ADRC 2027 Benefits Update: Medicare, Medicaid, FoodShare, and SeniorCare
Read a summary of the the video in the article that follows or pick where to go in the video by following the links below:
Important Reminder for Medicare Beneficiaries:
Mark your calendars! The annual Medicare Open Enrollment period runs from October 15 to December 7. This is your primary window each year to review, compare, and make changes to your Medicare prescription drug plans (Part D) and Medicare Advantage plans (Part C).
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Staying on top of public benefits can feel overwhelming, but keeping up with annual adjustments is essential to ensuring you receive the coverage and support you need.
In a detailed presentation, Kathy Cummings, Elder Benefit Specialist with the Aging and Disability Resource Center of Columbia County (ADRC), walked those attending a CoCo Dems Second Wednesday event last August through upcoming policy changes, financial estimates, and program rules.
Below is a summary of the updates shared by Cummings across four key areas: An introduction to herself and the ADRC, Medicare updates for 2027, Medicaid and FoodShare changes, plus an overview of Wisconsin’s SeniorCare program.
Introduction & The Role of the ADRC
Kathy Cummings has served as the Elder Benefit Specialist at the Columbia County ADRC for over four years, following seven years in Health and Human Services support services. As a State Health Insurance Assistance Program (SHIP) counselor, Cummings provides free, unbiased assistance with both public and private benefits.
Funding & Structure: SHIP positions are funded through a combination of federal (Older Americans Act), state, and county funds. Wisconsin structures its SHIP program so that every county has a dedicated (or shared) local counselor.
Legal Backup: SHIP counselors work under the guidance of program attorneys who assist with complex legal matters, such as skilled nursing facility appeals or Medicare coverage appeals.
Local Services: During Open Enrollment, Cummings meets with around 285 local residents. Due to high demand and budget limits, residents seeking one-on-one appointments must fill out an intake form—available in the ADRC’s Grapevine publication—and mail it in. Cummings conducts appointments in Portage, Columbus, Lodi, and Poynette (at the Poynette Library).
Medicare Updates for 2027
Cummings emphasized that many figures for 2027 remain proposed estimates until final figures are locked in by the federal government later in the year.
Financial Estimates & Premiums
Medicare Part B Premium: Proposed to rise to approximately $209.50/month (an increase of just under $7/month). High earners may pay more based on tax returns from two years prior.
Medicare Part B Deductible: Estimated to increase by about $9 to $292/year.
Medicare Part A Deductible: Projected between $1,789 and $1,820 per benefit period.
Prescription Drug Coverage (Part D)
Out-of-Pocket Maximum: Under provisions of the Inflation Reduction Act, the annual out-of-pocket cap for prescription drugs will rise to $2,400. This cap permanently replaces the old "donut hole" coverage gap.
Standard Part D Deductible: Can be as high as $700 in 2027 (up from $615). Generics often bypass this deductible, but brand-name or high-cost drugs usually require meeting the deductible first.
Expiration of Subsidies: Temporary federal subsidies for standalone prescription drug plans are ending at the end of 2026. This change may cause standalone Part D plans (including zero-dollar premium plans like WellCare Value Script or Humana options) to begin charging monthly premiums or raising costs.
Open Enrollment Tip: Always check your plan during open enrollment. Prices change, but more importantly, pharmacy networks shift. Your current pharmacy may not be in-network next year. Watch for your Annual Notice of Change (ANOC) arriving in the mail each September.
Medicare Advantage (Part C) Rules & Supplemental Benefits
CMS Star Ratings Overhaul: The Centers for Medicare & Medicaid Services (CMS) updated its star rating system, removing factors like call center performance and placing heavier weight on clinical outcomes and patient experience.
Elimination of Mid-Year Benefit Notifications: Plans are no longer required to send mid-year reminders regarding unused supplemental benefits (like gym memberships or over-the-counter allowances).
Relaxed Marketing Rules: Telemarketing call recording retention requirements for agents have been reduced from 10 years to 6 years, and agents are no longer required to refer callers to the local SHIP program.
Increased Federal Payments: Advantage plans are receiving a 2.48% payment increase (~$13 billion globally), which is intended to help stabilize benefits, preserve provider networks, and limit out-of-pocket hikes.
Special Needs Plans & Benefit Cards: Dual-Eligible Special Needs Plans (D-SNPs) for individuals with both Medicare and Medicaid offer extra allowances (such as up to $200/month for healthy foods, utilities, or gas). Starting in 2027, strict point-of-sale restrictions will enforce that card funds can only be spent on plan-approved items.
FoodShare Updates & Medicaid Work Requirements
Federal changes under H.R. 1 have altered renewal frequencies and eligibility criteria for food assistance and healthcare coverage.
FoodShare Adjustments
60–64 Age Bracket: Individuals aged 60 to 64 are now required to complete a renewal process every 6 months (submitting a mailed mid-year report and completing an annual phone recertification).
Ages 65+: Seniors aged 65 and older remain on a 3-year interview cycle.
Income Focus: FoodShare evaluates household income rather than assets.
H.R. 1 Medicaid Work Requirements
Implementation Timeline: Takes effect in January 2027. Existing recipients will not face these rules until their scheduled annual renewal date during 2027. Notices are mailed out 3 months prior to implementation.
Core Requirement: Non-exempt adults must complete 80 hours per month of qualifying activities (paid work, job training, school, or volunteering) or show a monthly income of at least $580 (federal minimum wage × 80 hours). Proof must be provided for the month prior to application or renewal.
Exemptions: Individuals receiving Social Security Disability Insurance (SSDI), those with documented medical disabilities, students, and participants in formal job training programs are exempt from the work requirement.
Wisconsin SeniorCare Overview
For Wisconsin residents aged 65 and older, SeniorCare remains one of the most affordable and flexible prescription drug assistance programs available.
Eligibility & Cost: Available to any Wisconsin resident aged 65 or older. The annual enrollment fee is just $30 per person.
Income Levels & Out-of-Pocket Tiers:
Level 1 (Income at or below 160% of the federal poverty level): Low copays right away ($5 for generic, $15 for brand-name drugs) with no deductible.
Level 2A (Income above 160% and at or below 200% of the federal poverty level): $500 deductible per person, then copays ($5 for generic, $15 for brand-name drugs).
Level 2B (Income above 200% and at or below 240% of the federal poverty level): $850 deductible per person, then copays ($5 for generic, $15 for brand-name drugs).
Level 3 (Income more than 240% of the federal poverty level):
Retail price for covered drugs during spenddown
Once spenddown is met, meet an $850 deductible per person
The SeniorCare rate for covered drugs until the $850 deductible is met
Once $850 deductible is met:
$5 copay for each covered generic prescription drug
$15 copay for each covered brand-name prescription drug
Creditable Coverage: SeniorCare is recognized by the federal government as creditable prescription coverage. Joining SeniorCare satisfies the requirement to have drug coverage, protecting seniors from Part D late-enrollment penalties if they decide to join a Medicare Part D plan later.
Coordination with Medicare: SeniorCare can be used as a primary drug plan or as a secondary payer alongside a Medicare Part D or Medicare Advantage plan to help cover remaining copays and deductibles.
Need Help? Contact the ADRC
If you have questions about your 2027 options, need help reviewing your prescription drug list, or want to apply for SeniorCare or FoodShare, reach out to your local Aging and Disability Resource Center. Columbia County residents can contact the ADRC office in Portage or request an appointment form through The Grapevine.
Office Location
Columbia County Aging & Disability Resource Center
111 E. Mullett Street
Portage, WI 53901
Hours & Contact Info
Monday through Friday
8:00 a.m. to 4:30 p.m.
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Phone: (608) 742-9233
Toll-Free: 1-888-742-9233
FAX: (608) 742-9277
Email
Mailing Address
Columbia County Aging & Disability Resource Center
P.O. Box 136
Portage, WI 539