Healthcare Options for 2026

What I’m learning as our health insurance costs triple... 😳

It’s open season for health insurance right now in the U.S., and it’s been… a ride. Both politically and personally. Caitlin and I have been deep in the weeds comparing ACA plans in our respective states (Colorado and Texas) to find something that fits our families. The cost for my family’s current plan has more than tripled (!!!), so we’ll be switching plans - but even the “cheaper” ones are still more than double what we’ve been paying.

We had a great discussion on this topic during last week’s Wealth Wednesday session (you can view the recording here), but since so many of you are still asking about health coverage options, I wanted to share a quick breakdown of what’s out there, including some creative ways people are trying to save money or fill the gaps.

It’s even possible to mix and match some of these, like getting a bare-bones catastrophic plan for U.S. emergencies while using medical tourism for planned procedures. It’s wild (and sad) that we have to think this way in the richest country in the world… but for now, we’re just doing the best we can with the system we’ve got.

Health Insurance Options:

• Employer-sponsored insurance plan: Coverage through your job, usually with your employer paying part of the premium.

  • Often have good networks and lower total costs than individual plans, but if you leave your job, your coverage typically goes with it.

  • COBRA may allow you to keep your current coverage for up to 18 or 36 months after leaving a job.

• Affordable Care Act (ACA): https://www.healthcare.gov

  • Must have income of at least 100% of the Federal Poverty Level (FPL) to qualify.

  • Government subsidies available for income <400% of the FPL.

  • Must accommodate pre-existing conditions.

  • All Bronze and Catastrophic plans are considered “High-Deductible Health Plans” (HDHP), and are eligible to pair with a Health Savings Account (HSA)

  • Catastrophic plans are available for individuals under age 30 and possibly for those over 30 who are above the 400% FPL cutoff (this is a new development!).

    
    

• Private Plans: https://finder.healthcare.gov/

  • May not accommodate existing conditions.

  • Can be a good option if you do not qualify for ACA or Medicaid.

• Medicaid: Low-income coverage that varies by state

  • States without expanded Medicaid (primarily in the southeast) may not cover individuals who do not have children or a disability – this leaves a coverage gap for individuals who do not make enough to qualify for ACA but also cannot get Medicaid.

    
    

• Medicare/Medicare Advantage: Individuals over age 65 (and some disabilities)

Healthcare Options that are Not Traditional Insurance:

(We always recommend going with traditional insurance if possible since medical costs are the leading cause of bankruptcy in the U.S., but here are some other options that may help when traditional coverage feels out of reach.)

• Health Sharing Ministries: Faith-based organizations where members contribute monthly to cover one another’s medical expenses. These are not insurance and are not regulated in the same way, meaning coverage is not guaranteed, but costs are often lower.

  
  

• Crowdfunding Health Share: https://www.joincrowdhealth.com/

  • Similar to the Health Sharing Ministries, but with a more secular, crowdfunding-based model.

    
    

• Global Healthcare Plan: International coverage options that typically require spending more than six months per year outside the U.S.

  • Usually significantly cheaper than U.S. health insurance.

    
    

• Medical Tourism: Traveling to other countries for medical procedures that cost a fraction of U.S. prices - especially common for dental, vision, and elective surgeries.

Other money-saving healthcare hacks:

So unfortunately we’re all trying to function in a very broken healthcare system. But while we wait (and hope) for larger reform, there are a few creative ways to save on care in the meantime. I’m not affiliated with any of these, but I’ve personally found them useful:

1) MDSave: This website allows you to compare prices of procedures from different providers. As an example, I ran MRIs in my city (Austin, TX) – that exact same procedure varies from $400 to $1000 based on the provider!

2) Dentalplans.com: This is not dental insurance, but it allows you to buy a ‘dental plan’ that qualifies you for the negotiated insurance rates. It seems weird (and is another good example of how broken the system is), but it can actually save you thousands on dental care and even braces.

3) UltaLab: This is one of my favorite hacks for lab work. Instead of going through the doctor’s office and getting billed at inflated “insurance rates,” you can order your own tests online, pay upfront, and go to a local lab for a fraction of the cost. Many basic blood panels cost $25–$30 instead of $100+.

4) GoodRx: Even though we have prescription insurance through our ACA plan, we still use GoodRx for some of our drugs because the coupon price is cheaper than the insurance copay!  

If you’ve been feeling overwhelmed by rising costs or confusing options, you’re not alone. I’m right there with you, spreadsheet open and hot tea in hand, trying to make sense of it all. The system may be broken, but we can still take care of each other - by sharing what works, asking questions, and making thoughtful choices for ourselves and our families.

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