Last week, I ran into a friend in front of the local grocery store. While holding a shopping basket, they brought up a letter from their insurance company, mentioning that Ambetter would be gone starting next year.

Their face looked so troubled. I felt more concerned knowing they rely on a marketplace insurance plan while managing their store alone.

When I got home, I looked into it carefully. The announcement from the company states that Ambetter from NH Healthy Families will cease its New Hampshire marketplace products as of December 31, 2026, and will not offer plans for 2027.

According to NHPR reports, as of June this year, there were over 11,600 Ambetter marketplace enrollees based on state insurance department data. Other reports indicated nearly 12,000 enrollees.

Ambetter was the second-largest marketplace insurer after Anthem, meaning one in five enrollees was not a small number.

The good news is that the same company's Medicaid plan, NH Healthy Families, and the Medicare prescription drug plan, WellCare PDP, will continue in 2027. So, those on Medicaid or Medicare don't need to be alarmed by this news.

The issue lies with those who purchased individual insurance through healthcare.com. The company states that while there's nothing to do immediately, they must choose a new plan during the open enrollment period.

New Hampshire does not have its own exchange, so they use healthcare.com directly. For phone consultations, they can call 1-800-318-2596, and assistance from brokers or navigators is also available.

This year's open enrollment started on November 1 and is scheduled to run until January 15, 2027. However, this timeline hasn't been smooth from the beginning.

A federal regulation aimed at shortening the enrollment period to mid-December was blocked by the courts in June, and the Department of Health and Human Services appealed in July. So, there was a lot of discussion about the dates.

Regardless, to ensure continuous coverage starting January 1, a plan must be selected by December 15. I would recommend circling this date in red on your calendar.

In 2027, three marketplace insurers will remain: Harvard Pilgrim, Anthem-affiliated Matthew Thornton Health Plan, and Boston Medical Center Health Plan, WellSense.

Insurance premiums are also expected to rise. According to the 2027 rate increase requests submitted by insurers, Harvard Pilgrim is at 10.7%, Matthew Thornton at 18.1%, and WellSense at 21.6%.

These figures are only at the application stage and are before subsidies are applied. The final confirmed rates will need to be checked separately.

Honestly, looking at these numbers made me sigh. Many households are already struggling financially this year.

This is because the enhanced federal subsidies will end by the end of 2025 and will not be extended. As a result, households exceeding 400% of the federal poverty line will not receive any subsidies in 2026.

Perhaps as a result, this year's open enrollment has seen a decrease to 66,024 enrollees. Still, about 55% of enrollees received subsidies, with an average discount of $378 per month, which is worth considering.

Subsidies are calculated based on the local silver plan prices. Therefore, if premiums rise, subsidies may also increase, potentially offsetting some or all of the increases for many enrollees.

If income is below 250% of the poverty line, there are benefits that reduce out-of-pocket costs when choosing a silver plan. Even if bronze plans seem cheaper, it's better for these households to look at silver plans first.

This is what I told my friend. First, check if their current primary care physician and specialists are in the new insurance network.

Second, see if their monthly medications are included in the new plan's drug list. By writing down the names of the medications and entering them into the healthcare.com comparison screen, they can find out quickly.

Third, I advised them not to only look at premiums but also to consider deductibles and out-of-pocket maximums. I've seen many cases where saving a few dollars a month leads to significant expenses during a hospital visit.

Also, don't forget to update income information to the latest figures. Leaving last year's numbers can lead to incorrect subsidy calculations, causing issues during tax reconciliation later.

Among the Korean community, there are many who miss deadlines because they delay due to English paperwork. The healthcare.com consultation phone service also offers interpretation services, so they can ask for help in Korean.

If someone has a chronic condition or is worried about needing to change medications, they should definitely consult their doctor or pharmacist before choosing a plan. Sometimes, one medication can change the choice of plan.

I oppose the vague expectation that they will be automatically transferred to another insurance. I believe that I should personally choose the plan that fits my needs to feel secure.

That day, my friend smiled and said they would open their laptop as soon as they got home. After sharing concerns, their face looked much brighter.

If you know anyone enrolled in Ambetter, please offer them a warm cup of tea and mention the December 15 deadline. That one conversation could help protect someone's healthcare costs in the new year.