5 Things Medicare Agents Should Know This AEP

Medicare’s Annual Enrollment Period is underway. From October 15 through December 7, beneficiaries can make plan changes for January 1, 2027. If you sell Medicare Advantage or Part D plans, here are five things to keep in mind as you help clients review their options.

1. Start With Clients Facing the Biggest Changes

Your clients should have received their Annual Notice of Change in September. Have they read it?

Help them understand changes to premiums, benefits, and out-of-pocket costs. Prioritize appointments for clients whose plans are ending or whose coverage is changing significantly. For Medicare Advantage clients, also confirm that their doctors and hospitals will remain in network. This doesn’t mean searching every provider, but if you’ve heard about any big contract negotiations between provider groups and the carrier, it’s worth investigating.

Don’t assume a satisfied client’s current plan will still meet their needs next year.

2. Keep Recording Those Sales Calls

As CMS explains in its Final Rule for 2027, independent agents subject to the third-party marketing organization rules must record Medicare Advantage and Part D marketing, sales, and enrollment calls in their entirety, including the audio portion of web-based calls.

With AEP underway, check that your system is recording properly and that recordings are retrievable. Follow applicable consent and retention requirements.

3. The Part D Cap Doesn’t Replace Plan Shopping

The annual out-of-pocket cap introduced at $2,000 in 2025 increases to $2,400 for 2027, as noted on Medicare.gov. But it only applies to covered Part D drugs. Prescriptions the plan doesn’t cover generally fall outside that protection, making it more important to shop Part D plans every year instead of simply renewing as is.

Some carriers are responding to the out-of-pocket cap by increasing their premiums, more than doubling in some cases. Others are making changes to their formularies, so a drug that was previously covered may no longer be. Having the client log in to Medicare.gov pulls up their recent prescriptions and makes this process quicker and easier.

4. Non-commissionable Plans Still Deserve Attention

Some carriers have eliminated commissions on stand-alone Part D business, so be sure to check each carrier’s current compensation schedule.

But, whether brokers receive a commission or not, clients still need help choosing drug coverage. For Medicare supplement agents, offering a Part D review as a courtesy can strengthen the relationship and help clients avoid expensive surprises.

5. Group Agents Could Be Your Next Referral Partners

For plan years beginning in 2027, CMS is retiring the old simplified creditable-coverage test for employer-sponsored health plans. Among other requirements, the revised method requires plans to cover, on average, at least 73% of prescription expenses. Actuarial testing remains an alternative.

Some employer plans may no longer qualify as “creditable”. Employees working past 65 should review their creditable-coverage notices and explore Medicare options when necessary to avoid Part D late-enrollment penalties.

Consider partnering with group benefits agents who don’t specialize in Medicare. You can be the expert they call when employees need guidance.

AHCP can help you serve these clients. We offer Medicare Advantage and Medicare supplement options across the country. Visit AHCP’s Medicare carrier page to explore available carriers, and please let us know if you have any questions.