I N S U R A N C E  &  M E D I C A R E

Open the plan change letter before Open Enrollment does

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• The Annual Notice of Change is in the mailbox. Plans were required to send it by September 30. Three things inside it matter: whether the drugs a parent takes are still on the formulary, whether their doctors and pharmacy remain in network, and the new out-of-pocket maximum. Open Enrollment runs October 15 through December 7 for coverage starting January 1.

• Part D is priced without the cushion for 2027. With the premium stabilization demonstration ending, the base beneficiary premium rises to $41.33 from $38.99, the maximum standard deductible to $700 from $615, and the annual out-of-pocket cap to $2,400 from $2,100.
  The $35 insulin cap is unchanged. Stand-alone drug plan premiums may move more than they
  have in past years.

• Part B is projected at $209.50 a month, up about 3.5% or $6.60, with a $292 deductible,
  according to the Medicare Trustees. That is a projection; CMS announces the final figure in late
  October or November. After a nearly 10% jump for 2026, a 3.5% increase would be real relief.

• Long-term care insurers asked Maryland for increases of 27% to 242% on roughly 12,600
  in-force policies. Regulators typically approve far less than requested, but carriers file across
  states, and the “your premium is doubling” letter travels. The choice when it arrives is accept,
  reduce the benefit, or take the nonforfeiture option.

 

Sage Guidance: Do not let any Medicare plan auto-renew this year. Put the ANOC letter, the full medication list, and the pharmacy name on the table together, and book the plan review for the last two weeks of October, once the COLA and Part B numbers are public.

I L L I N O I S S P O T L I G H T • L E G A L & L O C A L P O L I C Y

Deb’s Law is live, and Medicaid renewals are about to double

 

• Facilities are declaring where they stand. Since Illinois’ medical aid in dying law took effect
  September 12, hospitals, hospices, and residential communities across Cook and the collar
  counties have been issuing written notices confirming whether they participate on site. Communities that prohibit staff participation must give advance written notice. The law states
  that using it is not suicide and cannot invalidate life insurance or alter an annuity.

• Illinois Medicaid changes on a hard timeline. Noncitizen eligibility narrowed October 1.
  Starting with the first redetermination on or after January 1, 2027, adults 19 to 64 without
  minor children and not on Medicare face a work requirement (80 hours a month of work, school, or volunteering, or $580 in earnings) and move from annual to six-month renewals. Seniors on Medicare and people in long-term care are not the target. The daughter who left her job to care for her mother is. She may qualify under the federal exemption for family caregivers of “a disabled individual,” but that depends on what documentation Illinois asks for.

• Two more changes on the elder law calendar: a shorter window for retroactive Medicaid
  coverage starting in 2027, and a home equity cap for long-term care Medicaid fixed at $1 million beginning in 2028, with no inflation adjustment.

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Sage Guidance: For a relative in palliative care, confirm the community’s or hospice’s participation policy in writing and make sure the advance directive reflects it. For every caregiving family, update the address on file with HFS now and open every envelope; a missed renewal is the most
common way people lose coverage they still qualify for.

H O U S I N G & S E N I O R L I V I N G

Nearly full, barely building, and changing hands

• Occupancy held at 89.9% across the 31 NIC MAP primary markets in Q2 with a record
  number of units occupied, while inventory grew under 1% for a fifth straight quarter. NIC’s
  outlook puts the shortfall at roughly 576,000 units by 2030 and more than a million by 2035.
  Two million Americans turn 80 this year.

• Institutional buyers keep consolidating. American Healthcare REIT closed a $696 million
  purchase of eight assisted living and memory care communities, pushing its 2026 investments
  past $2 billion, and Chicago-based RiverGlade Capital Partners acquired a 24-community
  operator in the Northeast. When a building changes hands, pricing and staffing policy often
  follow within a year. Budget for 4% to 6% annual base rent increases plus separate level-of-care fees of $500 to $1,500 or more per tier.

• Illinois now bars assisted living communities from referring residents to unlicensed home care agencies under HB 4612, and IDPH is tasked with a public campaign on verifying
  licensure before hiring in-home help. A community’s referral is not the same as a vetted one.

 

Sage Guidance: Treat touring as reconnaissance, not shopping. If a move is plausible within 12 to 18 months, place refundable wait-list deposits at two or three communities now, and ask each for its last three years of rate increases and its written level-of-care fee schedule. The tour taken after a
hospitalization is the worst tour a family will ever take.

 

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​​F I N A N C I A L P L A N N I N G

Build the 2027 budget on the net number, not the headline

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• The COLA lands October 14. Estimates cluster at 3.5% to 3.6%, the largest raise in three
  years, worth roughly $75 a month for the average retired worker. The same adjustment flows to
  VA disability compensation in January. If Part B rises about 3.5% at the same time, the net
  change to many checks will be close to a wash.

• No October funding cliff; December 11 is the date. The continuing resolution signed September 2 funds Older Americans Act programs (Meals on Wheels, Area Agency on Aging services, the National Family Caregiver Support Program) through December 11. Anyone waiting on a Community Care Program assessment or a respite grant should not defer paperwork to winter.

• Selling the house to fund care got harder this month. The 30-year mortgage rate climbed
  from a 6.66% August average to 7.03% by September 24, and existing-home sales remain near a 30-year low. The sale date and the move date are two separate decisions.

• Family caregiving is now valued at $1.01 trillion a year by AARP, from 59 million caregivers providing 49.5 billion hours. For employers, the operational figures land harder: in a 2026 survey, 53% of working caregivers had missed work and 24% had considered leaving the workforce because of care responsibilities.

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Sage Guidance: Hold the 2027 care budget until October 14, then schedule one meeting with the family’s advisor or CPA that covers the COLA, Part B, the drug plan premium, any long-term care
policy notice, and the timing of a home sale. These belong in the same conversation.

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