Issue #4 · October 6, 2026
Midterm issues hitting close to home for families making care decisions right now.
With midterm elections about a month away, health care costs have risen to the very top of voters' concerns, tied with gas prices as the number one economic worry. For families caring for aging loved ones, this tracks with what we hear every day. The cost of care, whether it's home health aides, prescription drugs, or hospice services not fully covered by Medicare, is weighing heavily on households across the country. A recent KFF poll found that voters trust Democrats more on health care affordability, but regardless of which party you favor, the fact that care costs are dominating the national conversation is worth paying attention to. When politicians are talking about something, policy changes tend to follow.
At the same time, shifts in federal vaccine policy are creating real confusion for families with elderly loved ones. The current administration has moved toward fewer routine vaccine recommendations and more emphasis on individual choice, which has contributed to declining vaccination rates. For seniors, especially those in hospice or receiving home health services, this matters a great deal. Older adults remain the most vulnerable to flu, pneumonia, RSV, and COVID-19. If you're coordinating care for someone at home, now is a good time to have a direct conversation with their physician about which vaccines are recommended for their specific situation. Don't rely on the headlines. Ask the doctor.
The Affordable Care Act Marketplaces hit record enrollment in 2025, but 2026 has brought a sharp reversal. Enhanced premium tax credits expired, meaning people are paying significantly more for coverage. On top of that, tightened eligibility rules have pushed some people off marketplace plans entirely. If your loved one is under 65 and relying on an ACA plan while they wait for Medicare eligibility, or if a family caregiver has been using marketplace coverage for themselves, costs may have jumped considerably this year. Review your plan now rather than waiting for open enrollment surprises in November.
This is also relevant for families caught in that difficult gap where a loved one needs home health services but isn't yet eligible for Medicare's home health benefit or hospice coverage. If their ACA premiums have increased or they've lost eligibility, there may be a coverage hole that wasn't there last year. Reach out to your state's health insurance assistance program, often called SHIP, for free counseling on your options.
Let's talk about what Medicare actually covers when it comes to vaccines for seniors receiving home health or hospice care. Medicare Part B covers flu shots, pneumococcal vaccines, COVID-19 vaccines, and Hepatitis B vaccines at no cost to the patient. Medicare Part D covers most other vaccines, like the shingles vaccine, though you may owe a copay depending on your specific plan. Under the Inflation Reduction Act provisions that took effect in 2023, Part D vaccines now come with zero cost sharing for most beneficiaries, which is a genuine improvement over how things used to work.
Here is the practical piece. If your loved one is enrolled in the Medicare hospice benefit, their hospice provider is responsible for coordinating care related to the terminal illness, but vaccines and preventive services are still covered under regular Medicare. That means a hospice patient can and should still receive their flu shot or COVID booster through their primary care provider or a pharmacy, and Medicare will cover it separately. Some families assume that once someone is on hospice, preventive care stops entirely. That is not the case, and skipping vaccines can lead to preventable infections that cause real suffering.
October is here, and for many families this is the season when care decisions feel most urgent. The weather is turning, flu season is starting, and the holidays bring both togetherness and tough conversations about what comes next. We want you to know that Best Hospice and Home Health is always free for families, and our only goal is to connect you with verified providers who can help. If someone you know is trying to figure out hospice or home health care for a loved one, please share this newsletter or send them to our website. Nobody should have to figure this out alone.