2026 Health & Insurance Changes
Annual Enrollment has Ended
Annual Enrollment was October 14 through October 31, 2025. Pfizer benefits support each of life’s moments, but we know that your needs can change. So don’t miss Pfizer Benefits: The Annual Enrollment Tour — use this once-a-year chance to review your health and insurance benefit options and elect the coverage that is best for you and your family for next year.
Need help picking your plan options? Check out the 2026 enrollment resources including the medical plan option modeler to help you pick your health plan!
Validate Eligibility and Coverage for Your Dependents: Verification Coming January 2026
During Annual Enrollment, be sure to confirm your covered dependents still meet Pfizer’s dependent eligibility requirements, and remove those that no longer do. In the first quarter of 2026, HMS (a Gainwell Technologies Company) will partner with Fidelity to conduct a random verification to confirm that your dependent(s) enrolled in Pfizer coverage meet Pfizer’s eligibility guidelines. If you do not provide proof of eligibility, your dependent(s) will lose coverage and colleagues found to be covering ineligible dependents may be subject to disciplinary action, up to and including termination.
Have a dependent child turning age 26? Remember their coverage will automatically end on their 26th birthday; they will be offered the opportunity to continue coverage at the full cost for a dependent child (or they must be certified as disabled before that date). Approximately 60 days prior to their 26th birthday, you’ll receive a separate letter from Fidelity at the Pfizer Benefits Center with information on what happens to their coverage and how to apply for disability certification, if applicable.
2026 Health and Insurance Changes
This is a summary of important changes affecting your health and insurance coverage options. For more details and additional changes, review the Summary of 2026 Benefit Changes.
Medical
Deductibles and out-of-pocket maximums are increasing for all medical plan options. Additionally, under the HSA Copay and Network Copay options, copays for certain services will increase. As a reminder, if you are enrolled in the HSA Copay option, due to recent legislation, as of August 1, 2025, the $15 copay virtual visits through your medical plan administrator are no longer subject to the deductible.
Enhanced Mental Health Coverage through Spring Health
There will be two additional coverage enhancements for mental health support through Spring Health:
- Starting January 1, 2026, Pfizer’s employee assistance program will be administered by Spring Health, providing you (plus your eligible household members) with 12 therapy and coaching sessions annually at no cost to you. In addition, if you (or your covered dependents) are enrolled in a U.S. Pfizer medical plan option through Horizon or UnitedHealthcare (UHC), you will be able to continue care through Spring Health as an in-network provider for medication management as well as for additional coverage beyond the 12 free therapy visits. Learn more.
- If you elect coverage through Horizon, you will have in-network access to Spring Heath providers for both virtual and in-person visits (currently in-person visits through Spring Health are not covered if you are enrolled with Horizon). If you are enrolled with UHC, you will continue to have in-network coverage through Spring Health for both virtual and in-person visits.
Remember, the HSA Copay option is the only option that includes the ability to contribute to a Health Savings Account — and receive a Company contribution from Pfizer if you are eligible depending on your annual base pay.
See the Medical Plan Comparison Chart to compare the available plan options.
2026 Contributions
For 2026, there will be increases to medical and dental contributions. Contributions for vision remain unchanged for 2026. Additionally, contributions for life, AD&D, LTD and Vacation Purchase may change if your covered pay changes or if you reach a new age band (for life insurance).
Prescription Drug
The prescription drug per prescription minimums and maximums for non-Pfizer brand medications and Pfizer medications (when a generic is available) are increasing. The out-of-pocket maximums are also increasing.
A new coverage tier will apply for non-Pfizer biosimilar medications; These medications will be covered with a $100 copay per 30-day supply. If you continue to fill the reference product for the biosimilar medication without a prior authorization through CVS Caremark, you will be required to pay your regular coinsurance plus an additional fee of $500 per 30-day supply (this additional fee will not count toward your deductible or out-of-pocket maximum). Currently, this will impact members taking Humira and Stelara. Affected members will receive additional information beginning early November from CVS Caremark.
Eligible Pfizer biosimilar medications will remain at no cost to you (unless you are enrolled in the HSA Copay option, then they will be covered at no cost after your deductible is met, unless they are on the HSA Preventive Drug List).
See the Prescription Drug Summary Chart.
Health Savings Accounts
If you elect the HSA Copay medical plan option most colleagues are eligible to receive a Company contribution to their Pfizer HSA. For 2026, the following changes will apply:
- If your Annual Base Pay is less than $85,000, you will receive the greatest Company HSA funding. See the HSA Company Contribution chart.
- The annual maximum HSA contribution set by the IRS will increase:
- Individual coverage — from $4,300 to $4,400
- Family coverage — from $8,550 to $8,750
Keep in mind, if you will be age 55 or older in 2026, you may contribute an additional $1,000 to your HSA as an HSA catch-up contribution.
Note: The annual HSA contribution limits noted above include your contributions plus Pfizer’s Company contribution, if applicable.
Dependent Care Account
Due to new legislation, the annual Dependent Care Account maximum IRS contribution limit for January 1, 2026, will increase to $7,500.
Limited Purpose (LPHCA) and General Purpose (GPHCA) Health Care Accounts
The IRS recently announced new limits for 2026 for these accounts. For 2026, the contribution limit will be $3,400 (and the carryover amount will increase to $680). Remember, if you elect the 2025 maximum contribution limit of $3,300, your 2026 LPHCA/GPHCA election will automatically increase to the new limit.
Before making your elections:
Use the Enrollment Resources to help you understand your options and choose which coverage will work best for you in 2026. You can also access plan legal documents via the Reference Library on netbenefits.com.
Meet with benefit representatives either onsite at certain Pfizer locations or through the Virtual Annual Enrollment Benefits Fair. Can’t make the date? Check out your benefit contacts.
Use the Pfizer Medical Plan Option Modeler to help you pick the best medical plan option and watch this video to help you understand how the plan options work.
Don’t forget to review the “enroll anytime” benefits through Benefit Extras, including Pet Health Care and Identity Protection.
Understand what happens If You Don’t Enroll. Most elections carry over each year but some important ones do not.
Your eligible domestic partner (same or opposite sex) is defined as a person who is:
- At least 18 years of age;
- Not related to you by blood to a degree of closeness that would prohibit legal marriage;
- Exclusively living with you and has done so for the prior 12 months with the intent to do so indefinitely;
- Not married to someone else or engaged in another domestic partnership or civil union, as applicable; and
- Financially interdependent with you.
Pfizer Company Contribution to the HSA
(As of September 1, 2025 or hire date if later)
(individual/family)
60% After-tax LTD Option
Note: Annual Pay is capped at $500,000 under all options.
* If you work between 40–60% of a part-time schedule, you and Pfizer share in a portion of your contributions.