 (retail) - $25 (mail)
Preferred - $50 (retail) - $125 (mail)
Non-preferred - $75 (retail) - $200 (mail)
Specialty - $150

Some operations (bariatric, hip/knee surgery, spinal, or CAR T-cell therapy) must be performed now through Carrum Health with Highmark and its covered 100% no deductible. All other operations are optional through Carrum Health but Highmark won't cover 100% of the cost, it goes to cost sharing after I meet the deductible.

They also stopped the company contribution to HSAs this year.

All this is for single person. Honestly I don't know what I'm going to do. I'm actually thinking about just dropping it altogether only way I'd keep it is if I can get the in-network only PPO plan. I'm 33 and never go to the doctor and I'm not any prescriptions so I'm giving away free money. I'm worth more with the life insurance honestly haha plus insurance is a scam anyways.

What sucks even more is even after paying all these insane premiums if something does happen and you end up needing surgery or a few nights stay in the hospital you are going to owe thousands upon thousands of dollars. It's totally a scam. Idk why Americans just go along with this system and scoff at universal.

 

[McDad]

What sucks even more is even after paying all these insane premiums if something does happen and you end up needing surgery or a few nights stay in the hospital you are going to owe thousands upon thousands of dollars. It's totally a scam. Idk why Americans just go along with this system and scoff at universal.

I scoff because we are 37T in debt.

 

[BigOrangeMojo]

What sucks even more is even after paying all these insane premiums if something does happen and you end up needing surgery or a few nights stay in the hospital you are going to owe thousands upon thousands of dollars. It's totally a scam. Idk why Americans just go along with this system and scoff at universal.

If govt could prove they could do anything this size reasonably well, then sure.

Look at social security as an example and get back to me why you think universal wouldnt be a bigger clusterF than SS....

 

[BeardedVol]

I scoff because we are 37T in debt.

Good thing Republicans are using all those Doge cuts to pay down the deficit on your behalf.

When they cut the ACA subsidies at the end of the year, I'm sure those will also go to paying down the debt as well.

 

[McDad]

Good thing Republicans are using all those Doge cuts to pay down the deficit on your behalf.

When they cut the ACA subsidies at the end of the year, I'm sure those will also go to paying down the debt as well.

I know. They're almost as insincere as the Ds.

Non partisans understand this.

 

[volfanhill]

I scoff because we are 37T in debt.

 

[BeardedVol]

I know. They're almost as insincere as the Ds.

Non partisans understand this.

Maybe Trump will roll out another version of the EMTALA and not fund it either just like Reagan.

That way future generations can continue to enjoy even more Republican unfunded healthcare legislation that costs us more than a single-payer system.

 

[K-town Vol Fan]

I scoff because we are 37T in debt.

And....?

 

[McDad]

Maybe Trump will roll out another version of the EMTALA and not fund it either just like Reagan.

That way future generations can continue to enjoy even more Republican unfunded healthcare legislation that costs us more than a single-payer system.

Maybe so. I hope you're around to keep us up to speed.

 

[LadyVolette]

Well, if we wouldn’t have passed Obamacare or at least repealed it, we would all be better off.. but it could be worse.. mine is 1500 a month through work, high deductible-5000 k deductible.. same as it was two years ago.. and I am in healthcare.. fam of four… we took my husband’s 5000 deductible, 1000 a month.. Cigna, it went up last year 200 a month, same coverage ... it’s all sh!tty

 

[McDad]

And....?

And what? To me 37T in debt is self explanatory.

 

[BigOrangeMojo]

And what? To me 37T in debt is self explanatory.

The same entity that has made SS potentially insolvent and has amassed 37T in debt should be in charge of healthcare.....

Makes perfect sense to me

 

[GordonC]

Maybe so. I hope you're around to keep us up to speed.

yeah but wen his googler breaks he'll have nuffin

 

[BeardedVol]

Maybe so. I hope you're around to keep us up to speed.

I hope you're around to pretend to be non-partisan while you enjoy it with me.