Understanding Your New Health Insurance Plan and Benefits

Did you get a new health insurance plan for 2026? Or did your current health plan change in terms of covered benefits or costs?

Either way, below we tried to make it easier for you to understand your new health insurance plan or benefits.

New Health Insurance Plan? What to Know.

If you got a new health insurance plan for this year, the biggest things to know are:

1.      What your monthly premium will be to keep the plan

2.      What your annual deductible is

3.      What benefits are covered and what are not

4.      What providers are in network vs out, and if you need to do some research to find new ones (or budget to pay existing ones out of pocket)

5.      If there are any rules or limitations on specific services that will determine how much or how little is covered

If Your Health Insurance Benefits Changed

Most health plans change covered services every year. It’s important to read your plan’s coverage policy very carefully before using it. When reviewing a plan who has changed its benefits, be careful to note the following:

• What services are no longer covered.

• What new services have been added.

• How cost coverage has changed for services. For example, if your plan used to cover 100% of preventive screenings but now only covers 80% you’ll want to know that. This is the most important thing to review because it will determine how much your plan will actually pay for, and when, and when you will be mostly or completely responsible for a service.

• If your provider networks have changed

• Conditions for specific services that will determine how much or how little is covered.

 If Your Health Insurance Costs Changed

Unfortunately, many are facing large increases in healthcare costs this year with 20-30% increases in premiums alone. We know this can feel stressful, so if your healthcare costs have changed, here’s what we recommend doing:

1.      Review your healthcare budget and try to adjust for new premiums and copays as best you can

2.      Verify providers are in-network before going to appointments

3.      Use HSA and FSA fund where possible to help offload out-of-pocket costs

4.      Explore options like a Care credit card that may help alleviate upfront large costs and make them easier to pay over a set period with little to no interest

 If You Changed to Medicare or a New Medicare Plan

If this is your first year using Medicare, it can feel overwhelming at first. The key parts—Medicare Part A (hospital insurance) and Part B (medical insurance) —are what will be used the most, along with a Part D prescription drug plan if you have one of those too.

If you just got Medicare or changed to a new Medicare plan, the fastest way to make sense of your coverage is to do the following:

1.      Review any packets of information you’ve been sent, and use Medicare.gov to review 2026 covered benefits for Parts A and B

2.      Carefully review premiums and other costs to adjust any healthcare budgeting for the year

3.      Review what’s not covered for 2026 and adjust any budgeting or health needs accordingly

4.      Double-check that your healthcare provider accepts Medicare or Medicare Advantage, and if no, find an in-network provider in your area to avoid paying additional costs

For example, Family Medicine Associates of Texas ONLY accepts traditional Medicare. We do not accept any Medicare Advantage plans.

 Need Help with Your Insurance Plan?

If you are not sure if we accept your health insurance plan or what basic coverage you need based on your health, we’re happy to help. Give us a call at 972-394-8844 or contact us online here. Ask to speak to a billing team member who will answer the questions you might have.