Medicare 2026

CMS's Proposed CARE Rule and Nursing Homes: What Would Change, and How to Comment by Jan. 11

The Centers for Medicare & Medicaid Services (CMS) has proposed a rule that would revise or remove a number of requirements the agency considers outdated or unnecessarily burdensome for hospitals, nursing homes and other providers. It's called "Cutting Administrative Requirements for Excellence in Patient Care," or CARE (CMS-3484-P). The proposal was published in the Federal Register on Nov. 10, 2026, and the public has until January 11, 2027 to weigh in.

If you have a loved one in a nursing home — or you're thinking ahead about long-term care — here's a plain-English look at what's on the table, plus what's already set for Medicare in 2027.

What the proposal would change for nursing homes

Ombudsman notices for emergency transfers. The Long-Term Care Ombudsman program advocates for residents of nursing homes and similar facilities. Today, facilities must send the Ombudsman a copy of the notice any time a resident is transferred, including for emergent (emergency) care. Under the proposal, nursing homes would no longer have to notify the Ombudsman for emergent transfers specifically. Ombudsman notice for other transfers would continue.

CMS is also asking for public input on a related idea: whether residents should be able to opt out of having their discharge notice sent to the Ombudsman at all, with the facility documenting the resident's preference in the medical record. CMS notes that residents who initiate their own transfer or discharge may not need or want Ombudsman review.

Resident rights stay intact. CMS is clear that existing transfer and discharge rules would continue — including a resident's right to appeal a transfer or discharge and the requirement that notice be given at least 30 days before a transfer or discharge.

Room and bathroom standards. Federal rules generally require no more than two residents per room and an in-room bathroom. Under the proposal, existing nursing homes that change ownership or have a gap in operations would be exempt from those standards. Instead, the two-residents-per-room and in-room bathroom requirements would apply based on building plans approved after November 28, 2016.

COVID-19 and respiratory illness reporting. The proposal would remove requirements for nursing homes to educate staff about the COVID-19 vaccine, offer it to them, and document those steps. It would also end ongoing weekly acute respiratory illness data reporting. According to the CMS fact sheet (which lists the CARE rule as issued on Nov. 5, 2026), the agency is also streamlining the remaining COVID-19 vaccine requirements for residents.

Facility assessments. Nursing homes must regularly assess their resident population and staffing needs. The proposal would drop the requirement that representatives of direct care staff be actively involved in that assessment, while keeping the rest of the facility assessment rules.

How to comment

Comments are due by January 11, 2027. You can submit them:

• Online at regulations.gov under docket CMS-2026-3631
• By mail, referencing file code CMS-3484-P

Public comments become part of the official record and are read by CMS staff before a final rule is issued.

What's already set for Medicare in 2027

While the CARE rule works its way through the comment process, a few 2027 Medicare numbers are already locked in:

• Part D out-of-pocket cap: $2,400 in 2027 (it was $2,100 in 2026). Once your out-of-pocket drug spending hits that cap, you pay $0 for covered Part D drugs the rest of the year.
• Maximum Part D deductible: No Part D plan may charge more than $700 as a deductible in 2027.
• Part D base beneficiary premium: $41.33 for 2027. This is a national figure used to calculate the late-enrollment penalty; actual plan premiums are set plan by plan.
• Social Security COLA: The Social Security Administration announced a 3.6 percent cost-of-living adjustment for benefits payable beginning January 2027.

The 2027 Part B standard premium and deductible, and the IRMAA income-related surcharge brackets, have not been announced yet. CMS typically releases them in the fall. Please check Medicare.gov for the official figures when they're posted.

Annual Enrollment is happening now

Medicare's Annual Enrollment Period runs October 15 – December 7, 2026, with new choices taking effect January 1, 2027. During this window you can join, switch or drop a Medicare Advantage plan or a stand-alone Part D drug plan.

If you have Medicaid or Extra Help (the Low-Income Subsidy), you have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or switch stand-alone Part D plans. Full-benefit dual-eligible individuals can also join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month.

When comparing Medicare Advantage with Original Medicare plus a Medigap policy and a Part D plan, there are trade-offs either way. Medicare Advantage plans often bundle drug coverage and extra benefits but typically use provider networks and prior authorization. Original Medicare plus Medigap generally offers broad provider access and more predictable out-of-pocket costs, but Medigap and Part D are separate purchases. The right fit depends on your health, your doctors, your prescriptions and your budget.

Where to learn more

For official Medicare information — including enrollment, plan comparisons, and 2027 figures as they're announced — visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day, 7 days a week.

This article is for general education only. It is not affiliated with or endorsed by any government agency.