The Wellness Collective

Your Health Insurance Is About to Get 114% More Expensive. Here's Your Path Forward

Danielle Dorman
November 11, 2025

Twenty-four million Americans are about to lose access to affordable healthcare, not because of a change in circumstance, but because the system is pricing them out entirely. For many, this open enrollment period is no longer about choosing between plans. It’s about choosing between survival and surrender.

Maybe you’ve already felt it: that stomach-drop moment when you logged into your benefits portal and saw the numbers for 2026. The premium you could barely afford last year has more than doubled. Copays for office visits and essential medications are now beyond reach. Or the deductible is so high that you’ll be paying out-of-pocket for everything anyway. You double-check the numbers, hoping it’s a mistake. It’s not.

If you’re feeling overwhelmed, frustrated, or downright scared, those feelings are valid, and you’re definitely not alone. Millions of Americans are trying to reconcile the same impossible math. And while we can’t fix a broken healthcare system, we can help you understand your options so you can make the best decision for you and your family.

Here’s what’s actually happening—and more importantly, what you can do about it right now.

the crisis at a glance

Over 24 million Americans rely on Affordable Care Act (ACA) subsidies to pay for their health insurance, a benefit that is set to expire December 31st unless Congress acts. This expiration represents a legislative cliff that would more than double monthly healthcare premiums—an average 114% increase for the exact same coverage.

And the subsidy cliff isn’t happening in isolation. Medicare telehealth flexibilities expired in October, restricting virtual care access for millions of seniors—many of whom struggle with mobility issues, or no longer drive and rely on family members for transportation. If you have aging parents or grandparents, you may already be feeling this: more doctor’s appointments and pharmacy trips, more time off work, and more stress trying to coordinate their care.

Base premiums are also rising 26%, driven by skyrocketing hospital costs and expensive new medications. And with the government shutdown revolving around the subsidy debate, there’s chaos during open enrollment when what people need most is clarity. The entire healthcare system feels like it’s shifting beneath our feet.

So, what’s the best thing to do when systems feel like they’re collapsing all around you? Take control of what you can.

your path forward

While the headlines are focused on what might happen in Washington, let’s talk about what you can do right now. Here are some practical solutions that can help bridge the various coverage gaps and keep you and your family safe.

Before exploring paid alternatives, check to see if you qualify for Medicaid or CHIP (Children’s Health Insurance Program). These programs offer free or low-cost comprehensive coverage, and income thresholds vary significantly by state. Don’t automatically assume you won’t qualify without applying—many people are surprised to learn they’re eligible. Visit Healthcare.gov or Medicaid.gov to check your eligibility. The application process will take some time, but if you’re eligible, it’s comprehensive coverage at little to no cost.

If government programs aren’t an option, catastrophic coverage is something to consider. This may be the very definition of being between a rock and a hard place, but if you find yourself unable to afford traditional coverage, a catastrophic policy offers protection against worst-case scenarios.

These plans typically have low monthly premiums paired with very high deductibles (typically $8,000 or more). This protects you from medical bankruptcy if something truly catastrophic happens, but it won’t help with routine care or prescription medication costs until that massive deductible is reached.

And this is exactly where most people get stuck. They need prescriptions to manage chronic or acute conditions but have no way to access or afford them.

when you need straightforward prescription access

This is where we come in. If you’re facing a coverage gap, can’t afford your copays, or have been priced out of the system entirely, TelyRx offers a straightforward alternative.

Here’s how it works: You pay a flat $22 doctor review fee to connect with a board-certified physician licensed in your state, and this fee remains fixed whether you need one prescription or several. No surprise charges, no out-of-network restrictions, no prior authorizations, and no coverage denials.

Our licensed pharmacies dispense only FDA-approved medications, and our platform displays transparent, upfront pricing so you know exactly what each medication will cost before you request it. Once prescribed, your medications are delivered conveniently to your door.

TelyRx is a perfect solution for several common situations:

You’re between jobs and have a coverage gap. Maybe you’re waiting for new employer benefits to kick in, or you’re transitioning to self-employment. You still need your medications, but COBRA costs are astronomical.

You have a high-deductible plan that doesn’t help until after you’ve spent thousands. Technically, your policy “covers” your prescriptions, but you’re paying full price out-of-pocket until you hit that deductible, while still having to deal with the hassles and limitations of insurance.

Your chronic medications cost less out-of-pocket than they do going through insurance. This happens more often than you’d think—sometimes the cash price is actually lower than your copay, especially for generics.

You’ve been priced out entirely. If the 114% premium increase means you simply can’t afford coverage at all, you still deserve straightforward access to essential medications.

what TelyRx is—and what it's not

TelyRx is a digital pharmacy and telehealth platform that provides direct-to-patient medication access, not comprehensive medical care. If you need diagnostics, treatments, or ongoing care, you’ll need a traditional insurance plan. What we offer is affordable, accessible, and convenient prescription access anytime you face barriers to getting essential medications—a reality millions of people are facing right now.

take action today: your step-by-step plan

What follows is a step-by-step plan to help you calculate your true healthcare costs and identify the strategy that will best suit your unique situation. So, grab your insurance renewal letter, a calculator, and maybe a cup of coffee. This part isn’t fun, but it’s necessary.

Step 1: Calculate your true annual costs

This is your real annual healthcare cost. It’s much more than just the monthly premium you see on paper.

Step 2: Inventory your medications

List every prescription you take regularly. For each one, compare three prices: your insurance copay, the cash-pay price at your local pharmacy, and the TelyRx price. You may be pleasantly surprised to discover that some medications—especially generics—actually cost less without insurance.

Step 3: Check government program eligibility

Even if you’re pretty sure you won’t qualify, check anyway. Income limits are often higher than expected, especially in states that have expanded Medicaid eligibility. The application takes time, but it costs nothing, and the potential savings are substantial.

Step 4: Build your hybrid strategy

Now that you know your costs and have checked your options, it’s time to customize the approach that will work best for your unique situation. Most people aren’t choosing one solution—they’re combining several:

Catastrophic insurance (worst-case protection) + TelyRx for prescriptions and medications
Medicaid (if eligible) + TelyRx for medications that require lengthy prior authorization
High-deductible plan + cash-pay for routine care + TelyRx while under deductible
No insurance + TelyRx for prescriptions and medications + emergency savings fund for unexpected medical costs

Your best strategy depends on your health needs, budget, and what’s available in your state.

Step 5: Set up backup access now

The best time to set up backup access is before you need it. You don’t want to be scrambling when you’re sick or realize you’re down to your last few pills. It’s also a good idea to identify cash-pay providers in your area for urgent care, and bookmark important resources like your state’s Medicaid website, local community health centers, and prescription discount programs.

a final word

Our goal here was straightforward: to remind you that you have options, and to give you a strategy to help you evaluate them. Millions of Americans are navigating the shifting healthcare landscape right now, and finding workable solutions by combining strategies and building backup plans.

Visit TelyRx.com to check medication prices and create your account. Whatever happens with subsidies or premiums, you’ll have a backup plan ready.

You’ve got this. And we’ve got you.

Disclaimer

This blog post is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. The content provided here is not a substitute for professional medical advice, consultation, or care from a qualified healthcare provider. Always seek the guidance of your physician or another licensed health professional with any questions you may have regarding a medical condition or treatment. Do not disregard or delay seeking professional medical advice based on information read on this site. Learn more about our editorial standards here.

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Your Health Insurance Is About to Get 114% More Expensive. Here's Your Path Forward

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