Losing your insurance? What happens to your prescriptions

Short answer: your prescription does not end when your plan does. What ends is the plan paying for it. You have more time and more options than the renewal notice makes it feel like, and most of them work better if you use them before your supply runs out.

Open enrollment starts Sunday, November 1, in most states. KFF reports that benchmark silver premiums are up 13% on average for 2027, after 26% for 2026. The enhanced premium tax credits expired in 2026, and people with incomes above 400% of the federal poverty level no longer qualify for federal credits, though some states offer their own help. KFF cites a Congressional Budget Office projection that Marketplace enrollment falls from 22.4 million in 2025 to 13.1 million in 2027.

The New York Times put it this way on Friday: "Obamacare Dealt Yet Another Blow as Premiums Jump Again."

A plan can end on a date. The condition it was paying for does not. Here is what to do with the gap.

What actually changesCopy link

A prescription is a clinician's order to a pharmacy. Insurance is one way of paying for it. When coverage ends, the pharmacy can still fill a valid prescription, and you pay the price without your plan. Ask your pharmacist how many refills are left and when the prescription expires.

The risk is cost. In CDC data from 2021, 22.9% of uninsured adults aged 18 to 64 who took a prescription drug did not take it as prescribed to save money: they skipped doses, took less, or delayed a fill. Among those with private insurance, it was 6.5%.

If you are tempted to skip or halve doses to make a supply last, ask a clinician or pharmacist first.

Before your coverage endsCopy link

• Find the exact end date. Do not assume. Job-based coverage ends when your plan says it does, so ask your employer.
• Ask about refilling early. Ask your pharmacy whether your plan will cover a refill before the end date. Some plans limit how early you can fill.
• Write down what you take. Name, dose, prescriber, and pharmacy. It makes everything after this faster.

Your options for coverageCopy link

• Open enrollment. HealthCare.gov's dates: enroll by December 15 for coverage starting January 1. Open enrollment ends January 15. State-run marketplaces can differ, so check yours.
• Special Enrollment. If you lost qualifying coverage, HealthCare.gov gives you 60 days before or after the loss to enroll, and 90 days after losing Medicaid or CHIP. Choosing to drop COBRA does not count.
• Medicaid and CHIP. You can apply any time of year. If your income changed, check whether you qualify.
• COBRA, as a backstop. The Department of Labor gives you 60 days to enroll, counted from when coverage ends or when your notice arrives, whichever is later, and 45 more days for the first payment. Coverage reaches back to the day you lost your job-based plan. You usually pay the full premium, up to 102% of the cost to the plan, and your first payment may cover more than one month.

If you stop paying a Marketplace premiumCopy link

This is the path that catches people. With a Marketplace plan and the premium tax credit, the grace period is usually three months. If you do not catch up, you can lose coverage dating back to the first month you missed, and losing coverage this way does not qualify you for Special Enrollment. Ask your insurer whether it will pay for services in the second or third month before you fill.

If you are paying without insurance for a whileCopy link

• Ask for the cash price, then compare. Ask more than one pharmacy, and check a discount card against the cash price. A discount card is not insurance.
• Ask about a lower-cost equivalent. A pharmacist or your prescriber can tell you whether one exists.
• Look at manufacturer programs. Some drugmakers run assistance programs for brand-name medications.

Where Temi fitsCopy link

Losing a plan can also mean losing the doctor who wrote your prescription. Temi does not take insurance, so nothing about our service changes when your coverage does. A clinician reviews your request within 48 hours and decides whether a prescription is right for you. A refill review is $15 and a new prescription review is $79. Those fees pay for the review, not for an approved prescription. You pay your pharmacy for the medication, and you can still use insurance or a discount card there if you have one. Temi does not prescribe controlled substances.

SourcesCopy link

1. Matt McGough, Rayna Wallace, Justin Lo, Kaye Pestaina, and Cynthia Cox, "9 Things to Watch for the 2027 ACA Open Enrollment Period," KFF, Oct. 30, 2026. https://www.kff.org/affordable-care-act/9-things-to-watch-for-the-2027-aca-open-enrollment-period/
2. Reed Abelson and Margot Sanger-Katz, "Obamacare Dealt Yet Another Blow as Premiums Jump Again," The New York Times, Oct. 30, 2026. https://www.nytimes.com/2026/10/30/business/obamacare-health-insurance-rates.html
3. National Center for Health Statistics, "Characteristics of Adults Aged 18-64 Who Did Not Take Medication as Prescribed to Reduce Costs: United States, 2021," NCHS Data Brief No. 470, June 2023. https://www.cdc.gov/nchs/products/databriefs/db470.htm
4. HealthCare.gov, "When can you get health insurance?," checked Oct. 31, 2026. https://www.healthcare.gov/quick-guide/dates-and-deadlines/
5. HealthCare.gov, "Getting health coverage outside Open Enrollment," checked Oct. 31, 2026. https://www.healthcare.gov/coverage-outside-open-enrollment/special-enrollment-period/
6. HealthCare.gov, "Medicaid & CHIP coverage," checked Oct. 31, 2026. https://www.healthcare.gov/medicaid-chip/getting-medicaid-chip/
7. U.S. Department of Labor, "FAQs on COBRA Continuation Health Coverage for Workers," checked Oct. 31, 2026. https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-health-coverage-workers
8. U.S. Department of Labor, "Continuation of Health Coverage (COBRA)," checked Oct. 31, 2026. https://www.dol.gov/general/topic/health-plans/cobra
9. HealthCare.gov, "Grace period," glossary, checked Oct. 31, 2026. https://www.healthcare.gov/glossary/grace-period/
10. HealthCare.gov, "Premium payments, grace periods, & losing coverage," checked Oct. 31, 2026. https://www.healthcare.gov/apply-and-enroll/health-insurance-grace-period/
11. G. Edward Miller, Steven C. Hill, and Yao Ding, "Retail Drug Prices, Out-of-Pocket Costs, and Discounts and Markups Relative to List Prices: Trends and Differences by Drug Type and Insurance Status, 2011 to 2016," Agency for Healthcare Research and Quality, Research Findings #44, October 2019. https://meps.ahrq.gov/data_files/publications/rf44/rf44.shtml
12. CareSource, "Lost, Stolen, Damaged, Vacation and School Supply of Medication," Administrative Policy Statement PAD-0091-MPP, effective Oct. 1, 2024. https://caresource.com/documents/marketplace-ga-in-ky-wv-oh-policy-admin-pad-0091-mpp-20241001.pdf
13. Georgia Attorney General's Consumer Protection Division, "Prescription Discount Cards," Ask Consumer Ed, June 30, 2016. https://consumered.georgia.gov/node/1656
14. Michigan Attorney General, "Prescription Drugs - How to Safely Save Money," checked Oct. 31, 2026. https://www.michigan.gov/consumerprotection/protect-yourself/consumer-alerts/home-health/prescription-drugs-save-money
15. Medicare.gov, "Help with drug costs," checked Oct. 31, 2026. https://www.medicare.gov/basics/costs/help/drug-costs
16. Centers for Medicare & Medicaid Services, "Pharmaceutical Manufacturer Patient Assistance Program Information," checked Oct. 31, 2026. https://www.cms.gov/medicare/coverage/prescription-drug-coverage/patient-assistance-program
17. Niteesh K. Choudhry and others, "Drug Company-Sponsored Patient Assistance Programs: A Viable Safety Net?," Health Affairs, May-June 2009. https://pmc.ncbi.nlm.nih.gov/articles/PMC2873618/