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Understanding Your Medicare Plan ANOC: Why it Matters

If you have a Medicare Advantage (Part C) plan or a Medicare Part D prescription drug plan, you’ll receive an Annual Notice of Change (ANOC) every fall. While it might be tempting to toss it aside with other “Medicare mail,” Understanding your Medicare Plan ANOC is important. It explains changes to health coverage, costs, and benefits for the upcoming year.

What Is an ANOC

The ANOC is a letter both Medicare Advantage and Part D plan are required to send enrollees by September 30. It outlines any changes the plan will make for the next calendar year, starting January 1. Even if enrollees are happy with their current coverage, these changes can directly impact what they pay and the care they receive.

The ANOC will compare the current year’s benefits, costs, and coverage with what they’ll be next year, including:

• Monthly premium changes
• Copays and coinsurance updates
• Deductible adjustments
• Changes to your provider network (doctors, specialists, hospitals)
• Changes to your drug formulary (which prescriptions are covered and how much they cost)
• Any added or removed benefits like dental, vision, hearing, or fitness programs

Why Is the ANOC Important

The ANOC is an early warning system for how coverage will look in the year ahead. Ignoring it can lead to unpleasant surprises like; your doctor is no longer in-network or prescription costs have gone way up.

By reviewing the ANOC carefully, you can:

1. Spot coverage gaps. Make sure medications, providers, and benefits are still covered next year.
2. Avoid unexpected costs; premiums, copays, and deductibles can increase.
3. Compare other plan options. If you don’t like the changes, you can explore new plans during the Medicare Annual Enrollment Period (AEP), which runs from October 15 to December 7.
4. Plan ahead; knowing changes in advance allows you to budget for new costs or switch to another plan before the year starts.

Agents watch a quick YouTube video on AEP marketing rules

What to Do When You Get Your ANOC

1. Open it immediately. Don’t let it sit in a pile of unopened mail.
2. Review every section. Pay close attention to drug coverage, provider networks, and cost changes.
3. Make a comparison chart. List 2025 vs. 2026 benefits and costs to see differences clearly.
4. Ask questions. Call your plan or talk to a licensed Medicare agent if you need clarification.
5. Take action during AEP. If the changes aren’t favorable, you can switch to a new plan.

Bottom Line

The ANOC is more than just a piece of Medicare paperwork; it’s a guide to understanding how your plan will serve you next year. Reviewing it now could save you money, protect your access to care, and ensure you have the coverage you truly need. The best way to get the coverage you need is to speak with a licensed Medicare agent who can go over all your options.

Agents stay updated on agent events and information – click here

If you are an agent who is ready to join the team at Crowe – click here for online contract.

Adding Ancillary Products to MA Sales – Why Agents Should Consider It.

Medicare Advantage (MA) plans have been attractive to beneficiaries because of their low or $0 premiums and extra benefits like dental, vision, hearing, and OTC allowances. However, changes are coming in 2026 that may make those extras less generous; or even disappear in some plans. This shift creates a perfect opportunity for agents to make additional sales by adding ancillary products to MA sales to fill these gaps.

Why Ancillary Products Matter in 2026 and Beyond

CMS’s recent updates, combined with economic pressures on carriers, mean some MA plans will scale back or remove certain supplemental benefits starting in 2026. For example, dental allowances might shrink, hearing aid coverage could become more limited, and OTC card values might drop. These changes could leave clients with unexpected out-of-pocket expenses for everyday healthcare needs.

By offering ancillary products alongside MA plans, agents can ensure clients still have access to comprehensive coverage while also boosting retention and cross-sell opportunities.

Types of Ancillary Products That Fit Well

When pairing ancillary products with Medicare Advantage plans, focus on coverage areas where benefits may be reduced or absent:

1. Dental Insurance
   • Why it works: Standalone dental plans often have broader provider networks and higher annual maximums than MA dental riders.
   • Example: A plan offering two cleanings per year, plus $1,500–$2,000 toward major services like crowns and dentures.
2. Vision Plans
   • Why it works: Even if MA plans include vision, it’s often limited to a small annual allowance for glasses or contacts.
   • Example: A vision plan that covers annual exams, multiple pairs of glasses, and larger frame allowances.
3. Hearing Plans
   • Why it works: MA hearing coverage often only includes one device every few years at a fixed copay, and choices can be restricted.
   • Example: A plan offering coverage for top-tier hearing aids, rechargeable batteries, and annual testing.
4. Hospital Indemnity Insurance
   • Why it works: Helps offset inpatient hospital costs, which are often the largest out-of-pocket expense for MA members.
   • Example: A policy that pays $200–$300 per day for each day hospitalized, plus an ambulance benefit.
5. Cancer, Heart Attack, and Stroke Plans
   • Why it works: MA plans cover treatment, but beneficiaries may face significant copays, travel expenses, and lost income. Learn more about critical illness insurance.
   • Example: A lump-sum policy that pays $10,000–$20,000 upon diagnosis, with funds that can be used however the client chooses.
6. Final Expense(Life Insurance)
   • Why it works: Provides peace of mind for covering funeral costs, especially for clients on fixed incomes.
   • Example: A $10,000–$15,000 whole life policy with simplified underwriting.

How to Position Ancillary Products

When discussing changes to MA benefits, avoid fear-based selling. Instead, focus on ensuring clients have complete and predictable coverage:

• Review their 2026 Annual Notice of Change (ANOC) for benefit reductions.
• Explain how ancillary products can “lock in” richer benefits regardless of MA plan changes.
• Offer bundled solutions such as a dental + vision package or a hospital indemnity + cancer plan combination.

Watch our YouTube video- Why and How to Sell Ancillary with Medicare in 5 Minutes

The Takeaway

As MA supplemental benefits become less generous in 2026, ancillary products will play a bigger role in protecting clients’ health and finances. By adding these products to your Medicare Advantage sales strategy, you’ll not only provide better coverage but also strengthen client relationships and create new revenue streams.

Medicare agents who want to join the team at Crowe, click here

Don’t miss industry events and information; click here to learn more.

Now is the time to prepare; review your carrier contracts, identify gaps in MA coverage, and be ready to present clients with options that keep their healthcare truly comprehensive.

Medicare Advantage VBID Termination: What Agents Need to Know

The Centers for Medicare & Medicaid Services (CMS) announced the Medicare Advantage VBID termination. The Value-Based Insurance Design (VBID) Model will officially end after the 2025 plan year. This marks the end of a decade-long initiative aimed to innovate care delivery and cost management in Medicare Advantage. For agents, brokers, and plan sponsors, it’s important to understand what this change means and how to prepare.

A Quick Recap: What Was the VBID Model

Launched in 2017, the VBID Model was designed to test new approaches to delivering Medicare Advantage benefits. Its goal was to improve health outcomes and reduce costs. This allowed plans to tailor benefits based on chronic conditions, offer enhanced supplemental benefits, and experiment with cost-sharing structures that promoted high-value care.

Over time, the model evolved to include features like:

• Chronic Condition Special Needs Plan (C-SNP) enhancements
• Reduced or waived cost-sharing for high-value services
• Incentive programs for beneficiaries
• Expanded telehealth access
• Integration of Medicare hospice benefits (starting in 2021 as part of a separate Hospice Benefit Component pilot)

Are you ready to join the team at Crowe; click here for online contract.

Why Is CMS Ending the Model

Although VBID showed promise in some areas, CMS reported mixed results in measurable improvement in cost savings and health outcomes. Despite some plans reported success, the model overall did not produce consistent, scalable results that justified its continuation beyond 2025.

The separate Hospice Benefit Component, a key aspect of the VBID experiment since 2021, will also end in 2025. CMS plans to use the lessons learned from this model to inform future policy and innovation strategies.

What This Means for Agents and Beneficiaries

If you’ve worked with clients enrolled in VBID-participating Medicare Advantage plans, now is the time to start tracking changes for 2026. Although the VBID Model is ending, plans may still continue some of the supplemental and chronic condition benefits on their own; just outside of the CMS demonstration model.

Here’s what to keep in mind:

• No disruption for 2025: Plans participating in VBID will continue as usual for the rest of the plan year.
• Prepare for benefit shifts in 2026: Expect changes in cost-sharing structures, supplemental benefits, and chronic condition management tools once the model concludes.
• Watch for new CMS innovations: While VBID is ending, CMS may introduce new pilots or value-based initiatives influenced by VBID findings.

The loss or reduction in benefits makes this a great time to put your cross selling skills to the test. Find out what products you can offer clients that will provide they coverage they need.

Watch a YouTube video on Cross selling

The sunsetting of the VBID Model is a significant development for the Medicare Advantage landscape. As an agent, staying proactive by reviewing carrier updates, analyzing plan adjustments, and educating clients about any changes will be critical. Although one model is ending, the pursuit of value-based care in Medicare is far from over.

Stay up-to-date on agent events and information; click here to learn more.

Stay tuned for more CMS announcements and be ready to pivot as the industry evolves.

Is SPAP Considered Creditable Coverage – Can Enrollees Use it With MA Only Plans

For Medicare beneficiaries who also qualify for a State Pharmaceutical Assistance Program (SPAP), it’s important to understand how these state-run programs fit in with Medicare coverage. This is especially important in regard to prescription drugs. One question that comes up a lot is: Is SPAP considered creditable coverage for Medicare Part D? As well as; can beneficiaries use it with a Medicare Advantage (MA-only) plan?

The answer depends on the state and the specific benefits the SPAP provides. Let’s break it down.

What Is SPAP

SPAPs are programs individual states put in place to help eligible residents; typically low- to moderate-income individuals, afford prescription medications. These programs vary widely but often help with:

• Medicare Part D premiums
• Deductibles and copays
• Costs for medications not covered under Medicare

Is SPAP Considered Creditable Coverage

Yes, in some cases. Some SPAPs are considered creditable coverage for Medicare Part D, but not all.

What Is Creditable Coverage

Creditable coverage means the plan’s prescription drug coverage is expected to pay, on average, at least as much as Medicare’s standard Part D benefit. If you have creditable coverage when first eligible for Medicare, you can delay enrolling in Part D without facing a late enrollment penalty later on.

How SPAPs May Qualify

Some SPAPs meet this standard and notify both CMS and the enrollee that their coverage is creditable. These programs can help:

• Avoid the Part D late enrollment penalty if you delay enrolling
• Have peace of mind knowing you won’t be penalized for waiting

However, not all SPAPs are creditable. Each program must notify you annually about whether your coverage is creditable, so it’s critical to keep that notice.

Can You Use SPAP With a Medicare Advantage MA-Only Plan?

Yes, but with limitations. MA only plans cover Medicare Part A and B services but do not include drug coverage (Part D). And here’s the important rule:

You cannot enroll in both an MA-only plan and a standalone Medicare Part D plan (PDP) at the same time; unless you’re in a rare type of MA plan like a Medicare Medical Savings Account (MSA) or some PFFS plans.

Learn how the Canadian Medstore can help with prescription costs – watch our YouTube video

Three Common Scenarios:

1. You Have a Creditable SPAP + MA Only Plan
   If your state’s SPAP is creditable, you may delay enrolling in Part D while using your MA only plan. SPAP may help with limited drug needs during this time without incurring the Part D penalty.
2. You Need Comprehensive Drug Coverage
   If your SPAP is not creditable, or if you need more robust drug coverage, you should switch to a Medicare Advantage plan that includes drug coverage (MAPD). You can then use SPAP to help with cost-sharing.
3. Temporary or Transition Use
   Some beneficiaries use SPAP temporarily (during a SEP or between Part D plan enrollments). SPAP can provide some assistance in the gap, but this depends on the program’s structure. It is important not to let creditable drug coverage lapse for a period of 63 days or more, or you will face a penalty for the lapse.

If you are an agent who is ready to join the Crowe team; click here for our online contract.

Helpful Tips

• Check the SPAP’s creditable coverage status; this info should be provided to you in writing annually.
• Use SPAP to reduce drug costs, even if you’re enrolled in a Medicare drug plan (Part D or MAPD).
• Talk to a licensed Medicare agent or your state’s SHIP office to determine whether the SPAP coordinates well with your Medicare Advantage plan.

SPAPs offer valuable help, but understanding how they work with Medicare is essential. Some SPAPs are considered creditable coverage and can help you delay enrolling in Medicare Part D without penalty. Others are not, and relying on them alone could leave you with late enrollment penalties.

Individuals currently enrolled in a Medicare Advantage MA only plan should carefully weigh their prescription drug needs. In most cases, the safest route is to either enroll in a MAPD plan or verify that your SPAP qualifies as creditable coverage before delaying drug plan enrollment.

Medicare agents stay up-to-date on events and information – click here.

When to Use an MA-Only Plan Enrollment for Your Clients

As a Medicare agent, one of the most important roles you play is helping clients find the right coverage to fit their unique needs. While many clients are familiar with Medicare Advantage plans that include prescription drug coverage (MAPD), there are specific scenarios where Medicare MA only plan sales are a great option.

In this blog, we’ll explore when to clients should consider an MA only plan enrollment. This can be a good option if clients have creditable drug coverage through the VA, SPAP plan or other sources.

What Is a Medicare Advantage (MA Only) Plan

A Medicare Advantage (MA) plan without prescription drug coverage is commonly referred to as an MA only plan. This type of Medicare Advantage plan includes the benefits of Original Medicare, but does not include Part D coverage

Watch a quick YouTube video on the SEP for discontinued MA plans

When Should Agents Recommend an MA-Only Plan

There are specific situations where enrolling in an MA only plan is the most appropriate or beneficial choice. These include:

Client Has Creditable Prescription Drug Coverage (like SPAPs)

Some clients may already have creditable drug coverage from another source, such as a State Pharmaceutical Assistance Program (SPAP). If that coverage is deemed creditable (at least as good as Medicare Part D), they do not need to enroll in a separate drug plan and can avoid the Part D late enrollment penalty.

This makes them good candidates for an MA only plan. MA only plans provide added benefits (like dental, vision, or hearing coverage), but don’t include the drug coverage component.

Remember: Always verify that the SPAP coverage is creditable. Many state SPAPs are, but it’s important to confirm. You can usually find this information in the plan’s annual notice of creditable coverage.

Veterans with VA Drug Coverage

Clients who receive prescription drugs through the VA often prefer to continue using their VA benefits for medications. Since VA drug coverage is considered creditable, they may want to enroll in an MA only plan to take advantage of broader provider access and supplemental benefits without duplicating their drug coverage. Please note; some carriers offer plans specifically for veterans.

Clients Enrolled in Employer or Union Retiree Drug Plans

Some retiree coverage includes drug benefits that are also creditable. These clients can pair their employer or union drug coverage with an MA-only plan to take advantage of enhanced benefits and local provider networks.

Agents; click here to join the Crowe team or add a carrier to an existing Crowe contract.

What to Watch Out For

When considering an MA-only plan, keep these key reminders in mind:

• No Built-in Drug Coverage: If your client loses their other drug coverage in the future and doesn’t enroll in a Part D plan when first eligible, they could face a late enrollment penalty.
• Enrollment Timing Matters: Clients can typically enroll in an MA only plan during the same enrollment periods as MAPDs, such as the Initial Enrollment Period (IEP), Annual Enrollment Period (AEP), or with a Special Enrollment Period (SEP) if they qualify.
• Provider Networks Still Apply: Be sure the client’s preferred doctors and hospitals are in-network, even if they’re saving money by not enrolling in drug coverage.

Bottom Line

An MA only plan can be an excellent choice for clients who already have creditable drug coverage through another source. It allows them to receive the benefits of Medicare Advantage; like extra services and care coordination, without paying for additional prescription drug coverage.

Stay up-to-date on the latest agent event and information

As an agent, taking the time to ask about all forms of coverage and confirming whether they’re creditable will help you guide clients to the most cost-effective and appropriate Medicare solutions.

Need help checking if a client’s SPAP is creditable? Reach out to the plan provider for confirmation, or contact the SPAP directly. It’s always better to be safe than sorry to avoid Part D penalties!

2026 Medicare Carrier Certifications: What Agents Need to Know

It’s time to start your 2026 Medicare carrier certifications! As an independent Medicare agent, staying up-to-date with your certs is essential to ensure you’re ready to sell during AEP and beyond. From AHIP to carrier-specific training, this guide walks you through what you need to do to prepare.

Why Certification is so Important

Certification isn’t just a box to check; it’s your license to sell. Completing annual Medicare certifications shows you understand the latest CMS guidelines, marketing rules, enrollment procedures, fraud, waste, abuse (FWA) protocols and carrier specific plan information. Without these certifications, you won’t be considered “ready to sell” by Medicare Advantage and Part D plan carriers.

Start Early to Stay Ahead

Don’t wait until September to begin your certifications. Many carriers release their 2026 certification portals as early as June or July. AHIP typically launches in late June. Getting a head start allows you to complete training on your own schedule, avoid delays, and ensure you’re cleared to market plans by October 1.

Complete AHIP Medicare Training

The AHIP (America’s Health Insurance Plans) certification is required by most major Medicare Advantage and Part D carriers. Here’s what to expect:

• Two Key Components:
  • Medicare Basics: Covers eligibility, benefits, and plan types (MA, PDP, MAPD).
  • Fraud, Waste, and Abuse (FWA): Identifies potential fraud and how to report it.
• Exam Details:
  • 50 multiple choice questions
  • 3 attempts to score 90% or better
  • Failing all 3 attempts means you must repurchase the course; some carriers don’t let agents contract if they fail the first 3 attempts.

Tip: Many carriers offer AHIP discounts through their agent portals. Pinnacle also provides agents a discount. Contact Crowe and Associates for access to Pinnacle’s discount link.

Complete Carrier Certifications

Each Medicare Advantage and PDP carrier has its own certification process. These certifications usually include:

• Product training
• CMS compliance and marketing rules
• Carrier-specific tools and enrollment platforms

Keep Track of Requirements:

• Log into each carrier’s broker portal to check:
  • Certification launch dates
  • Required modules
  • Additional tests or attestations
• Many carriers provide access to AHIP as part of their training

Tip: Keep a spreadsheet of your carrier logins, certification statuses, and deadlines to stay organized.

Use a Certification Checklist

To streamline your process, consider building or using a checklist that includes:

• AHIP registration and completion
• Carrier 1 certification (e.g., Aetna, Humana)
• Carrier 2 certification (e.g., UnitedHealthcare)
• Carrier 3 certification (e.g., Wellcare)
• Product training or market-specific training
• Certification confirmations saved as PDFs

Watch a YouTube video: What you need to know before a Medicare sale (phone or face-to-face).

Don’t Forget Additional Requirements

• Errors and Omissions (E&O) Insurance: Most carriers require active E&O coverage with minimum limits.
• Background Check Authorization: New agents may be subject to background verification.
• Contracting Updates: Keep your license, and E&O information current with each carrier.

Getting certified early and staying organized gives you a competitive edge going into the 2026 AEP. If you’re working with an FMO or upline, use their support team to guide you through training and contracting. The sooner you’re certified, the sooner you can start pre-AEP marketing and helping clients find the plans they need.

Ready to join the Crowe team; click here for online contracting

Need help or a discounted AHIP link: Reach out to your FMO or email: teal@croweandassociates.com. Pinnacle /Crowe agents can find a list of carrier certification links on Pinnacle’s website; pfsinsurance.com, from there look under the services tab and click on the certifications link.

Stay up-to-date on agent events and information; click here

Medicare Part D Coverage phases 2026

With significant changes enacted under the Inflation Reduction Act (IRA), Medicare Part D prescription drug coverage is now simpler and more predictable. Beginning in 2025, beneficiaries no longer experience a “donut hole,” and starting in 2026, cost thresholds slightly increase to keep pace with inflation. This blog explains the Medicare Part D Coverage Phases for 2026.

Part D Coverage: Three Straightforward Phases

1. Deductible Phase

• In 2026, CMS will implement a maximum standard deductible of $615 (increased from $590 in 2025). Beneficiaries pay 100% of drug costs out of pocket until they meet the deductible. Keep in mind, plan providers have the option to offer a lower or zero deductible.

2. Initial Coverage Phase

• Once the beneficiary meets the deductible, they enter the initial coverage phase.
• In this phase beneficiaries may pay up to 25% coinsurance on covered drugs. Pleas note; most drug plans do not charge coinsurance for tier 1 or even tier 2 drugs.
• Beneficiaries continue to pay coinsurance until their total out‑of‑pocket spending reaches $2,100 in 2026 (previously $2,000 in 2025).
• There is no Initial Coverage Limit (ICL) separate from your out‑of‑pocket threshold, so no “gap” in coverage.

3. Catastrophic Phase

• Once the beneficiary has spent $2,100 out of pocket on formulary (covered) drugs, they enter the catastrophic phase.
• In this phase, beneficiary coinsurance drops to $0; they have no further cost-sharing on covered Part D drugs for the rest of the year.

Watch a YouTube video on the Part D drug cap

What Happened to the Donut Hole

• The coverage gap (“donut hole”) was officially eliminated starting January 1, 2025.
• Instead of transitioning from initial coverage to a gap, enrollees transition directly into catastrophic coverage once they reach the annual out-of-pocket cap ($2,000 in 2025; $2,100 in 2026).
• This means no more confusing coinsurance changes mid‑year; just a smooth journey through three phases.

Why No “Donut Hole”

Before 2025, Part D had four somewhat confusing cost-share phases:

• Deductible → Initial Coverage → Coverage Gap (“donut hole”) → Catastrophic Coverage.

Thanks to the Inflation Reduction Act:

• The donut hole was discontinued, coinsurance standardized at 25%, and a hard cap on TrOOP at $2,000 in 2025.
• In other words: Simplified coverage and predictability was put in place.

2026 Standard Benefit Summary

TrOOP stands for out of pocket. The TrOOP includes: deductible, copays and coinsurance. However the TrOOP does not include; plan premiums or drugs not covered under Part D of your plan.

Summary for Medicare Prescription Coverage 2026

• The year begins with beneficiaries paying up to $615 out of pocket toward their deductible.
• After that, they pay 25% of covered drug costs until their total out-of-pocket spending hits $2,100.
• Once they hit the cap, they move into catastrophic coverage and pay zero out-of-pocket for covered drugs for the rest of the year.
• As of 2025, the donut hole is gone, ensuring a smooth and straightforward benefit structure.
• Beneficiaries can consider enrolling in the Medicare Prescription Payment Plan if it helps spread out drug costs.

Medicare agents:

Click here for updated agent events and information

If you are ready to join the team at Crowe; click here for online contracting.

2026 brings continued relief and clarity for Medicare Part D enrollees; no donut hole, no complicated phases, just predictable costs and peace of mind.

How To Save On Prescription Drugs – Helping Medicare Clients

Prescription drug costs can be a major concern for Medicare beneficiaries, especially those on a fixed income. As a Medicare agent, helping your clients learn how to save on prescription drugs not only builds trust; it can also make a real difference in their overall healthcare experience.

Here are several effective strategies you can use to help your clients save on their prescriptions:

Review Medicare Part D Plans Annually

Encourage clients to compare Part D plans every year, especially during the Annual Enrollment Period (AEP). Drug formularies, pharmacy networks, and premiums can change annually, which may impact out-of-pocket costs.

Use Medicare’s Plan Finder tool or your quoting software to:

• Check if current medications are still covered
• Compare plan premiums, deductibles, and copays
• Identify preferred pharmacy networks for added savings

Look Into Medicare Advantage Plans with Drug Coverage

Some Medicare Advantage (MAPD) plans include prescription drug benefits that may offer lower costs than standalone Part D plans. Make sure to evaluate:

• Formulary tier placement for their medications
• Coverage phases (deductible, initial coverage, catastrophic)
• Extra benefits like mail-order options or pharmacy discount programs

Apply for Extra Help (LIS)

Let eligible clients know about Medicare’s Extra Help program, also known as Low-Income Subsidy (LIS). It helps cover:

• Part D premiums
• Deductibles
• Coinsurance

Each year, income and asset limits are updated. Help clients check eligibility and apply through Social Security or their state Medicaid office.

Check for State Pharmaceutical Assistance Programs (SPAPs)

Many states offer SPAPs that provide financial help with prescription drugs for low- to moderate-income seniors. These programs vary by state, so check what’s available locally and guide clients through the application process if applicable.

Request Generic and Therapeutic Alternatives

Encourage clients to:

• Ask their doctor if a generic version is available
• Discuss therapeutic alternatives that might work just as well at a lower cost
• Use formulary tools to find covered equivalents in lower tiers

This can result in significant monthly savings without sacrificing effectiveness.

Agents, if you are ready to join the team at Crowe; click here for online contracting

Use Preferred or Mail-Order Pharmacies

This one should be obvious, but some beneficiaries do not understand the possible savings. Help clients find pharmacies within their plan’s preferred network, where they’ll often get the lowest copays. In many cases, 90-day mail-order supplies are also more affordable and convenient for maintenance medications.

Explore Prescription Discount Programs

While they can’t be used in conjunction with Medicare, some clients may benefit from discount cards (like Glic, GoodRx or SingleCare) when paying cash. These may be helpful for:

• Medications not covered by their plan
• When the discount price is lower than their copay

Important: Remind clients that purchases using discount cards don’t count toward their Part D deductible or out-of-pocket threshold.

Consider Safe International Pharmacy Options

For some clients, especially those with high-cost brand-name prescriptions, licensed international pharmacies can provide considerable savings.

One popular and reputable option is The Canadian MedStore, which connects U.S. consumers with licensed international pharmacies in Canada and other Tier 1 countries. Key benefits include:

• Substantial savings on brand-name medications
• Licensed pharmacy partners
• Reliable customer service and refill support

Please note: Agents should advise clients to check with their doctors before switching sources and confirm that any international pharmacy is legitimate and properly licensed.

Watch a YouTube video with details on the Canadian Medstore

Saving on prescriptions doesn’t have to be complicated, sometimes all it takes is having the right resources. As an agent, you can guide clients toward cost-effective, safe solutions that help them stay healthy and financially stable.

Stay updated on the latest agent events and information

Whether it’s comparing plans, applying for Extra Help, or exploring alternative resources, your support can make a meaningful difference.

Get a Head Start on AEP: Prep Now for a Successful Enrollment Season

The Annual Enrollment Period (AEP) is one of the busiest and most profitable times of the year for Medicare agents. Between October 15th and December 7th, the demand for knowledgeable, trusted advisors skyrockets. But here’s the truth: agents who wait until the fall to prepare are already behind. It is best to get a head start on AEP before everything piles up.

The most successful Medicare agents treat the months leading up to AEP as preparation time. By getting a head start now, you’ll not only reduce stress but also position yourself to grow your book of business and serve clients more effectively when the rush begins.

Here are some steps you can take right now to set yourself up for your best AEP yet:

Complete Certifications and Training

Staying current with your certifications is critical. Most carriers require agents to complete either AHIP or NABIP certification and plan-specific training before they can begin selling Medicare Advantage or PDP plans during AEP.

• AHIP and NABIP typically launch in June, so mark your calendar.
• Many carriers offer a discount if you complete AHIP through their portal; take advantage of that!
• Start your carrier certifications as soon as possible so they do not pile up (they can be time consuming). This helps you minimize stress as it gets closer to the October deadline.

By getting these done early, you’ll be compliant, confident, and ready to hit the ground running.

Stay Updated on Industry Changes & Training Opportunities

The Medicare landscape is constantly evolving; plan changes, regulatory updates, compliance rules, and new technology are all part of the mix. That’s why staying informed isn’t just helpful; it’s essential.

Take time now to:

• Subscribe to carrier newsletters and CMS updates.
• Attend webinars, workshops, or local training events.
• Engage in forums or networking groups with other Medicare agents.

The more informed you are, the more value you bring to your clients—and the more confident you’ll feel going into AEP.

Click here to view the latest agent events and information.

Prepare and Update Your Marketing Materials

Your marketing materials are your first impression; make sure they’re working for you, not against you.

Before AEP begins, audit and refresh all your materials:

• Brochures
• Flyers
• Business cards
• Educational handouts
• Giveaways or branded items (under $15 for compliance!)

Make sure everything reflects your current branding, includes up-to-date contact information, and is tailored to your audience.

If you’re planning to promote yourself through social media, email, or your website, remember:

• Include all required disclaimers (especially for Medicare Advantage or PDP).
• Double-check whether your materials require HPMS filing and approval.
• For peace of mind, consider working with your compliance department to review and file your materials properly.

Watch a YouTube Video of the CMS proposed changes for CY2026

When in doubt; ask. Staying compliant now saves headaches later.

Test Lead Sources Before the Rush

Not all leads are created equal; the best time to figure out what works is before the pressure of AEP hits.

Now is the perfect time to test and evaluate:

• Digital leads (Google ads, Facebook campaigns)
• Direct mail campaigns
• Community referrals
• Educational events
• Grassroots marketing (partnering with local businesses or pharmacies)

Track metrics like cost per lead, contact rate, appointment set rate, and ultimately, conversion to sale.

Give yourself time to test, and refine your lead strategy so when AEP begins, you’re not guessing, you’re scaling.

Make a Marketing Plan

Don’t wait until October to promote yourself; start building awareness now. Consider:

• Planning grassroots marketing like community events or educational seminars.
• Designing print materials (postcards, flyers, business cards).
• Lining up email campaigns or social media content to build visibility.

Make sure your Permission to Contact (PTC) processes are compliant and ready to go.

Update Tools and Technology

Evaluate whether your current tools are working efficiently:

• Is your CRM user-friendly and up to date?
• Are your quoting tools and enrollment platforms ready?
• Do you need to upgrade your laptop, printer, or internet connection?

Watch a YouTube video on Connecture & Sunfire quoting and enrollment tools

A little tech prep now can save you major headaches later.

Check that your systems are:

• Updated and running smoothly
• Synced across devices
• Easy for both you and your clients to use

Key tools to have ready:

• Online quoting tools – for fast and accurate plan comparisons
• E-app platforms – for secure and paperless enrollment
• Video conferencing tools – for remote appointments
• Electronic scope of appointment (SOA) tools – for compliance

Also, make sure your email, calendar, and CRM are integrated so nothing slips through the cracks.

Learn about Pinnacle’s BOSS agent portal & CRM for agents

By mastering your tech tools before AEP, you’ll boost efficiency, reduce errors, and deliver a smoother experience to every client; earning trust and more referrals.

If you are ready to join the team at Crowe,; click here for online contracting

Take Care of Yourself

Don’t forget: you’re your biggest asset. AEP is a marathon, not a sprint. Use this pre-season time to get into a good routine; physically, mentally, and professionally so you can show up at your best every day during the rush.

Understanding SEPs for Medicare Chronic Special Needs Plans (C-SNPs)

Medicare Advantage Special Needs Plans (SNPs) provide targeted care and coordinated benefits to specific groups of beneficiaries. One common type of SNP is the Chronic Condition Special Needs Plan (C-SNP), which is available to individuals diagnosed with specific chronic health conditions. For agents, understanding C-SNP SEPs can ensure your clients receive the best coverage for the care they need.

To help eligible beneficiaries enroll in these plans, Medicare offers Special Enrollment Periods (SEPs) that allow people to join or switch into a C-SNP outside the standard Annual Enrollment Period (AEP).

Let’s explore what C-SNPs are, who qualifies, and how SEPs work to ensure timely access to care.

What is a Chronic Special Needs Plan (C-SNP)

A C-SNP is a type of Medicare Advantage plan tailored for people with certain severe or disabling chronic conditions. Private Medicare-approved insurance companies offer these plans. Plans must include the same benefits Medicare Part A and B provide, and usually include Part D prescription drug coverage.

C-SNPs often provide:

• A care team specializing in the chronic condition
• Coordinated services to help manage the enrollee’s health
• Lower costs on services that relate to the specific condition

Examples of eligible chronic conditions for C-SNPs include:

• Diabetes
• Congestive Heart Failure (CHF)
• Chronic Obstructive Pulmonary Disease (COPD)
• Cardiovascular Disease
• End-Stage Renal Disease (ESRD)

*Note: Medicare rules around ESRD and plan access changed in 2021; people with ESRD can now enroll in most Medicare Advantage plans, but ESRD-specific SNPs still exist in many regions.

Special Enrollment Period (SEP) for C-SNPs

Medicare offers a Special Enrollment Period when an individual is newly diagnosed with a qualifying chronic condition. This allows them to join a C-SNP as soon as they are eligible.

When Does the SEP Apply

You can enroll in a C-SNP:

When you are first diagnosed with a qualifying chronic condition
If you already have a qualifying condition but have not enrolled in a C-SNP before
If you move into or out of a service area that offers your C-SNP
If you lose your C-SNP eligibility because you no longer meet the chronic condition criteria

This SEP allows a one-time enrollment into a C-SNP for each qualifying diagnosis.

How the C-SNP SEP Works

Once diagnosed with a qualifying condition, beneficiaries typically have a Special Enrollment Period that lasts for 3 months, beginning:

• The month they’re diagnosed, or
• The month they are notified of the diagnosis

During this SEP, you can:

• Enroll in a new C-SNP specific to the condition
• Switch from another Medicare Advantage plan or Original Medicare into a C-SNP

Documentation Required

Enrollment into a C-SNP requires proof of the chronic condition, usually in the form of:

• A doctor’s attestation
• Medical records or diagnosis documentation
• A form provided by the plan for the provider to complete

What if Your Condition Improves

If you no longer have the qualifying condition (for example, your doctor no longer considers your diabetes as chronic or disabling), you may be disenrolled from the C-SNP. In that case, you’ll qualify for another SEP to enroll in a different Medicare Advantage plan or return to Original Medicare.

Why Agents Need to Understand C-SNP SEPs

If you’re a Medicare agent, being well-versed in the rules around C-SNPs and SEPs help:

• Connect chronically ill clients with better care coordination
• Avoid unnecessary wait times for clients who need immediate support
• Assist clients with navigating documentation and eligibility

Remember, not all areas offer C-SNPs, so always check plan availability by ZIP code.

Watch a YouTube video on using Connecture and Sunfire to run quotes for your clients

If you are ready to join the team at Crowe, click here for online contracting

Special Enrollment Periods for Chronic Special Needs Plans offer a vital lifeline to beneficiaries who need enhanced care and support for their chronic conditions. Understanding how and when these SEPs apply ensures that eligible individuals don’t miss out on essential benefits tailored to their health needs.

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