Medicare Skilled Benefits

Medicare has been changing yearly and 2026 will be no exception. What is ahead for Medicare this fall and why?Carriers are still feeling the effects of the Inflation Reduction Act, which passed in 2022, but just took full effect in January of 2025. Beginning January 1, 2025, people with Part D plans through traditional Medicare and Medicare Advantage plans with prescription drug coverage, won't pay more than $2,000 over the calendar year in out-of-pocket costs for their prescription medications, the donut hole or coverage gap is eliminated and there is a new payment plan to spread drug costs through the year. Those changes came at a cost to other benefits. The Inflation Reduction Act significantly increased the carriers expenses and in response benefit cuts occurred for 2025 and will continue for 2026. Carriers had to absorb the steep cost increase for the mandatory prescription drug plan changes by balancing the budget, which included increases in beneficiaries copays, deductibles added to plans, the plan maximum out of pocket increased, non-medical benefits were reduced, a prescription drug deductible was added, and prescriptions were re-tiered or eliminated from the list of covered drugs. 2026 will see further adjustments as the carriers remove most benefits deemed non-medical. Seniors who have grown accustomed to benefits such as an over-the-counter allowance or food subsidy may see those benefits sharply reduced or eliminated this fall. Plans must be submitted to Centers for Medicare & Medicaid Services for approval in early spring to be ready for the enrollment period in fall to be active for the following calendar year, so carriers have had little time to study the impact of the Inflation Reduction Act on overall costs. Insurance moves slowly. The changes we are feeling in 2025 are the result of a bill passed in 2022 and will continue to affect plans in 2026. This fall will feel like a continuation of the benefit cuts seniors faced in the fall of 2024 as carriers work to balance the budget while considering the increased prescription costs and trying to maintain the plan benefits seniors rely on. For more information visit: aismedicareandmore.com Editors Note: This article was submitted by Jolynn Allen with AIS Medicare & More.  Jolynn is the owner of AIS Medicare & More and may be reached at:  719-404-3202

In Colorado, In-Home Supportive Services (IHSS) is a Medicaid-funded program designed to assist individuals with disabilities or elderly individuals who need help with daily activities. These services enable individuals to live independently in their own homes rather than in institutional settings. IHSS provides support with tasks like personal care, housekeeping, meal preparation, and medication management.Eligible participants must meet specific criteria, including being a Colorado resident, requiring assistance due to a disability, and meeting income and resource limits. Services are tailored to each individual's needs and are delivered by trained caregivers, who may be family members or professional aides.IHSS is an essential resource for people with disabilities or the elderly, enhancing their quality of life by promoting independence while providing necessary care. It also alleviates the financial burden of long-term institutional care, offering a more cost-effective and personalized solution for those in need. Editor's Note: This article was submitted by Amazing Care Home Health Services. For more information they may be reached at 303-755-3170.

For 40 years, Sangre de Cristo Community Care has provided compassionate, expert support to patients and families facing chronic and serious illnesses. Now, we are proud to introduce our new Dementia Care Program, a groundbreaking initiative designed to enhance the quality of life for individuals living with dementia while providing much-needed support for their caregivers.This Medicare-approved program offers dedicated care navigators, 24/7 nurse support, caregiver training, and respite careall aimed at enabling individuals to remain in their homes and communities for as long as possible. With a mission deeply rooted in dignity and quality of life, our team ensures that both patients and caregivers receive personalized guidance and access to essential community resources.Available throughout Southern Colorado, this program is open to Medicare beneficiaries with a dementia diagnosis who are not in a nursing home or PACE program. Self-referrals and provider referrals are accepted.If you or a loved one could benefit from this program, please call 719-553-1919 to learn more. At Sangre de Cristo Community Care, we continue to expand our services with compassion, knowledge, and positivitybecause every moment matters.  Editors note: This article was submitted by Stephanie Ivankovich, Marketing Communications Manager for Sangre de Cristo Community Care, and many be reached at 719-542-0032 or by email at stephanie.ivankovich@sangre.org.