Updates to Medicare and Individual & Family health insurance for 2026
Happy Fall with nice fall colors and cool breeze. It’s our commitment to share with you some updates on Health Insurance. And please allow us to keep repeating “Do not let your policy auto-enroll" as well as do share the information as needed. Thank you.
MEDICARE
Annual Election Period (AEP) begins Oct.15 to Dec. 7 for Medicare and Part D. Most of the changes are associated with Medicare Advantage plans.
- The One Big Beautiful Bill has a new deduction for Seniors. From 2025 to 2028, if you are 65 (on before the last day of the taxable year) and older, you may claim an additional deduction of 6,000 or $12,000 for filing jointly in addition to the current standard deduction. Deduction phases out if you modified adjusted gross income over $75,000 or $150,000 for joint filers. Reference: IRS.gov.
- Medicare Advantage (MA)plan: Most plans have some changes. Please open your mail. By the first week of October, you should receive a Plan Annual Notice of Change (ANOC) from your insurance company. Please review it. Many plans are exited in several counties, and/or will have reduced benefits. Note, there are new plans that are expanded in new counties as well. It’s crucial to review your 2026 comparison plans.
- Medicare Supplement (Medigap) plan: Rates are increasing. If you are happy with the current plan, you don’t need to take any action. If you’d like to switch to a new company for a lower premium. You can use the Birthday rule, which is an opportunity to compare prices and apply for a new Medigap plan that starts 30 days before your birthday and ends 30 days after your birthday. If you’d like to switch to a Medicare Advantage Plan, you can use AEP, Oct. 15 to Dec. 7.
- Part D Prescription Drug plan: in 2026, the maximum out-of-pocket is $2,100. The M3P payment installation is available. Note, if you have a balance bill in 2025, you need to pay it off. Starting a new year doesn’t mean the amount you owe is being written off. If you have a stand-alone Prescription drug (with a Medicare supplement), please review the ANOC. Most companies reduce their plans. The deductible and formulary may be different from the 2025 benefits.
PLEASE NOTE
The changes have created financial pressure on insurance companies, so they will not pay compensation to agents or brokers for some MA and Part D plans.
Despite that, we commit to help you.
Individual & Family
Individual & Family: The Open Enrollment Period (OEP) is Nov. 1 to Dec. 15 for the effective date of 1/1/2026 and Dec. 16 to Jan. 15 for the effective date of 2/1/2026.
- The maximum out-of-pocket for 2026 plans has increased
- Expected premium increase
- Marketplace via Healthcare.gov:
- Make sure you have a username and a password for healthcare.gov
- Proof of income may be required at the time of submitting the application
- Most Bronze plans are Health Savings Account (HSA) - eligible
- Do not auto-enroll
- The Oregon Health Insurance Marketplace has awarded us to help people enroll in health insurance. Reference: Newsberg 08/12/2025
- This could be your last year to enroll via the Federal marketplace, as we are moving to a State-based marketplace in 2027
- Direct to the insurance company: There are more attractive plans being offered
- Preston Gullum: Most of you have phone conversations with Preston. He is a senior at GFU and carries high professional manners. We are pleased to announce that Preston is our newly licensed agent for Life and Health. We are confident that you will enjoy working with him. He will do a great job assisting you.
Preston Gullum
Small Group
Unlike other health insurance, it’s a year-round enrollment. A business needs to have at least one payroll employee to qualify for a small group. Premium is expected to be increased. To obtain a quote please contact us. We are doing more research on level-funded to offer your business as an alternative to traditional health insurance. Stay Tuned.
Health insurance is expensive, and you may think about opting out!!!
That is a fair thought. We agree! Having insurance helps you avoid financial burden. We’d also like to remind you of HB 3320, available for every Oregonian. You have the right and options to ask for financial assistance. The law requires non-profit hospitals to check if you are eligible for financial assistance when your medical costs are greater than $500.
Confused about Respiratory Virus Vaccines? Can you get it or not?
Yes, for every Oregonian even though there are conflicting messages from the federal government. What does this mean for people in Oregon who want a COVID-19 vaccine?
- The updated COVID-19 vaccine is available to everyone 6 months of age and older in Oregon. Pharmacies can vaccinate anyone 7 years and older.
- No prescription is required for the COVID-19 vaccine – either in pharmacies or in provider offices.
- Medicaid and Medicare and most commercial insurers will continue to cover the cost of the updated COVID-19 vaccines in Oregon.
- Learn more on
West Coast Health Alliance Frequently Asked Questions for the Public (PDF)
Thank you for reading to the end. It’s a lot. Let’s close it with why Every Day is a Sunny Day!
When we moved from Portland to Newberg in 1998. The home was built up on a hill on Hwy. 219. The east windows face the sunny blue skies with Mt. Hood and the forest as a background. In 2001, we searched for a business name. We are here in Chehalem land. Voila! Chehalem Insurance was born. Looking out the window with sunny skies gave us big smiles every day. We know in our hearts; we want to serve our clients and our community to have Every Day is a Sunny Day!