As we enter a new year, changes to insurance benefits, copay amounts, and deductible resets may affect your healthcare coverage. Here’s what to expect when your plan updates on January 1, 2026.
What is an insurance renewal?
Each year, insurance companies adjust their rates and coverage options, giving you the chance to renew your current plan or choose a new one. These updates reflect factors such as inflation, new medications, and other market changes. Annual renewals are also a good opportunity to reassess your healthcare needs and ensure your plan aligns with your goals.
If you had health insurance this past year, you likely participated in an “open enrollment” period in the fall. During this time, you reviewed any changes to your plan and confirmed which benefits would continue. You then had the choice to renew your current plan for another year or switch to a different option.
Why are insurance renewals important right now?
Most health insurance plans operate on a calendar year, so any changes take effect on January 1. Reviewing your plan updates now helps you avoid surprises and ensures you’re prepared for the year ahead.
Which insurance updates might impact me the most?
As you go through your yearly changes, keep an eye on the following factors—they could significantly affect your healthcare budget.
Your monthly premium
Your premium is the monthly cost of your health insurance plan. Premiums can change slightly from year to year, so double-check whether yours is increasing for the coming year.
Your copays and deductible
Your deductible is the amount you pay for healthcare services before your insurance provider begins covering the costs. For example, if your deductible is $2,500, you’ll need to pay that amount out of pocket before your copays take effect. Some plans have a combined deductible that covers both medical and prescription costs, while others have separate deductibles for each.
Most deductibles reset at the start of the year, which may increase your healthcare expenses until your deductible is met. It’s wise to plan your budget accordingly for this period.
Your copays and coinsurance—the amounts you pay for services after your deductible is met—may also change. Different types of services can have different copays, so be sure to review those you anticipate using the most.
Formulary changes
A formulary is a list of generic and brand-name medications covered by your insurance plan. It also includes tiers that indicate which versions are preferred by your insurer, often resulting in lower out-of-pocket costs for you.
If you’re currently taking prescription medications, confirm that your plan still covers them—especially branded drugs. You may also want to ask your healthcare provider if a more affordable version is available. If you fill your prescriptions with Alto, we can review cost-saving options for you and alert you to any alternatives that could lower your expenses.
For more information on common insurance terms, check out this helpful glossary from JDRF.
What can I do if my medications are more expensive?
Navigating insurance updates can be confusing, especially if your medication costs increase. If copay changes or deductible resets affect your out-of-pocket expenses, Alto will explore any available savings options to help make your medication as affordable as possible.
If your insurance plan requires a written request from your doctor to keep you on the same medication due to formulary tier changes, we’ll coordinate the process with your doctor and keep you informed every step of the way.
Read more about prior authorizations.
Is there good news?
Yes! Your updated insurance plan may include new benefits that save you money and support your health. Look for perks such as:
Free annual exams and preventative care
Discounts on fitness and nutrition programs, gym memberships, chiropractic care, and more
Savings on health and wellness products
Reduced rates for vision care
Many people overlook these extra benefits, which can lead to missed savings opportunities. Be sure to take full advantage of everything your plan offers.
The benefits of a better pharmacy
As you plan for the coming year, don’t forget the advantages of choosing a better pharmacy. With Alto, you get support with insurance and savings options, convenient courier delivery or nationwide shipping, and access to expert pharmacists seven days a week.
Have questions? Reach out any time through our secure in-app messaging or by phone at 1-800-874-5881.
This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
Editor’s Note: This post was originally published in January 2021 and has been updated for accuracy and completeness.
