The end of the year always brings a few deadlines. This year it brings more than usual. New Medicaid rules begin January 1, 2027, Social Security and SSI payments are going up, and several savings and enrollment windows close in the next few weeks.
You don't have to tackle all of it at once. Below, we've organized the year-end to-dos into four areas: health coverage, benefits, savings and gifts, and planning documents. Start with whatever feels most urgent for your family.
1. Health Coverage: Know Your Deadlines
Medicare Open Enrollment ends December 7. If your loved one has Medicare, either through SSDI or through Childhood Disability Benefits, now is the time to compare plans for 2027. Plans can change their drug lists, pharmacies, and costs each year. Read the Annual Notice of Change from the current plan, and confirm that every prescription and doctor is still covered. Changes take effect January 1.
Marketplace enrollment is open now. If your family buys coverage through HealthCare.gov or your state's marketplace, enroll by December 15 for coverage that starts January 1. In most HealthCare.gov states, open enrollment ends January 15. State-run marketplaces can set their own dates, so check yours. Premiums are rising for 2027, federal rules have changed who gets financial help, and some insurers are leaving certain markets, so don't let a plan simply auto-renew.
Medicaid work rules begin January 1. Under a new federal law, some Medicaid members ages 19 to 64 will need to show 80 hours a month of work or other approved activities, or earn at least $580 a month, unless they qualify for an exemption. The rules mainly affect adults covered through Medicaid expansion, so how they apply depends on your state. Many people with disabilities qualify for an exemption, including most SSI recipients and people who meet Social Security's disability standard. Some family caregivers may also qualify.
What to do now:
Open and respond to every letter from your state Medicaid agency right away.
Update your mailing address, phone, and email with your state Medicaid office or online portal.
Check your state Medicaid website for a screener or FAQ on the new rules.
If your loved one may qualify as "medically frail," start a folder of recent medical records and provider letters now.
Put the next renewal date on your calendar. Many adults will now renew every six months instead of once a year.
A plan with a lower premium could ultimately cost considerably more if your child or family member attends therapy several times each week.
2. Benefits: Get Ready for 2027
Payments are going up 3.6%. Social Security and SSI benefits will rise 3.6% in 2027. SSI recipients will receive the higher January payment on December 31, 2026. The maximum federal SSI payment rises to $1,029 a month for an individual, and the SSI resource limit stays at $2,000.
Watch the January 1 resource count. SSI looks at countable resources on the first day of each month. A December check that arrives on December 31, plus holiday cash gifts, could push a bank balance over $2,000 on January 1. Plan ahead by spending down on needed items, or by moving money into an ABLE account before the new year.
Be careful with holiday gifts. Cash given directly to someone on SSI generally counts as income and can reduce their payment. Gifts to a special needs trust or an ABLE account, or non-cash gifts like clothing, are usually better options. If family members like to give money, share these options with them before the holidays.
Look for your COLA notice. To see it online, create a my Social Security account and sign up for paperless notices by November 18. Paper notices arrive in early December. Save the notice; you'll need the new amounts for benefits reporting, budgets, and any housing or SNAP renewals.
Report work and wages on time. If your loved one works, keep reporting monthly earnings to Social Security. Gather pay stubs from 2026, and review whether work incentives like the Student Earned Income Exclusion or impairment-related work expenses could help in 2027.
3. Savings and Gifts: Use This Year’s Limits
ABLE contributions for 2026 must be made by December 31. Up to $20,000 can go into an ABLE account this year from all sources combined: the account owner, family, friends, and a special needs trust. Working account owners who don't contribute to a workplace retirement plan may be able to add more from their own earnings through the "ABLE to Work" provision. Contributions don't carry over, so unused room for 2026 is gone after December 31.
More people can open an ABLE account now. Starting in 2026, a person qualifies if their disability began before age 46, up from age 26. If a family member was turned away before, it may be worth checking again.
529-to-ABLE rollovers count toward the limit. If you plan to move money from a 529 college savings plan into an ABLE account, the rollover plus all other contributions must stay under $20,000 for the year.
Annual family gifts. For 2026, each person can give up to $19,000 per recipient without filing a gift tax return. Many families use this for gifts to a special needs trust or to siblings. Check with your attorney or tax professional about the right structure for your family.
Use flexible spending dollars. If you have a health or dependent care FSA through work, check your plan's deadline. Many plans have a use-it-or-lose-it rule at year-end or a short grace period.
Gather receipts for medical expenses. Families with high out-of-pocket medical costs, including therapies, equipment, and some home modifications, may be able to deduct them. Pull together 2026 receipts now so tax season is easier.
4. Review Your Planning Documents
The holidays often bring families together, which makes it a natural time to review the documents that protect your loved one. You don't need to rewrite everything. Just check that each one still reflects your family today.
Special needs trust: Is the trustee still the right person? Is there a named successor? Were distributions this year made in a way that protects benefits? Gather the trust's 2026 statements for tax filing.
Wills and beneficiary designations: Make sure retirement accounts, life insurance, and payable-on-death accounts don't name your loved one directly. They should usually name the special needs trust instead.
Letter of intent: Update daily routines, medications, providers, likes and dislikes, and goals. This is the guide a future caregiver will rely on.
Guardianship or alternatives: If you have a guardianship, check whether annual reports are due to the court. If your child is approaching 18, start exploring options like supported decision-making or powers of attorney now.
Contacts and records: Keep one up-to-date list of doctors, case managers, benefits contacts, and account information in a place your backup caregiver can find.
We’re Here to Help
Year-end planning is easier with someone in your corner. If you'd like help reviewing your family's benefits, ABLE strategy, or planning documents before the new year, we'd love to talk. Get in touch.
This article is intended for general educational purposes and should not be considered individualized insurance, legal, tax or financial advice. Health insurance coverage and public benefit rules vary based on individual circumstances and may change.
