There’s A LOT of information coming from a variety of sources about what’s happening in Medicare as we head into the 2027 AEP. So today, we touch on what information is out there and how it may affect AEP results for agents.
CMS Projects 2027 MA Premium Decrease, Another Report Says ‘Mixed Bag’ Ahead
Many of you may have seen the CMS announcement about a 16% decrease in the 2027 MA premium across MA plans. This sounds like fantastic news for Medicare clients and agents.
Another report paints a mixed picture for 2027. MA plans are focusing more on HMOs than PPOs, some areas are seeing coverage consolidation that prioritizes core benefits, and Medicare enrollees may face higher cost shares.
So, which of these are we to believe about 2027? We should believe both of these to be true.
Lower monthly premium costs are possible because MA payers are making tough choices about their 2027 plan mix and the coverage maps for those plans. MA payers are also in different phases of their cost-mitigation programs to maintain their margins.
Some MA payers are further along in this process and are better able to produce MA plans with richer 2027 benefits, while others are just starting and will have 2027 plans that reflect the organization’s need to address this challenge through benefit cuts, increased client cost-shares, and reduced plan footprints.
About Those MA Plan Footprints
There’s great information about this as it comes into focus. The total number of plans, both nationwide and by state, indicates there will be 21 fewer total MA plans in 2027 than in 2026.
That’s not a significant decrease in plans year-over-year, and it’s good news for both Medicare clients and agents. 29 of the 51 jurisdictions with MA plans will see fewer MA plans, while 21 will see more.
Florida, Ohio, and Illinois are the three states losing the most MA plans. Wyoming, Montana, Maryland, Minnesota, and the District of Columbia are seeing the largest percentage declines in MA plans within their jurisdictions.
Tennessee, Missouri, Alabama, and Arizona are the states adding the most MA plans for 2027. There’s also clarification showing how each MA plan ranks against its peers on entering and leaving 2027 counties.
You can see the details and overview of each jurisdiction here.
To see the full list of 2027 MA and PDP plans available nationwide from CMS, click here.
And Here’s a New MA Opportunity
Earlier this year, CMS said MA plans can, for the first time, set enrollment caps for specific plans in their product portfolios. If an MA plan sets an enrollment cap for a specific plan, it agrees not to disenroll any of the plan’s members, and once the plan hits the enrollment cap, no new members can enroll until natural attrition occurs.
There are 15 MA payers with 65 MA plans across 11 states, with 2027 enrollment caps. These MA plans are great opportunities to match Medicare clients with lifetime coverage that best addresses all of their individual needs and concerns.
For these reasons, Medicare agents should be 100% certain these plans are a good fit for their clients before enrolling them in a capped MA plan.
The Medicare Agent Bottomline
So what does all of this mean for Medicare agents? Opportunities are out there to be had, but picking your payer partners will be critical to find the best coverage options in the markets you serve. A market with fewer MA plan options may have an MA plan with great benefits if it’s offered by an MA payer that’s further along in managing its costs.
And you should always have a strong, substantial portfolio of Medicare supplement and ancillary coverage options in all of your markets to address clients who need that as their best coverage option.
The Agility Difference
There’s a great deal of information here for Medicare agents to digest. So, Agility’s Medicare experts are here to help you analyze and digest it to what you need to maximize your business opportunities helping Medicare clients.
Call (866) 590-9771 or email support@enrollinsurance.com for immediate assistance from the team. As the insurance market changes, Agility helps agents stand out by sharing updates and offering our team’s expertise to help you grow.
If you have questions or want to talk to our ACA, CHOICE, Group, life, or ancillary experts, reach out to our dedicated Producer Support at (866) 590-9771 or support@enrollinsurance.com. We can add you to our weekly email list for tips and updates.
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