New Update: Healthcare Costs Increasing by Over 60% in Some States. Will you be impacted?

Humana Retirees Face ACA Premium Shock—Here’s How Others Are Responding

Healthcare Provider Update: Humana is one of the largest health insurance companies in the United States, primarily offering a range of Medicare Advantage plans, individual and family health insurance, and group health plans for employers. As we look towards 2026, healthcare costs are expected to rise significantly, with many experts forecasting increases in health insurance premiums across various states. For Humana, the pressure stems from a confluence of factors including the anticipated expiration of enhanced federal premium subsidies under the Affordable Care Act (ACA) and rising medical costs. The Kaiser Family Foundation projects that without renewed subsidies, a staggering 92% of ACA policyholders could face premium hikes of over 75%, making 2026 one of the most challenging years for consumers navigating their healthcare finances. Factors like escalating hospital and drug costs, aggressive rate increases by insurers, and overall economic conditions contribute to this inflationary trend. Click here to learn more

'Humana employees approaching retirement should recognize that proactive income and health care planning can make the difference between preserving subsidy eligibility and facing sharply higher ACA premiums.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'Humana employees planning their retirement should consider how income levels influence ACA subsidies, as even small adjustments in taxable withdrawals can affect future health care affordability.' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

How the expiration of enhanced ACA subsidies after 2025 could impact health care costs for retirees and early retirees.
Real-life case studies illustrating how different individuals are adjusting to rising ACA premiums.
Practical steps Humana professionals can take before enrolling in 2026 Marketplace plans.

by Brent Wolf, CFP®, Wealth Enhancement

As open enrollment for 2026 Marketplace plans begins, many households are seeing dramatic shifts in their renewal letters. Rising base premiums and the possible end of enhanced subsidies after 2025 could mean significantly higher out-of-pocket costs for anyone purchasing coverage through the Affordable Care Act (ACA) exchange.

The Kaiser Family Foundation (KFF) estimates that if Congress does not extend enhanced premium tax credits, average net premium payments could more than double in 2026. ¹

“It feels like a second mortgage to pay this premium.”

Profile: A couple in their early 60s who retired a few years before becoming Medicare-eligible.

What changed: Their ACA premium had been manageable due to increased subsidies. Their renewal now indicates a rise of about $1,000 to $1,200 monthly if enhanced credits expire.

Decision pressure: They faced hard choices—drawing more taxable income from IRAs, going without coverage, or returning to the workforce for employer-based insurance.

Our response: We reworked their income plan to align with the ACA’s income-based subsidy structure. By controlling their Modified Adjusted Gross Income (MAGI) through smaller IRA withdrawals, use of cash reserves, and partial Roth conversions, we kept them eligible for key subsidies. Comparing a Bronze high-deductible plan with a health savings account (HSA) to a Silver plan revealed the Silver plan—thanks to cost-sharing reductions—was more economical given their expected medical treatments.

“I can’t risk losing coverage while battling an illness.”

Profile: A single client in her early 60s undergoing ongoing medical treatment.

What changed: Without enhanced subsidies, her premiums nearly tripled.

Decision pressure: Balancing affordability with the need to keep her care team and prescriptions consistent.

Our response: We prioritized staying with her provider network and controlling her out-of-pocket costs. A dedicated “medical reserve” fund—equal to one year’s maximum out-of-pocket limit—gave her a cushion without liquidating investments during market declines. We also worked with her physicians to identify lower-cost prescriptions through her plan’s formulary.

“The new premiums are hurting our business margins.”

Profile: A self-employed couple—one partner managing asthma and the other a cardiac rhythm condition.

What changed: Without subsidies, their net premiums are expected to rise sharply.

Decision pressure: Continue paying high premiums, choose a plan with a very high deductible, or seek W-2 employment for benefits.

Our response: We compared total annual costs for a Silver plan versus a Bronze option, factoring in frequent specialist visits and prescriptions. Once total medical costs were considered, the Silver plan proved more cost-effective. We also aligned their life and disability coverage and tailored their tax approach to reflect potential changes in premium tax credits.

“I’m young and healthy—do I even need full coverage?”

Profile: An independent contractor in their 20s with minimal expected medical use.

What changed: Premiums for mid- and high-tier plans nearly quadrupled.

Decision pressure: Choosing between a high-deductible Bronze HSA plan and catastrophic coverage.

Our response: We modeled three options—a Bronze HSA-eligible plan, a mid-tier plan, and catastrophic coverage. The Bronze HSA option offered the best mix of lower premiums and long-term tax benefits. Monthly automated HSA contributions build a future medical fund that can later be used for qualified health care expenses or Medicare premiums (excluding Medigap) after age 65.

Five Steps to Take Before You Enroll

1. Evaluate your total annual cost, not just the premium. Factor in deductibles, copays, and the possibility of reaching your out-of-pocket maximum.

2. Manage your MAGI carefully. ACA subsidies depend on income. Coordinate Roth conversions, capital gains, and IRA withdrawals strategically.

3. Verify your doctor and prescription coverage. Always confirm your plan’s provider network and formulary before enrolling.

4. Maintain a medical reserve fund. Hold six to 12 months of premiums plus a portion of your maximum out-of-pocket in cash or short-term Treasuries.

5. Finalize your plan by December 15. Open Enrollment for 2026 coverage ends on December 15, with plans effective January 1.

If Affordability Is a Concern

Choosing to go without insurance can expose you to serious financial strain in case of illness or accident. Consider the most affordable Bronze plan that still meets ACA minimum coverage requirements. If your income decreases during the year, you may become eligible for Medicaid or CHIP and qualify for a Special Enrollment Period. ²

How The Retirement Group Supports Humana Professionals

For Humana employees approaching or already in retirement, the intersection of rising health care costs and income planning can be complex. The Retirement Group focuses on helping clients navigate ACA subsidy rules, tax-efficient withdrawal strategies, and health care cost planning during retirement transitions.

To speak with an advisor about aligning your retirement income and health care planning, call (800) 900-5867 today.

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Sources:

1. Cox, Cynthia, et al. “ACA Marketplace Premium Payments Would More Than Double on Average Next Year if Enhanced Premium Tax Credits Expire.” Kaiser Family Foundation (KFF) , 2025, pp. n.p., https://www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire/ .
2. Centers for Medicare & Medicaid Services. ' Understanding Special Enrollment Periods. ' June 2025.
Other resources:
1. “When Can You Get Health Insurance? | Dates & Deadlines.” HealthCare.gov , U.S. Centers for Medicare & Medicaid Services, n.d., https://www.healthcare.gov/quick-guide/dates-and-deadlines/ .
2. Publication 969: Health Savings Accounts and Other Tax-Favoured Health Plans. Internal Revenue Service, 2024, pp. 8–9, https://www.irs.gov/pub/irs-pdf/p969.pdf .
3. “Silver vs. Bronze Plan Selection: Cost-Comparison Scenarios.” Centers for Medicare & Medicaid Services (CMS) , 23 Dec. 2024, pp. 1–3, https://www.cms.gov/files/document/silver-vs-bronze-cost-comparison-scenario-resource.pdf .
4. Murphy, Tom. “Expect Health Insurance Prices to Rise Next Year, Brokers Say.” AP News , Associated Press, 24 Aug. 2025, https://apnews.com/article/health-insurance-drug-costs-2026-rates-c4d865ec09c7088ecc6b55dc520f3566 .

What is the purpose of Humana's 401(k) Savings Plan?

The purpose of Humana's 401(k) Savings Plan is to help employees save for retirement by allowing them to contribute a portion of their salary to a tax-advantaged account.

How can employees enroll in Humana's 401(k) Savings Plan?

Employees can enroll in Humana's 401(k) Savings Plan through the company’s benefits portal during the open enrollment period or within 30 days of their hire date.

Does Humana offer a matching contribution for its 401(k) Savings Plan?

Yes, Humana provides a matching contribution to the 401(k) Savings Plan, which helps employees boost their retirement savings.

What types of investment options are available in Humana's 401(k) Savings Plan?

Humana's 401(k) Savings Plan offers a variety of investment options, including mutual funds, target-date funds, and other investment vehicles tailored to different risk tolerances.

Can employees change their contribution percentage in Humana's 401(k) Savings Plan?

Yes, employees can change their contribution percentage at any time through Humana’s benefits portal.

What is the minimum contribution required to participate in Humana's 401(k) Savings Plan?

The minimum contribution required to participate in Humana's 401(k) Savings Plan is typically set at 1% of an employee’s salary, but employees can choose to contribute more.

When can employees access their funds in Humana's 401(k) Savings Plan?

Employees can access their funds in Humana's 401(k) Savings Plan upon reaching retirement age, or in cases of financial hardship, as defined by the plan.

Are there any fees associated with Humana's 401(k) Savings Plan?

Yes, there may be administrative fees and investment-related fees associated with Humana's 401(k) Savings Plan, which are outlined in the plan documents.

How does Humana educate employees about the 401(k) Savings Plan?

Humana provides educational resources, including workshops, webinars, and one-on-one consultations, to help employees understand and maximize their 401(k) Savings Plan benefits.

Can employees roll over funds from another retirement account into Humana's 401(k) Savings Plan?

Yes, employees can roll over funds from other qualified retirement accounts into Humana's 401(k) Savings Plan.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.

Humana provides a defined benefit pension plan and a 401(k) plan with company match.

Humana grants RSUs to its executives and certain employees. RSUs vest over several years, aligning employee interests with the company's long-term goals.