A Recap of This Year’s Medicare Advantage Changes
These are changing times for Medicare Advantage, and with half of the year over and the Open Enrollment period drawing closer, we thought it would be a good time to summarize changes so far in 2024.
Let’s start with new regulations that were announced in April that range from how agents interact with clients to how much insurers will be paid by Medicare.
The CMS Makes Big Changes
- The Centers for Medicare & Medicaid Services (CMS) announced 2025 rules affecting agent commissions. The CMS established a fixed amount a Medicare Advantage plan can compensate a broker or agent. All plans pay the same amount of commission for the sale of an MA policy. Commissions will be higher for new enrollments and lower for renewals but the same for each plan.
- The CMS also ended insurance providers paying agents administrative fees. The CMS said these compensation changes were necessary to protect consumers and place “guardrails” on the industry.
- The CMS finalized 2025 rates for Medicare Advantage (MA) and Part D prescription drug plans. The CMS announced a payment increase of 3.7% over 2024 for MA plans.
Some worry this increase will not be enough. They say the expected increase in payments will not cover the full rise of 2025 healthcare costs. This could lead to a cut in benefits for Medicare Advantage plans, which could lead to more consumer cost share.
In another CMS regulation, there are restrictions on how customer data is to be used. The agency made it a requirement that beneficiaries must now give express, written consent that their personal data be shared. The rule affects data collected by a TPMO (third party marketing agency) and used for marketing or enrolling someone into a Medicare Advantage or Part D plans.
Medicare Advantage Surges in Popularity
Early in 2024, it was announced that more people are now enrolled in private Medicare Advantage plans than in traditional Medicare. This is a first. In 2023, 30.8 million people were enrolled in Medicare Advantage plans, 51% of the eligible Medicare population.
Star Ratings Change
In a major boost for insurers, the CMS announced in June it will re-calculate 2024 star ratings for insurers and only change the ratings if the ratings show improvement. The ratings are important because they are used by consumers to select insurers and they also can determine bonuses paid by the CMS to insurers.
The change could send hundreds of millions of federal dollars to insurers and follows court rulings that challenged star ratings.
Quick Reminder: It’s Time to Get Your Certification
Looking ahead, this summer is a great time to earn your required training and certification for preventing Medicare Fraud, Waste and Abuse. Insurers require that agents have this certification before selling Medicare Advantage (MA) plans during open enrollment. The AHIP organization makes its test prep/certification services available for agents and Pandora agents receive a discount. Contact us to find out more.
How Pandora Can Help
- Pandora Insurance partners with the major insurers in the Medicare market. We have the training, commissions, and marketing support that you deserve. Enjoy these benefits when contracted with us!
- Free Pre-license courses for our contracted agents
- Industry leading carrier contracting
- Federal Marketplace Certification for Affordable Care Act (ACA)
- MEDICARE AHIP annual certification discount
- Knowledge-based and practical training
- Partnerships with proven sales professionals in the Medicare industry
- Medicare off-the-shelf marketing material, custom layouts
- Carriers include: ACA (Obamacare), Medicare, life and supplemental
- Commission and bonus reporting
- Bilingual support
Start today on your path to growing your Medicare business! Get contracted by filling out a simple form on our website. Or contact us at 305-231-9898.
This information is confidential and intended solely for broker use. Distribution to Medicare beneficiaries is not permitted.
