The U.S. health insurance industry is a vast and complex sector, and most farmers are not health insurance experts, which can make it challenging to navigate the complex options and requirements. As farmers prepare for 2026, they should be aware that the cost of health insurance is rising, and for dairy farmers, finding affordable and comprehensive coverage will be challenging.
Industry-wide projections show the need for high to very high increases in both medical and prescription drug costs. Carriers are exiting the market, enhanced premium tax credits may be ending, and there is an increased demand for behavioral health services. These are just some of the factors contributing to double-digit rate increases this year.
At the federal level, the Department of Health and Human Services (HHS) oversees the health insurance industry, while state insurance departments are responsible for regulating health insurance companies within their borders.
States have the authority to enact their own health insurance mandates, which can vary widely and often complement federal regulations. There are many insurance providers available, so shop around for the best deals. Understand that you have options.
Here are five considerations when shopping for health insurance plans.
- Plan options. Given your priorities and budget, farmers should explore a variety of carriers and plan options. You should look to compare at least three different plan options. If you are working with an agent, the plan options they present depend on their market access. It is beneficial to know how many carriers they work with and if they have someone who can assist with the federal Health Insurance Marketplace. Consider how much you’ll pay monthly, what you must pay before insurance kicks in and what your maximum out-of-pocket costs could be. This helps you budget effectively, especially during seasonal income fluctuations.
- Network and care specialist options. Since access to health care providers may be more limited in rural areas than urban areas, it is important to confirm your providers are in the health plan’s network. You should also confirm if telemedicine options are available.
- Health insurance riders. Some carriers may include riders to enhance your benefits. A rider is an insurance policy provision that adds benefits to or amends the terms of a basic insurance policy to provide additional coverage. Riders tailor the insurance policy to the specific needs of the policy-holder – for example, a provision that includes an accidental injury benefit that covers the first $2,000 of an accident.
- ICHRA health plan options. Individual Coverage Health Reimbursement Arrangement is a benefit strategy that allows employers to reimburse employees for health insurance, that they would purchase on their own, rather than offering a traditional health insurance plan. The rule, when it was implemented, was designed to expand health coverage options by allowing employers to reimburse employees for their health insurance premiums on a tax-free basis. The employer sets a budget. The employer decides how much money they want to contribute monthly because they're still making a monthly contribution to the employee premium; then the employee will go with that money and buy their own insurance.
- Customer support. Explore the enrollment process and availability of ongoing support. Is there an expectation that your staff will need to help employees complete applications, process enrollment and organize information? Confirm what support is available and whether bilingual support is included. Make sure you understand how to file claims, track coverage and renew your policy.
This article is provided for information purposes only. Readers should consult their own professional advisers for specific advice tailored to their needs. Information contained in this article may be subject to change without notice.
