🧠 What 2026 Health-Insurance Changes Mean for Your Therapy Care
- WPA Therapy
- 5 hours ago
- 3 min read
At WPA Therapy, we believe knowledge is power — especially when it comes to your mental-health care. With significant health-insurance changes coming in 2026, we want to help you understand what’s happening, how it could affect your therapy, and what to ask when Open Enrollment begins November 1.
What’s Changing
Starting in 2026, several shifts in the health-insurance marketplace may affect patients — especially those buying coverage through Pennie (Pennsylvania’s Marketplace) or receiving federal subsidies.
Premiums are going up. Many insurers have filed requests for average increases of 18–20 percent for 2026.
Temporary subsidies may expire. The extra federal premium tax credits that lowered costs during the pandemic are set to end December 31, 2025 unless renewed by Congress.
If subsidies end, your monthly payment may jump. Without that financial help, some enrollees could see premiums rise by hundreds of dollars each month.
Plan details may shift. Changing networks or coverage levels could alter what’s covered, which providers are in-network, and how much you owe per visit.
What It Means for Your Therapy
If your plan changes or becomes more expensive, you may face decisions about coverage, costs, and care continuity. Here’s how it could affect your therapy:
Budget changes. Higher premiums or deductibles may require you to re-evaluate your healthcare budget.
Coverage verification. Always confirm your therapist and mental-health services remain in-network for 2026.
Potential care gaps. If you switch or lose coverage, there’s a risk of interrupted sessions. WPA Therapy will work with you to maintain consistency through insurance transitions or temporary self-pay arrangements.
Smart Questions to Ask During Open Enrollment
When reviewing plans this fall, asking the right questions can prevent costly surprises later:
Does this plan cover therapy and mental-health services?
Check for limits on the number of sessions or special deductibles for behavioral health.
Is my therapist (or WPA Therapy) in-network?
If not, what are your out-of-network benefits or reimbursement options?
What are my total out-of-pocket costs?
Include copays, deductibles, and coinsurance, not just the monthly premium.
How much will my premium increase next year?
Ask whether subsidy changes will raise your cost and what lower-cost alternatives exist.
If I lose or change coverage, how can I keep therapy going?
Discuss self-pay options, payment plans, or sliding-scale arrangements with your therapist.
Using Health Accounts to Manage Therapy Costs
If you expect higher out-of-pocket expenses in 2026, Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) can help you plan ahead.
Health Savings Accounts (HSAs)
You qualify if you’re enrolled in a High-Deductible Health Plan (HDHP).
HSAs let you set aside pre-tax dollars to pay for eligible expenses like therapy, medications, and deductibles.
They offer a triple tax advantage: contributions lower your taxable income, growth is tax-free, and withdrawals for qualified expenses are tax-free.
HSAs roll over yearly and remain yours even if you change jobs or insurance.
Flexible Spending Accounts (FSAs)
Offered by many employers, even if you don’t have a high-deductible plan.
FSAs also use pre-tax dollars for medical expenses but typically must be spent within the plan year.
Estimate how often you expect to use therapy and contribute accordingly.
Tip: Treat therapy as an investment in your well-being. Planning through an HSA or FSA — or setting up a budgeted self-pay plan — can keep care consistent even when insurance costs fluctuate.
Steps to Take Now
Mark your calendar: Open Enrollment runs from November 1 – January 15.
Review your current plan: Know your premium, deductible, and subsidy amount before comparing new options.
Talk with your therapist: We can help verify coverage and discuss payment options.
Budget early: Estimate your 2026 costs so you can plan for any premium or deductible changes.
Stay proactive: If your plan changes, we’ll help you transition smoothly — your care comes first.
Final Thoughts
Yes, healthcare costs are rising — but preparation puts control back in your hands. The more you know now, the smoother next year will be.
At WPA Therapy, we’re committed to helping you stay informed, empowered, and connected to the care you need. Your mental health is worth protecting — and we’re here to ensure insurance changes don’t stand in the way of your progress.
If you have questions about your coverage or want help understanding how these changes could affect your therapy, reach out to our team. We’ll walk through it together — calmly, clearly, and with your well-being front and center.
