*Agent Use Only. Not For Use With the General Public*
Welcome to the 2024 AEP for CY2025 enrollments, which lasts from October 15-December 7. We're ready for another great AEP season!
As everyone knows, it's been another year of a lot of disruption on many fronts.
As we navigate a landscape filled with both challenges and opportunities, let’s dive into some exciting updates and insights shaping the Medicare Advantage landscape this year.
New Statistics in Medicare Advantage Enrollment
This year, we're seeing a substantial increase in Medicare Advantage enrollment. As of 2024, 34.8 million individuals are enrolled in these plans, which is about 59% of the total Medicare population.
By 2025, projections indicate that enrollment could exceed 36 million, highlighting the ongoing shift in beneficiary preferences.
It’s important to note that the total number of Medicare Advantage plans will decrease slightly in 2025, with a 3% reduction, totaling 5,218 plans available nationwide compared to 5,377 in 2024.
As agents, it's vital to recognize that this increase may lead to more inquiries and requests for assistance. Prepare yourself for the wave of clients seeking guidance on their Medicare options this AEP!
Premium Trends
Despite all of the disruption, the average Medicare Advantage plan premium is expected to decrease by $1.23 in 2025 to $17.00.
Approximately 87% of all 2025 Medicare Advantage plans will have a monthly premium under $50, and over 58% will have a $0 premium.
That said, there will be a decrease in the number of $0 premium / $0 drug deductible (MAPD) plans, dropping from 39% in 2024 to 22% in 2025.
Plan Terminations and Impact on Clients
According to DEFT, over 2 million members will experience a plan termination this AEP.
This adds another layer of urgency for agents, as more clients than ever will need help navigating their options. Here are some additional data points from DEFT that could impact you:
- Premiums for MAPD plans held flat year-over-year, while PDP premiums increased by 2.8%.
- Drug deductibles increased by $165.60 for the average member.
- Maximum Out-of-Pocket (MOOP) costs rose by $323.
- Medical deductibles increased by $14.20.
Also, Low-Income Subsidy (LIS) beneficiaries who lose their MAPD plan coverage will be automatically reassigned to a $0 premium qualifying stand-alone Medicare Part D prescription drug plan (PDP), ensuring they continue to have access to necessary medications.
These changes underscore the importance of your role as agents during this AEP. Clients will be looking for guidance and solutions more than ever!
Unique Challenges and Compliance Changes for 2025
The 2024 AEP for 2025 contract year enrollments comes with some unique compliance changes that agents need to be aware of. Here’s what you should know.
Increased Plan Switching
We expect 40-70% of beneficiaries to switch plans due to evolving CMS payment policies. This is a significant jump from the typical 10-15% we’ve seen in the past.
It’s essential to prepare for an influx of clients needing your expertise during this transition.
More Plans With Part B Give Backs
There will be a 93% increase in the total number of Medicare Advantage plans that rebate or 'give back' a portion of the Medicare Part B premium, offering potential cost savings for clients.
Stricter Consent Requirements
New regulations mean we must obtain clearer and more specific consent from consumers.
Transparency in lead generation practices is more crucial than ever, so make sure your consent forms and marketing scripts are up to date to avoid potential penalties.
Read More: Compliance Guidelines for TPMO Data Sharing
Impact of the Inflation Reduction Act
The Inflation Reduction Act introduces substantial changes to Medicare Part D, including a $2,000 out-of-pocket maximum.
Understanding these adjustments will be key for agents as we guide our clients through these new cost structures. You can read a lot more about the IRA changes in our 2025 AEP Playbook.
MedicareCENTER and LeadCENTER Updates
Technology continues to play a significant role in enhancing our workflows and client interactions. Here’s what’s new in MedicareCENTER and LeadCENTER.
For a full view of the Integrity Tech Suite, download this packet.
Integration of Ask Integrity
We’re excited to introduce Ask Integrity, an AI-powered digital assistant that allows agents to access client information on the go.
This tool will help you prepare for meetings and ensure compliance with SOA requirements, making your life a bit easier during the busy AEP season.
Enhanced Client Management Features
The Integrity Suite now boasts improved client management tools that streamline communication, consent tracking, and client preferences.
Here are some specific features that will make your work easier:
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Comprehensive Client Profiles: You can view a complete history of each client, including their health conditions, prescription medications, and previous interactions. This allows for more personalized service during consultations.
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48-Hour SOA Tracking: The system automatically tracks the status of Scope of Appointment (SOA) forms, alerting you when a new SOA is required or if one is about to expire, ensuring compliance and reducing administrative tasks.
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Automated Reminders: Set reminders for follow-ups, appointments, or necessary paperwork. This feature ensures you stay organized and maintain regular contact with clients, enhancing your service quality.
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Secure Document Storage: Easily upload and store important documents related to each client’s healthcare plans, making it convenient to access and share essential information during consultations.
This means you can focus more on what matters: serving your clients effectively.
Recent Enhancements to MedicareCENTER
Here are a few more recent enhancements that make it easier for you to connect with and serve your clients:
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Contact Map: This feature, available in the Integrity for Agents mobile app, allows you to filter and sort clients by location on a zoomable map for efficient outreach.
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Low Income Subsidy (LIS) Indicator: You can indicate client LIS eligibility directly in their Contact Profile, which automatically filters plan options. Clients can also reflect their LIS status on PlanEnroll, ensuring updated plan cards.
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Multi-Pharmacy Comparison: Enter up to three pharmacies at once to compare prices. Clients can choose their preferred pharmacy through your Personal Agent Website link, which updates their PlanEnroll profile accordingly.
Lead Generation Improvements
LeadCENTER has stepped up its game!
Now offering real-time leads and customizable ad campaigns, agents can effectively target specific demographics. This integration ensures you can engage potential clients promptly.
Read More: PlanEnroll 2025 AEP Consumer Campaign is Live!
PlanEnroll Personal Agent Website
The Personal Agent Website is a fully compliant platform that enables agents to easily share plan options with clients.
This personalized site is essential for building trust and facilitating smoother enrollment processes.
Conclusion
The 2024 AEP is poised to be a transformative period for Medicare Advantage, marked by rising enrollment and significant compliance changes.
With the added complexity of plan terminations and increased costs, your role as an agent is more crucial than ever. By staying informed and utilizing the enhanced tools available, you can effectively support your clients in navigating these complexities.
If you have any questions regarding the MedicareCENTER, LeadCENTER, or the upcoming changes for 2025, please reach out. Together, let’s make this AEP our best one yet!
Good selling!
