On Tuesday, Sept. 23, A.M. Best issued its Best’s Special Report, “Challenges to Medicare Advantage Will Negatively Impact Profitability,” discussing the financial health of Medicare Advantage (MA) through 2024. The report states from 2023 through the end of 2024, the Medicare Advantage sector incurred a $5.7 billion underwriting loss.
Almost 75% of companies with an MA concentration of business incurred an underwriting loss for the MA business line in 2024. The A.M. Best report also states that in 2025, the number of MA companies with a 4-star MA contract is down 25% from the 2022 number of 4-star contracts.
Since 4-star MA contracts receive higher payment rates from CMS, this decrease suggests that some MA companies are also experiencing lower revenue from their MA business line. A.M. Best says in the report these MA companies will continue evaluating their position in the MA business line in 2026.
What This Means to Medicare Agents
- From 2019 to 2022, MA companies achieved underwriting gains, resulting in profits. Therefore, MA companies must address any underwriting losses they may have.
- MA companies will continue to refocus their operations on the more profitable aspects of MA, as they have been doing over the last couple of years, with service area reductions and exiting specific types of policies.
- MA is still growing, with thousands of baby boomers retiring each day, so leaving a growing market is not a good decision.
- Expand your product portfolio to prepare for lower MA plan benefits, including ancillary products such as dental, vision, hospital indemnity, and critical illness policies, among others.
Carolina Alcorta, Agility’s Medicare Product Specialist, and Chris Gaston, Agility’s Ancillary expert, are here to help you strategize and connect with the MA and ancillary products that can maximize your revenue. You can reach Carolina at calcorta@enrollinsurance.com.
Carolina can refer you to the best MA plans in your markets to contract with for AEP. Chris can direct you to our Ancillary Products Contracting website, where you can find the best ancillary products available in your market to support your Medicare clients during plan transitions.
For general insurance questions, contact the Agility Producer Support Team at (866) 590-9771 or support@enrollinsurance.com. Carolina, Chris, and Producer Support can add you to our free weekly email list for timely tips and updates to help you maximize this Medicare AEP.
