Podcast Summary: HerMoney with Jean Chatzky

Episode Title: Your Money Map Replay: How to Prepare for Rising Healthcare Costs in 2026: Medicare, ACA & More
Date: October 31, 2025
Host: Jean Chatzky
Guests: Marcia Mantell (Retirement Advisor, Mantell Retirement Consulting), Jay O (Certified Financial Planner, Author of "Maximize Your Medicare")

Episode Overview

This episode focuses on the looming rise in healthcare costs for 2026—especially for women—covering major changes to ACA (Affordable Care Act) subsidies, employer-provided insurance, and Medicare. Jean Chatzky teams up with financial and healthcare experts Marcia Mantell and Jay O to provide listeners with context, strategic guidance, and actionable steps for navigating a shifting landscape. The conversation is candid, practical, sometimes funny, but deeply empathetic—acknowledging the unique financial burdens many women face and offering clear, specific advice for what to do next.

Key Discussion Points and Insights

1. The Healthcare Cost Crisis (01:37–06:54)

• Context: Healthcare costs are rising rapidly, and millions who rely on ACA subsidies may face major cost increases if enhanced tax credits lapse at the end of December 2025.
• ACA History: The ACA made insurance accessible for more people, but affordability was only addressed with federal subsidies, based on income (between 100% and 400% of the federal poverty level).
• Pandemic Changes: During COVID, ACA rules were enhanced for wider access—these temporary enhancements are about to expire.
• Quote:

  "The big budget bill that passed this past July didn't include the extension. So these advance premium tax credits, these subsidies, the expanded portion of them, are set to expire this December, December 31st. Setting up 2026 as an extremely expensive year for many people."
  — Marcia Mantell [06:20]

2. ACA Subsidy “Cliff” and Who’s Hit Hardest (06:54–09:14)

• Premium Increases: If enhanced subsidies expire, some ACA premiums could more than double, e.g., exceeding $18,000/year for some households.
• Groups Most at Risk: People just above the subsidy cutoff and those aging into higher-cost brackets.
• Quote:

  "Your net price after the credits can be in the five digits plus per year for a household. That is absolutely an expectation."
  — Jay O [08:13]

3. Shopping During Political Chaos: What to Watch For (09:14–12:33)

• Open Enrollment Changes: No more automatic re-enrollment or set-it-and-forget-it. New paperwork and eligibility verification rules mean plan shoppers must provide more documentation every year.
• Sticker Shock Examples:
  • Macon, GA – 57-year-old with $50k income: $282/mo in 2025 → $415/mo in 2026.
  • Minnesota – $82k income: $575/mo in 2025 → $770/mo in 2026.
• Quote:

  "It's not that case anymore. With the ACA, you have to reprove every year. There’s no more automatic re-enroll. So…the process is different, the paper trail is different…It's a big deal."
  — Marcia Mantell [10:27]

4. What To Do If You’re Facing Higher Costs (15:14–18:02)

• Insurance Networks: Double-check that the doctors and hospitals you use accept any new ACA plan you consider—especially as insurers exit states (e.g. Aetna leaving Georgia).
• Tailoring Coverage: Healthy individuals shouldn’t feel compelled to buy the most expensive plan; consider lower-premium plans if personal health and risk level allow.
• Quote:

  "The last outcome I want...is for you to purchase insurance which is already expensive, bring it to the doctor’s office and find out, ‘we don't take this insurance.’”
  — Jay O [16:13]

5. High Deductible Plans & Health Savings Accounts (HSAs) (18:02–20:55)

• High-Deductible Plans: Potential option for older (50+) healthy individuals—lower premiums, but more out-of-pocket risk.
• HSA Advantages: Triple-tax benefits: money is tax-deductible on deposit, grows tax-free, and withdrawals for qualified expenses are also tax-free (about $4,500/year for individuals, $9,500 for families).
• Quote:

  "You also have the ability to save separately in this triple tax advantaged vehicle called a health savings account or the HSA…It's a really effective way for many people if it's an option for them."
  — Marcia Mantell [19:31]

6. Employer-Based Insurance: Be Prepared for Changes (21:39–23:42)

• Rising Costs: Employer plans are also expecting increases (~6% for 2026, average premium around $10,000/year for individuals).
• Deductibles Increasing: Employers may shift more cost-sharing to employees; plan for higher out-of-pocket maximums, both in-network and out.
• Quote:

  “Our in-network...$6,000 for each of us, a $12,000 out-of-pocket family maximum...if we end up needing to be out-of-network...$24,000.”
  — Marcia Mantell [22:18]

7. Cost of Inaction (24:02–25:52)

• “Clicking to Renew” Risks: Sticking with last year’s plan without review could cost thousands due to shifting premiums, benefits, and networks.
• Hardship Exemption: Employees facing high premium shares may still qualify for ACA subsidies if employer costs cross a threshold; application is through healthcare.gov.
• Quote:

  “Inaction...is thousands of dollars running to a person...if your portion as an employee is too high, there is a hardship exemption...you still may be able to get a subsidy and be off and into the Affordable Care Act.”
  — Jay O [24:02]

8. Medicare in 2026: Costs, Risks, and Changes (25:52–31:37)

• Parts & Costs:
  • Part A: Hospitalization (no premium for most, pay per use).
  • Part B: Outpatient/doctor visits; premium rising from $185/mo (2025) → $206/mo (2026, estimate).
  • Part D: Drug coverage; insurers and plans pulling out, fewer drugs may be covered.
  • Part C (Advantage): Many PPOs being eliminated; $0 premium plans may now charge.
  • Medigap: Supplements rising 4–6% per year.
• Review Plans Annually: Carriers leaving markets, and coverage changes every year.
• Quote:

  “If you just stick with what you've got, it's quite possible that what worked for you last year is not going to work for you this year.”
  — Jean Chatzky [29:09]
  "Every single detail is up for change, subject to change every single calendar year. This has always been the case. It just happens to be that we’ve got this incredible convergence...You’ll want to check every detail every year…”
  — Jay O [30:22]

9. Budgeting for Essential Healthcare (31:37–34:08)

• Guaranteed Income: Use reliable income sources (Social Security, annuity, pension) to cover healthcare, housing, and food.
• Budget for Everything: Don’t forget over-the-counter needs, vision, hearing, dental costs which often aren’t fully covered.
• Resources: Free worksheet available at boomerretirementbriefs.com, Social Security tab.
• Quote:

  "For me, it is the budgeting piece. And it's not only Medicare and Medigap that you have to budget for...Not everything is a prescription that we need as we get older. So you need to plan for that..."
  — Marcia Mantell [32:22]

10. Avoiding Scams and Marketing Tricks (34:08–36:49)

• TV and Online Ads: Carrier ads must be government-approved; generic “hotlines” can be predatory.
• Consumer Protections: Ask any agent for their National Producer Number (NPN) as proof of licensure.
• Scams: Never give personal details to unsolicited callers/emails; regulations now limit spam calls but vigilance is still needed.
• Quote:

  "You can simply ask the person who calls you what's your NPN? NPN is National Producer Number. It is a unique number for everyone with an insurance license…if the person is a legitimate person, then they will have it."
  — Jay O [35:04]

11. Top Actionable Tips for 2026 (37:35–41:13)

Jay O’s Top Three Tips:

• Don’t just copy what friends/family pick—every situation is unique.
• Start from where you are—avoid regret, focus on the best choice for today’s circumstances.
• Recognize that for many, Medigap is a superior contract, but cost and needs vary.

Marcia Mantell’s Top Three Tips:

• Don’t hesitate to get expert help: ACA navigators, Medicare SHIP volunteers, and employer info sessions.
• Use the tools: Medicare.gov for Medicare, healthcare.gov for ACA—look for state-specific resources.
• At work, proactively ask questions during open enrollment—rules and coverage are changing rapidly.

Quote:

"Ask questions at these info sessions...Are, for example, dependents being continued to be covered? Are domestic partners going to be covered?...So many new questions...So ask and attend and read, read."
— Marcia Mantell [40:40]

Notable Quotes & Moments (with Timestamps)

• “It's not that case anymore. With the ACA, you have to reprove every year. There’s no more automatic re-enroll.”—Marcia Mantell [10:27]
• “Your net price after the credits can be in the five digits plus per year for a household. That is absolutely an expectation.”—Jay O [08:13]
• “This has always been the case...you’ll want to check every detail every year. That is the way our world works. I don't think we're going back to a situation where you can set it and forget it.”—Jay O [30:22]
• "For me, it is the budgeting piece...You need to plan for [over the counter, dental, vision, hearing] or for vision to get your new eyeglasses..."—Marcia Mantell [32:22]
• “You can simply ask the person who calls you what's your NPN? NPN is National Producer Number. It is a unique number for everyone with an insurance license...”—Jay O [35:04]

Important Timestamps

• 01:37 – Jean Chatzky introduces the episode theme and guests
• 04:05 – Marcia explains ACA, subsidies, and the federal poverty level
• 07:17 – Jay outlines the real-world scale of premium increases
• 09:56 – Marcia details how to prepare for “sticker shock” and red tape during enrollment
• 15:14 – Jay’s advice on checking insurance networks and considering coverage options
• 19:03 – Marcia on high deductible plans and HSAs
• 21:39 – Differences in employer-based insurance and further cost increases
• 24:02 – Jay explains risks of simply renewing without checking plan changes
• 25:52 – Marcia’s breakdown of the five Medicare parts and premium jumps
• 29:38 – Jay on why reviewing Medicare plans annually is now more critical than ever
• 31:37 – Marcia: Budgeting healthcare costs to guaranteed income
• 34:42 – Jay on deciphering ads, fighting scams, and consumer protections
• 37:35 – Final list of actionable consumer tips from both guests

Final Takeaways

• Healthcare cost increases in 2026 will impact nearly everyone, but especially those buying on ACA exchanges, those with employer insurance, and retirees on Medicare.
• Proactive shopping, new documentation, and annual comparison-shopping are mandatory for keeping coverage and managing costs.
• Women—often family finance managers—should use all the tools and expert help available, and never be afraid to ask for clarification or assistance.
• Always confirm network and plan details, budget ahead, use tax-advantaged accounts where possible, and always question unsolicited contacts about your coverage.
• The landscape is changing, but taking deliberate, informed steps can help keep healthcare affordable and reliable.

Resources Mentioned:

• healthcare.gov
• medicare.gov
• boomerretirementbriefs.com (Social Security tab for expense worksheet)
• State SHIP offices for Medicare help
• HerMoney newsletter

HerMoney delivers financial wisdom with compassion and practical detail—this episode is a must-listen for anyone worried about rising healthcare costs, but especially for women preparing their families for 2026.