Medicare 2026

Medicare's 2027 Home Health Rule Clarifies Palliative Care at Home — Here's What Patients Should Know

In November 2026, the Centers for Medicare & Medicaid Services (CMS) finalized its calendar year 2027 home health rule. One part that caught a lot of attention: CMS confirmed that palliative care can be provided under the Medicare home health benefit when the usual coverage rules are met. If you or someone you love is navigating a serious illness, this is worth understanding — along with a few other Medicare basics heading into 2027.

What the 2027 home health rule actually does

The rule (CMS-1844-F) was published in the Federal Register on Nov. 9, 2026, and its home health payment provisions take effect January 1, 2027. CMS estimates Medicare home health payments will rise by $415 million, or 2.4 percent, in 2027 — reflecting a 2.1 percent payment update and a 0.3 percent bump tied to the updated fixed-dollar loss ratio used for outlier payments.

The headline policy change isn't really a "change" in the strict sense. CMS is clarifying that a person who meets the home health coverage requirements can receive palliative care services under the home health benefit, as long as a physician or allowed practitioner orders them. CMS stresses there is no separate payment or billing code for palliative care, and the services must fit within a covered skilled service in the patient's plan of care.

What "palliative care at home" means under Medicare

Palliative care focuses on relieving symptoms and improving quality of life. It isn't the same as hospice. CMS was explicit on this point: home health and hospice serve distinct purposes and patient populations, and this clarification isn't meant to blur that line.

A few important details:

• You don't have to be terminally ill to qualify for home health, and there's no expectation that you avoid life-prolonging therapies.
• Whether you have "restoration potential" isn't the deciding factor in whether skilled services are needed.
• All of the usual home health eligibility requirements still apply: homebound status, a qualifying skilled need, an order from an allowed practitioner, a plan of care, and a face-to-face encounter.

In other words: if a doctor determines you meet the home health criteria, palliative care can be part of what you receive at home — it just has to be delivered through a covered skilled service.

What you pay

Under Original Medicare, Medicare.gov says you pay nothing for covered home health services. For Medicare-covered durable medical equipment, you pay 20% of the Medicare-approved amount after you meet the Part B deductible.

A second change: external infusion pumps at home

The same rule, effective April 1, 2027, treats certain external infusion pumps, their home infusion drugs, and related supplies as meeting Medicare's "appropriate for use in the home" equipment requirement when all of the following are true:

• The drug's prescribing information calls for a health care professional to give or supervise it.
• That professional is on site at the home.
• A qualified home infusion therapy supplier gives or supervises it.
• The drug is to be infused at least 12 times a year intravenously or subcutaneously, or at rates that require an external pump.

For patients who need professionally administered infusions, this opens the door to receiving them at home rather than traveling to a facility.

A quick refresher on your 2027 coverage choices

As you consider what you need from Medicare in 2027, keep a few program-level facts in mind:

• The Part D out-of-pocket cap rises to $2,400 in 2027 (it is $2,100 in 2026).
• The most any Part D plan may charge as a deductible in 2027 is $700.
• The Part D base beneficiary premium for 2027 is $41.33 — a national figure used to calculate the late-enrollment penalty. Actual plan premiums are set plan by plan.
• Social Security 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 brackets, had not been announced at the time of writing. CMS typically announces these in the fall.

Annual Enrollment runs October 15 – December 7, 2026, with choices taking effect January 1, 2027.

Original Medicare vs. Medicare Advantage: a neutral word

If you're weighing Original Medicare (often paired with a stand-alone Part D plan and sometimes a Medigap policy) against a Medicare Advantage plan, both can cover the home health services clarified in this rule, but they work differently. Original Medicare lets you see any provider that accepts Medicare, and Medigap can help with out-of-pocket costs. Medicare Advantage plans typically use networks and prior authorization, and may bundle extra benefits. Neither is "better" — the right fit depends on your health needs, finances, and preferences.

Extra Help and Medicaid: more flexibility to switch

Since 2025, people with Medicaid or Extra Help have a monthly Special Enrollment Period to move to Original Medicare with a stand-alone Part D plan, or to 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. This gives low-income beneficiaries more opportunities throughout the year to find coverage that fits.

Where to learn more

For the most current, trustworthy information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24/7. You can look up home health eligibility rules, compare plans, and check updated figures as CMS announces them.