Each year, if you do nothing during the open enrollment period, your Health Marketplace plan renews automatically for the following year. It sounds convenient, but insurers adjust their doctor and pharmacy networks from one year to the next, and that silent renewal can leave you with out-of-network providers without you realizing it. Before your plan renews for 2026, it is worth reviewing a few key points.
Why automatic renewal can be a problem
Each year, if you take no action during the open enrollment period, the Health Marketplace automatically renews your current plan for the next year. This sounds convenient, but it carries a real risk: insurers update their networks of doctors, hospitals, and pharmacies every year, and your renewed plan does not necessarily keep the same providers you used this year.
What exactly changes from one year to the next
Insurers review and adjust their provider networks — that is, the list of doctors, specialists, hospitals, and pharmacies that accept your plan — at the start of each coverage year. A doctor who was in network in 2025 may be out in 2026, without you receiving an individual, detailed notice about it. The same applies to the list of covered medications, known as the formulary, and to preferred pharmacies.
The 3 things you should check before your plan renews
- Your primary care doctor and specialists are still in the plan’s network for 2026
- Your usual pharmacy is still preferred, since prices can rise if it becomes non-preferred
- The medications you take regularly are still on the plan’s formulary
How to check your network before automatic renewal
You can confirm this information in three ways: by calling your insurer directly, by reviewing the updated provider directory on the plan’s site for 2026 (not the 2025 one), or by asking a licensed advisor who has access to the Marketplace’s plan comparison tools.
What to do if your doctor or pharmacy is no longer covered
If you find that your current provider is leaving the network in the renewed plan, you have two options during open enrollment: switch to a different plan from the same insurer that does include your provider, or switch insurers entirely. Both options require acting before open enrollment ends, generally January 15, since after that date you can only make changes if you qualify for a Special Enrollment Period.
What happens if you do nothing
If you do not review or change anything, your coverage continues uninterrupted under the renewed plan, but you run the risk of discovering at the doctor’s office or the pharmacy that your provider is no longer covered — which can mean paying the full cost out of pocket.
Sources: healthcare.gov, cms.gov.
Frequently asked questions
When does my Health Marketplace plan renew automatically?
If you do not actively select a plan during the open enrollment period — generally November 1 to January 15 — your current plan renews automatically for the next coverage year.
Will I get a notice if my doctor leaves the network?
Insurers do not always notify you individually and in detail about changes to the provider network. It is the enrollee’s responsibility to check the updated directory each year.
Can I change plans after automatic renewal?
Yes, while the open enrollment period is still active. Once it ends, you can only make changes if you qualify for a Special Enrollment Period due to a qualifying life event.
What is a drug formulary and why does it matter?
It is the list of medications your plan covers and at what copay level. Formularies change every year, so a medication covered in 2025 could have a higher copay or not be covered in 2026.
Do subsidies or tax credits change if my plan renews automatically?
Yes. If your income or family situation changed, the subsidy calculated for the automatic renewal might not reflect your current situation, which can affect your monthly premium.
Who can I ask for help reviewing my network before renewal?
A licensed advisor can help you compare provider networks, drug formularies, and prices across different plans available in your area, at no additional cost to you.
Before your Health Marketplace plan renews on its own, review your provider network and talk to a licensed advisor at Aion to compare your options at no cost.
