Aging at home, and the policy that shapes it.

What the 2026 Medicare Advantage Changes Mean for Aging at Home

If you or someone you love is on a Medicare Advantage plan, this year's rule changes are worth understanding before they surprise you at a doctor's visit or a renewal notice.

Back in 2018, Medicare Advantage plans were given broad flexibility to offer what CMS called "Special Supplemental Benefits for the Chronically Ill." Over the years, that flexibility turned into a wide range of extras: meal delivery, transportation, over-the-counter allowances, and in some cases things that had a much looser connection to health, marketed under the banner of "expanded benefits."

In January of this year, CMS tightened that up. The new rule requires that any supplemental benefit be able to demonstrably improve or maintain a patient's health. Benefits that don't clear that bar are no longer allowed, even if a plan has offered them for years. CMS also added a rule requiring Medicare Advantage plans to notify a patient's care team immediately when they make a coverage decision on a hospitalized patient, and clarified a patient's right to appeal a coverage denial while treatment is ongoing.

Here's why this matters for a Haven family specifically. A lot of people assume that if their Medicare Advantage plan covers something like grab bars or a home safety visit one year, it always will. This year's rule is a reminder that supplemental benefits can shift from one plan year to the next, and coverage that looked generous during enrollment season can look different by summer. If a family is counting on a specific in-home benefit to make aging at home affordable, I'd encourage you to reread the Annual Notice of Change every single year rather than assuming last year's coverage carried forward.

It's also worth naming plainly what hasn't changed: neither traditional Medicare nor Medicare Advantage has ever covered ongoing, non-medical, in-home support — the day-to-day help with mobility, safety, and daily living that most families actually need to keep someone at home long-term. That gap is exactly why Haven exists, and why I always tell families to treat Medicare as one piece of the puzzle, not the whole plan.

My advice this year is the same advice I'd give in any year: don't wait for a fall or a hospitalization to find out what your plan will and won't pay for. A home safety assessment gives you a real picture of what your home needs, independent of what any insurance plan happens to cover this year.

— Jade

Kansas Is Stepping Back From Money Follows the Person. Here's What Families Should Know.

Not every policy update is good news, and I'd rather tell you the hard ones straight than let you find out from a denial letter.

Money Follows the Person (MFP) was a federal program that helped people move out of nursing facilities and back into their own homes or communities, with Medicaid dollars following the person rather than staying tied to the facility. Kansas had paused the program for several years, and had planned to bring it back this year. Instead, citing a sharp reduction in federal funding for the program, the state has decided to withdraw from MFP altogether. For families who were counting on that pathway to bring a parent home from a nursing facility, that door has closed.

This is happening against a bigger backdrop. The federal budget law passed last year (often referred to as the One Big Beautiful Bill Act) includes roughly a trillion dollars in Medicaid reductions phased in over ten years. The first piece of that took effect January 1 of this year, eliminating a temporary funding incentive some states had used to support Medicaid expansion. More changes are expected to phase in over the coming years, and Kansas's MFP decision looks like an early sign of how those federal cuts are landing at the state level.

I want to be careful not to overstate this. It doesn't mean Kansas has no home-based Medicaid support left. The HCBS Frail Elderly Waiver still exists for Kansans 65 and older who are Medicaid-eligible and meet a nursing-home level of care, covering things like personal care, adult day services, and personal emergency response systems. The Senior Care Act, which I'll write about separately, is a non-Medicaid, sliding-scale program that many families haven't even heard of.

What it does mean is that the margin for error is shrinking, and waiting until a crisis to figure out what's available is a riskier bet than it used to be. If your family is trying to bring a parent home from a facility, or trying to keep them from ever needing one, I'd start that conversation with your local Area Agency on Aging now, not after a hospitalization forces the question.

— Jade

The Kansas Senior Care Act: A Resource Most Families Don't Know Exists

Of everything I get asked about, this is the resource I wish more families knew to ask for by name.

The Kansas Senior Care Act (SCA) is a state-funded program, separate from Medicaid, that helps Kansans age 60 and older get non-medical in-home support so they can stay in the community instead of moving to a facility. Unlike KanCare, it doesn't have strict income limits — it works on a sliding fee scale, so what a family pays is based on income and assets, not a hard cutoff that disqualifies you the moment you're over it.

Services vary a bit by county, since the program is administered locally through the state's Area Agencies on Aging, but generally include things like attendant care, respite care for the family caregiver, homemaker services, chore assistance, and adult day care. One detail that surprises people: in many cases, a family member can actually be hired and paid to provide some of that care, which matters a lot for families where an adult child has already stepped into a caregiving role without any way to be compensated for it.

Here's how to actually get started. Your local Area Agency on Aging, through the Kansas Aging and Disability Resource Center (ADRC), does the functional assessment that determines eligibility. You can reach the statewide ADRC call center to get pointed to your local AAA and start that process. It's a phone call, not a formal application packet you have to figure out alone.

I bring this program up constantly with families, because it sits in a gap a lot of people don't know exists: too well-resourced to think they'd qualify for Medicaid, not sure where else to turn, and quietly assuming a nursing facility is the only real option once more help is needed at home. The Senior Care Act, and a proper conversation with your AAA, is very often the missing piece. It's also exactly the kind of thing Ashley and I walk families through during a Haven insurance and benefits consultation — not because you need us to make the phone call, but because most families don't know the call is worth making.

— Jade