Issue #1 · May 19, 2026
ACA deductibles jumped $1,000 this year. Here's what families caring for elders need to know.
If you've been helping a parent or loved one manage their health insurance this year, you've probably already felt the sting. The enhanced premium tax credits that kept Affordable Care Act Marketplace plans affordable for millions of Americans expired at the end of 2025, and the fallout has been swift. According to a new KFF analysis, the average ACA Marketplace deductible shot up 37% this year, climbing from $2,759 in 2025 to $3,786 in 2026. That's a jump of more than $1,000 per person in a single year, the steepest increase in the program's history. Many enrollees have been forced to shift into higher deductible plans just to keep their monthly premiums manageable.
For families with aging loved ones, this matters in ways that go beyond the obvious. Many adults in their late 50s and early 60s, the years right before Medicare eligibility kicks in at 65, rely on Marketplace coverage as their primary insurance. A $3,786 deductible means thousands of dollars in out of pocket costs before insurance pays for much of anything. If your loved one is in that gap between employer coverage and Medicare, this is worth a serious conversation about their options, including whether they qualify for Medicaid or other state programs that might help bridge the gap.
COVID-19 hasn't disappeared, and for older adults receiving care at home or in hospice settings, it remains a real concern. Global tracking data shows the virus is still circulating, and health systems continue to adjust their responses. If your loved one is receiving home health visits or hospice care, now is a good time to ask their care team what infection control protocols are still in place. Are aides and nurses masking when they enter the home? Is there a plan if your loved one tests positive? These are simple questions, but they matter enormously for people with compromised immune systems.
Also worth your attention: state level health coverage programs are shifting, particularly for immigrant families. If you are caring for an aging parent who is a noncitizen or who has mixed immigration status within the family, coverage options vary dramatically depending on which state you live in. Some states have expanded Medicaid access for immigrants regardless of status, while others have not. If this applies to your family, it's worth checking your state's current rules, because they may have changed in the last year.
Let's talk real numbers. If your loved one is on a Marketplace plan in 2026, they're now looking at an average deductible of $3,786 before most covered services are paid by insurance. For someone managing chronic conditions, needing regular lab work, or facing a hospitalization, that can add up fast. And here is where it gets tricky for families weighing home health care: many Marketplace plans cover home health services, but only after the deductible is met and often with significant cost sharing on top of that.
If your loved one is already on Medicare, the picture is different but still complex. Medicare covers home health care with no copay when a doctor certifies it's medically necessary, and the Medicare hospice benefit covers nearly all costs related to the terminal illness, including medications, equipment, and aide visits. The hospice benefit is one of the most comprehensive in all of Medicare, yet many families don't realize it exists until they're deep in a crisis. If you're unsure whether your loved one qualifies for hospice or home health under Medicare, that's exactly the kind of question our team can help you think through. It costs you nothing to ask.
Welcome to the very first issue of The Best Hospice and Home Health Brief. We started this newsletter because we know how overwhelming it can be to make care decisions for someone you love, and we wanted to put useful information in your hands on a regular basis. Best Hospice and Home Health is completely free for families. We connect you with verified hospice and home care providers across the country, and we never charge you a dime for it. If this newsletter was helpful, please forward it to a friend, a sibling, a coworker, or anyone else who might be caring for an aging loved one. Nobody should have to figure this out alone.