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Some agents think that once a sale is made their work is done. This could not be further from the truth. Managing your book of business is extremely important if you want to keep your clients and earn your renewal commissions. Ensuring your existing clients are happy is just as important as brining in new clients. Your income is made up of renewals as well as new business.   In fact, maintaining a good rapport with all your clients, leads to more referrals of their friends and family. This provides a steady stream of new business.

Contact your clients

It is important to regularly contact your clients. This helps remind them you are there for them and keeps them from looking elsewhere for answers to their Medicare coverage questions

There are many opportunities to stay in touch with clients. Consistency is important so they remember you are there for them if a question or concern comes up. 

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Some reasons to contact clients:

1. After you submit their application, it is a good idea to notify them when it is approved and when to expect their new card.
2. Once a client enrolls in a plan, agents should check in and see if they are happy with their choice.
3. At the start the Medicare AEP or a little before, agents should contact clients and collect any health, medication or provider updates needed to check plan options for the following year. Keep in mind, agents can’t discuss plan details for the following year until October 1st.
4. In the event a potential client is coming up on their IEP, you should contact them a few months ahead and advise them of how to enroll in Medicare and set an appointment to discuss plan options.
5. If you r client has an opportunity for an SEP, be sure to explain the details and timeline so they do not miss an opportunity to make a change.
6. It is a good idea to send birthday greetings to your clients. In some instances, you may need to send a condolence card when appropriate.
7. If you have specific information that the client may find useful or when you are hosting an event, you may want to notify your clients.

Try to keep updated client contact information so you are able to contact clients when you need to.

How to contact clients

There are many ways to contact clients. Although if you have a deadline for important messages, it is probably best to make a phone call. It is important to be sure the client or prospect agrees to the mode of communication before you send anything to them. Here are a few suggested ways to contact clients or prospects:

1. Make a phone call or send a text.
2. Schedule a video call or zoom meeting.
3. Mail cards or other general information that is not urgent.
4. Send them an email.  For bulk emails, be sure to include an opt out.
5. For general information, a post on your social media platforms such as Facebook, or LinkedIn will work.

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Compliant communications

No matter how you choose to communicate with clients, it must be compliant with CMS regulations.

1. Get a permission to contact from your potential client
2. If you plan to make phone calls or send texts, be sure to abide by the (TCPA)Telephone Consumer Protection Act guidelines.
3. Be sure to record any marketing, sales or enrollment calls you make to remain compliant with CMS’s regulations.  Phone calls to existing clients to say hello or check in, do not need to be recorded.
4. If you are thinking of sending an email, be sure you comply with the CAN-SPAM Act.

View a YouTube video of the key elements to a compliant phone recording

When you send out a bulk email, make sure you do not use misleading information.  If you are sending an advertisement, make that intention clear.  Always include an opt-out for future communications.  It is important to include your contact information and address in your signature.  Agents must include a TPMO disclaimer on all email communications.

If you are sending an email to a current client, you may not need to follow all the rules exactly as stated.  It is a good idea to use your best judgement and when in doubt, err on the side of caution.

Sending out mail

If you are sending out a card, application or something else to an individual, you should include instructions, contact information and postage paid return envelopes when necessary. 

When sending out bulk advertisements or informational mailings, follow all CMS guidelines.

Watch a YouTube video on Medicare marketing rules

New business

Of course it is important to expand your Medicare book if you want your business to grow and generate more income, you need to add new clients. There are many ways to find new clients. This includes through recommendations of existing clients.

Our agents have access to some great lead companies as well as a seminar sales program that has proven to be very successful. Another good way to meet new prospects is by setting up a table at local events and providing free Medicare guidance to those who ask for it.

Learn how to get more Medicare referrals

Effective marketing strategies as well as community outreach help establish you as a trusted resource. It is always important to follow all permission to contact rules as well as any CMS marketing guidelines before hosting any event or initiating contact with potential clients.

Once your book grows to a good size, you may want to consider hiring someone to help you manage your book and ensure that all clients are taken care of. This can be a person to answer the phones, schedule appointments or provide basic information. Although you may need more help than that. If this is the case, hiring a licensed agent to go over plan details or write plans for clients may be a good option for you. either way, it is important to stay organized and pay attention to your client’s needs.

The 2025 prescription payment plan is available to Medicare Part D beneficiaries. It lets them pay high out-of-pocket prescription costs over the course of months instead of all at once. The other name for The prescription payment plan is Smoothing. The payment plan is part of an effort to make prescription drugs more affordable for Medicare beneficiaries.

How the prescription payment plan works

Any Part D plan enrollee can participate in the prescription payment plan as long as they have high-cost prescriptions that are on their plan’s formulary. Beneficiaries have the chance to divide their out-of-pocket prescription costs into manageable monthly payments.

Eligible beneficiaries can contact their Part D insurance provider to opt into the program. The plan provider will calculate the payments to spread out evenly over the course of the year. The beneficiary can contact their insurance Part D provider if they need to add prescriptions to their current arrangement and have it adjusted.

Enrollees do not pay a cost to participate in the payment plan. Beneficiaries do not pay interest or penalties on their medication costs.

How to join the prescription payment plan

It should be fairly simple to enroll in the plan. In some instances, the Part D plan provider may contact beneficiaries who are known to have high-cost prescriptions. Beneficiaries who are interested in the plan should contact their plan provider for instructions to opt in.

Why enroll in the plan

There are many reasons to enroll in this program. Enrollment may help beneficiaries manage their budget by spreading out their prescription costs. This is a great way to avoid a large bill at the pharmacy.

Knowing there is an alternative to a large bill, may help ensure beneficiaries fill their necessary prescriptions without having to face financial stress. In some cases, beneficiaries have had to go without needed medications due to budget concerns. This help eliminate that issue. The plan also provides peace of mind with the safety of predictable monthly costs.

Click here to learn about the $2,000 annual cap on Out-of-Pocket prescription costs

Watch a YouTube video on the drug cap for 2025

Each year, Medicare makes changes to the plans beneficiaries are offered. This is why both agents and beneficiaries need to stay up to date on all changes that place. Knowing all the choices available helps beneficiaries receive the coverage they need and plan for their year ahead. A licensed insurance agent can provide advice to ensure beneficiaries choose a plan that suite their needs and budget.

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Many Medicare enrollees are wondering what the costs for Medicare Part B 2025 will be. Medicare Part B is a critical part of healthcare coverage for Medicare beneficiaries. It covers outpatient services, preventive care, doctor visits, and durable medical equipment. Knowing the expected premiums and deductible amounts can help beneficiaries plan their healthcare budgets effectively.

Medicare Part B Premiums in 2025

The Medicare Part B premium is the monthly amount that beneficiaries pay for medical coverage. In recent years, premium costs have steadily increased due to rising healthcare expenses, which include the cost of outpatient services and medical advancements.

For 2025, the CMS (Centers for Medicare and Medicaid Services) has projected an increase in the standard monthly premium for Medicare Part B to $185. This is up from $174.70 in 2024.

Please note; individuals who have an income over the specified threshold will pay an IRMAA and therefore the cost of their Part B coverage will be higher. For 2024, the high-income threshold was 103,000 for an individual and $206,000 for a couple. For 2025, it increases to $106,000 for an individual and $212,000 for couples.

Individuals who enroll in Part B coverage late may pay a penalty and therefore their monthly premiums are also higher.

Medicare Part B Deductible in 2025

In addition to the monthly premium, Medicare Part B enrollees must meet an annual deductible before Medicare starts covering most of the costs. For 2024, the Part B deductible was $240. For 2025 the deductible is predicted to be about $257.

Once the deductible is met, Medicare generally covers 80% of the Medicare approved costs leaving the beneficiary responsible for the remaining 20%. Factoring in the deductible as well as anticipated co-payments help with healthcare budgets.

Planning for Higher Costs

With the cost increases in 2025, there are a few ways beneficiaries can prepare:

Beneficiaries with a low income and limited assets may be able to apply for MSP. MSP may pay for Medicare Part B for those who qualify.

Those who are near the income threshold for IRMAA adjustments, consider strategies to manage your taxable income to potentially reduce your premium amount.

Consider a Medicare Advantage (Part C). These plans bundle Parts A and B and often Part D. They may also include additional benefits, like vision, dental, hearing and more. They sometimes offer lower out-of-pocket costs compared to traditional Medicare.

Look into a Medigap plan (Medicare Supplement). Medigap/supplemental policies help cover costs not paid by Medicare, such as co-pays and deductibles, which can help offset increases in Part B costs.

Navigating Medicare Costs

Medicare costs can be complicated, and even a small increase can have a significant impact on a fixed income. Resources like licensed Medicare agents and the State Health Insurance Assistance Program (SHIP) offer free advice for Medicare beneficiaries. This helps them understand their options and make the best possible choices.

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Agents – Click here to watch a YouTube video of updates to Connecture and Sunfire for 2025

Knowing what to expect in terms of Medicare Part B costs helps enrollees make informed decisions about healthcare coverage.

Understanding Medicare Part D Costs in 2025

Medicare Part D, the part of Medicare that covers prescription drugs for millions of Americans, provides significant savings but comes with costs that beneficiaries need to plan for. Each year, adjustments are made to premiums, deductibles, and other costs associated with Part D. There will be some significant changes to the Medicare Part D costs 2025. We will discuss the Part D costs, what changes to expect, and tips to manage these expenses.

Watch a YouTube video on the Part D drug cap

Key Cost Components of Medicare Part D

Medicare Part D plans are offered by private insurance companies. Each plan has varying costs depending on the specific plan chosen. In 2025, the cost structure will include four main components:

Monthly Premiums

Medicare Part D premiums vary significantly, depending on plan and location. The average monthly premium for 2025 is around $40. Keep in mind, premiums for individual plans may be as high as $150 or as low as $0. Additionally, some beneficiaries qualify for the Medicare Extra Help program, which can help reduce premiums and other Part D costs.

Annual Deductible

In 2025, Medicare Part D’s standard annual deductible is capped at $590, though not all plans charge the maximum deductible. In general, plans use tiered pricing, meaning they might charge no deductible for lower-tiered drugs.

Initial Coverage Phase

Once the enrollee meets the deductible, they enter the initial coverage phase. During this phase, enrollees are responsible for a copayment or coinsurance for each prescription. In 2025, the initial coverage limit will be set at $2,000. This means that once the amount spent by the plan and the beneficiary reaches this threshold, enrollees transition to the catastrophic phase.

Catastrophic Coverage

In past years, after reaching the coverage gap or donut hole, beneficiaries would enter the catastrophic phase, with Medicare covering the bulk of prescription costs. A major shift in 2025 is the elimination of coverage gap/donut hole phase, meaning enrollees won’t have to pay coinsurance or copayments after reaching the catastrophic coverage limit of $2,000 in true out-of-pocket costs. This limit provides significant relief, especially for those needing high-cost medications.

Changes and Reforms Affecting Part D Costs in 2025

The Inflation Reduction Act (IRA) of 2022 brought changes to Medicare Part D in an effort to improve cost predictability and help enrollees manage high prescription drug expenses. Here’s a breakdown of the key IRA-related reforms that apply in 2025:

$2,000 Annual Out-of-Pocket Cap
Starting in 2025, Medicare Part D beneficiaries will have an out-of-pocket cap of $2,000 per year on prescription drugs. This landmark change helps beneficiaries with high drug costs avoid excessive spending and will particularly benefit those with high-cost prescriptions as long as they are on their plan’s formulary.

Monthly Payment Options
Medicare will introduce a “smoothing” option for beneficiaries with high prescription costs. This allows enrollees to spread out payments over the course of the year, rather than facing steep costs in any one month.

Managing Medicare Part D Costs in 2025

Compare Plans Carefully

Each Part D plan varies in terms of premiums, deductibles, and formulary (the list of covered drugs). Enrollees should review all available options carefully each year during the Medicare AEP (October 15 – December 7). A licensed Medicare agent can help to ensure beneficiaries choose a plan that best meets their needs and budget.

Use preferred pharmacies

Most Medicare Part D plans have preferred pharmacy networks where beneficiaries can get lower costs. Using these pharmacies can reduce copayments and coinsurance expenses. If enrollees use an out of network pharmacy, prescription drugs will usually cost more.

Ask your provider about lower-cost options

In some cases, when a beneficiary has a high-cost medication that is not on their plan’s formulary, they may want to ask their healthcare provider if there are generic or alternative medication that may be more affordable. Sometimes, a small change in medication can lead to considerable savings. If there is no generic available, their provider may need to ask for a formulary exception. When this is the case, the PDP plan provider agrees to pay for a non-formulary medication.

Evaluate Extra Help Options or patient assistance programs

Those who have a limited income and resources, may qualify for Medicare’s Extra Help program, which can help cover premiums, deductibles, and copayments. This program offers significant savings and could reduce costs drastically.
Additionally, many pharmaceutical companies offer assistance programs that provide discounts on high-cost drugs. Checking for available assistance can be a good strategy, especially for high-cost or specialty medications.

Preparing for 2025 and Beyond

The changes coming to Medicare Part D in 2025 are a step towards making prescription drugs more affordable for Medicare beneficiaries. The introduction of an annual out-of-pocket cap and the smoothing program can help provide Medicare enrollees better predictability of their prescription drug costs.

Anyone who relies on Medicare Part D, should review plan details and explore resources to manage these costs effectively. By understanding the structure of Part D and the recent changes, beneficiaries can maximize savings and access their medications without breaking the bank.

There are many good ways to get Medicare referrals. Medicare referrals are a great way to build your book of business without spending a lot of money on leads that may not work out.

Make sure you have a good relationship with existing clients

A good agent is available when their client has questions or concerns. It is important to build a relationship with your clients. The most important way to so this is by listening to their wishes and understanding their coverage needs. Once you do this, they are happy to share your contact with their friends and family. You must stay in contact with your clients, so they remember you are there for them and they do not ask another agent for help.

Be sure to contact them before AEP so you can help them update their information and choose the best plan for the coming year.

Watch a YouTube on Sunfire and Connecture quoting and enrollment updates for 2025

Collecting your client’s contact information such as email and phone number can help you stay in contact. Agents can send out informational emails to clients or even contact a specific client if needed.  The phone numbers are another way to contact clients. They are also good in the event you decide to send text messages for general updates.

If clients are happy with the service you provide, you can ask them for referrals if you do it in a tactful way that makes you both comfortable.

Click here to watch a quick YouTube video on AEP marketing rules

Build relationships with local healthcare professionals

Do not be afraid to introduce yourself to area healthcare providers, clinics or other care facilities. Once they are familiar with you and the service you provide, they may be willing to form a partnership. Having a good rapport with these providers can open doors to a whole new stream of leads.

It is always a good idea to volunteer at local healthcare events and workshops to connect with providers. These professionals can refer people who need assistance with Medicare coverage. This will help establish you as a reliable resource for individual’s coverage needs.

Build an online presence

In today’s digital age, a strong online presence is essential. Agents should create a business profile on social media. After the profile is created, it is important to keep the platform updated with pertinent information potential clients may find useful.  Including information on Medicare choices and answers to common questions are good ways to engage readers and encourage visitors to go back to your platform. An online presence reaches a broad audience and presents you as knowledgeable resource in the field of Medicare.

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Educational workshops

Hosting either free Medicare workshops or webinars help educate the community about coverage options and changes in Medicare. Providing valuable information to those who need help you gain credibility as a valuable resource.  Those who attend may be inclined to refer friends or family to you for guidance when they are seeking help with their Medicare choices.

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Offer Referral Incentives

Create a referral program to reward current clients or anyone who refers new clients to you. Incentives for clients cannot include a gift card or anything appropriate with a value over $15. It is important to remain complaint when you offer a referral gift. Acknowledging and appreciating referrals encourages your existing clients to actively promote your business.

Referral gifts of up to $100 per sales is acceptable for other agents or professionals (ACA agents, P&C agents, other Medicare agents).  Do not forget to pay them so they will refer more clients to you in the future.  Please note in most cases, financial planners cannot accept the referral gift.

Collaborate with Local Businesses

Look into forming relationships with local businesses that cater to the senior population. Consider creating connections with senior centers, fitness clubs, or retirement communities. These relationships can be mutually beneficial, you can each refer clients to one another.

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Stay up to date on Medicare plans and regulations

Because Medicare plans make annual changes, agents need to be educated on all available plan options. It is also imperative to stay updated on compliance rules and attend product training sessions, workshops and conferences.  Building relationships with broker managers and other agents in the industry. These are both sources of potential referrals if they have a beneficiary who needs assistance in your area.  Informed well-known agents are more likely to attract referrals from clients and other professionals.

Medicare sales agents need to build a large referral network to achieve long-term success. By focusing on client satisfaction, and following the suggestions above, agents can build a successful referral-based business that brings in new clients and more opportunities.