Navigating 2025 Medicare Product Changes: What You Need to Know
Recently, we have seen unprecedented changes to live Medicare Advantage plans during Medicare AEP. Several carriers have made the decision to suppress plans from electronic enrollment systems and/or make certain Medicare Advantage plans non-commissionable to agents. The thinking is that these are plans that the carriers would like to slow down or stop new sales as much as possible.
Suppressed Plans and Non-Commissionable Plans
- Certain plans from carriers are becoming non-commissionable or suppressed in electronic platforms. The Pinnacle team has compiled a list of these plans that are available to agents.
- Some plans that are now being made non-commissionable in specific areas remain commissionable through paper enrollment in other areas.
- Suppression means such plans will not appear in platform searches such as Connecture and Sunfire. The electronic enrollment suppression also extends to the carrier enrollment platforms.
Examples of Changes
- Cigna has non-commissionable in certain states, while in other states, they remain commissionable with paper applications.
- Aetna has made plans non-commissionable in several states and suppressed from electronic enrollment.
- Anthem has changes leading to suppression and non-commission status.
- UHC has suppressed several plans in specific states.
- WellCare plans are suppressed but remain commissionable through paper enrollments.
Paper Enrollment Options
- Use Pinnacle’s Enrollment Services: We have a dedicated team to process paper enrollments quickly and efficiently.
- Direct Carrier Fax: You can send paper enrollments directly to carriers using their new business fax numbers listed in Pinnacle’s services.
Understanding Platform Usage
- Platforms like Connecture and Sunfire still may allow searches for plans that are now suppressed, but you can no longer enroll through the platform. Otherwise, you would need to use Medicare.gov to run a product comparison.
- For plans you can’t enroll online, it would be necessary to use paper to submit plans.
The Business Decision Behind Suppression
The driving force behind these changes is a strategic decision by carriers to control enrollment volumes into specific plans, which controls their costs. Changes in the way that CMS is applying Star Ratings as well as changes to the PDP’s implemented through the Inflation Reduction Act are all factors.
Serving as an Agent and Supporting Your Clients
We recommend:
- Reviewing plan changes specific to your sales region.
- Accessing the necessary documentation and understanding alternate plan options.
- Continuously supporting your clients by offering them the most appropriate plans
Conclusion
The 2025 Medicare plan adjustments impose a learning curve for us all, but by staying informed and adaptable, we can continue to provide exceptional service to Medicare beneficiaries. If you have any questions or need more guidance, Pinnacle Financial is here to help every step of the way.
Bob Brzyski
Vice President, Marketing