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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.

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Medigap Plan N vs Plan G: Which Is Right for You

When shopping for a Medicare Supplement (Medigap) plan, there are many options. Plan G and Plan N are two of the most popular choices for people looking to fill in the coverage gaps of Original Medicare. While they share many similarities, there are key differences in cost, coverage, and how they handle out-of-pocket expenses. Understanding Medigap Plan N vs Plan G can help you choose the plan that best fits your healthcare needs and budget.

What Medigap Plans Have in Common

Both Plan G and Plan N are standardized Medicare Supplement plans, meaning the basic benefits are the same no matter which insurance company offers them. With either plan, you get:

• Coverage for Medicare Part A coinsurance and hospital costs (after the beneficiary uses up Medicare’s benefits) for up to 365 days
• Coverage for Part B coinsurance or copayment (with exceptions for Plan N – explained below)
• Blood coverage (first 3 pints per year)
• Part A hospice care coinsurance or copayment
• Skilled nursing facility coinsurance
• Part A deductible
• Foreign travel emergency coverage (up to plan limits)

Key Differences Between Plan G and Plan N

1. Part B Excess Charges

• Plan G: Covers 100% of Medicare Part B excess charges (extra costs you may be billed if your provider doesn’t accept Medicare’s standard payment).
• Plan N: Does not cover Part B excess charges; if your provider bills them, you’ll have to pay out of pocket.

2. Office Visit & ER Copays

• Plan G: No copays for office visits or ER (after Medicare pays its share).
• Plan N: You may pay up to $20 for some doctor visits and up to $50 for emergency room visits (waived if admitted to the hospital).

3. Monthly Premiums

• Plan G: Generally has higher monthly premiums because it covers more.
• Plan N: Often has lower monthly premiums but requires more cost-sharing through copays and the possibility of excess charges.

4. Part B Deductible

• Both plans require you to pay the annual Medicare Part B deductible before coverage kicks in (for 2025, it’s $257).

Watch our YouTube video on Medicare Advantage vs Medicare Supplements

Which Plan is The Best Fit

• Choose Plan G if:
  • You want the most comprehensive coverage available to new Medicare enrollees.
  • You prefer predictable costs and don’t want to worry about excess charges or visit copays.
  • You see specialists who may charge more than Medicare’s approved amount.
• Choose Plan N if:
  • You want a lower monthly premium and are okay with occasional copays.
  • You typically see Medicare-assigned doctors who don’t bill excess charges.
  • You’re healthy, visit doctors less often, and want to save on monthly costs.

Both Plan G and Plan N are strong options that can protect you from high out-of-pocket costs not covered by Original Medicare. The right choice depends on how often you use healthcare services, whether your providers accept Medicare’s payment terms, and how much you want to pay each month in premiums versus at the point of care.

When comparing, it’s smart to enlist the help of a licensed Medicare agent who get quotes for both plans from multiple carriers. Please note: premiums vary by carrier even though the benefits are standardized.

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Changing Medicare Supplement Plans: What to Know Before You Switch

Medicare Supplement (Medigap) plans are a great choice for covering the portion of out-of-pocket costs that Original Medicare doesn’t. However, as health needs and financial situations change, beneficiaries might consider changing Medicare supplement plans. Whether it’s to reduce premiums or adjust coverage, making a change requires some thought and planning.

Here’s what to keep in mind when considering a change to Medicare Supplement coverage.

Why People Change Medigap Plans

There are several reasons why someone might decide to change their Medigap plan:

• Overpaying for coverage: The current plan might offer more coverage than needed, meaning the policyholder may not use as much coverage as much as expected.
• Needing additional benefits: Health needs can change, and a different plan may provide better or more suitable coverage.
• Shopping for a better rate: Even if the benefits remain the same, switching to a different insurance carrier offering the same plan at a lower premium makes sense.
• Company dissatisfaction: Some beneficiaries want to change to a new insurer due to customer service or other experiences.

When You Can Switch

Changing Medigap plans isn’t quite as simple as enrolling in Medicare for the first time. There are only a few scenarios when someone can switch plans without facing potential roadblocks:

• During their six-month Medigap Open Enrollment Period: This period starts the month they turn 65 and are enrolled in Medicare Part B. During this time, they can buy any Medigap plan offered in their state or switch plans. Insurance companies cannot deny coverage based on health.
• 30 day free look period: After purchasing a new Medigap policy, you have 30 days to decide if you want to keep it. This allows beneficiaries to compare other plans with their your current plan. 
• With guaranteed issue rights: These are special protections that allow someone to buy certain Medigap plans without medical underwriting. Common situations that trigger guaranteed issue rights include losing employer coverage or moving out of a plan’s service area. However, there are currently 4 states that offer guaranteed issue rights regardless of the circumstance.

Please note: A new Medigap policy doesn’t automatically cancel the old one the way Medicare Advantage and PDP plans do. It is best not to cancel your old Medigap policy until you are sure you want to keep the new one.

Watch a YouTube video on Medicare Supplement underwriting.

Outside of the situations listed above, beneficiaries may need to go through medical underwriting to enroll in a new Medigap plan.

Understanding Medical Underwriting

Medical underwriting is a review process insurers use to assess an applicant’s health history and current conditions. Based on this review, a company can:

• Approve or deny the application.
• Charge a higher premium.
• Apply a waiting period for coverage of pre-existing conditions.

If a person applies for a Medigap plan outside their Open Enrollment Period and without guaranteed issue rights, their application could be declined based on health.

One common underwriting consideration is tobacco use. Smokers often face higher premiums, even if they are otherwise in good health.

No Waiting Period to Switch

There’s a common misconception that people have to keep their Medigap plan for a set amount of time before switching. The truth is, once someone has a Medigap policy, they can apply for a new one at any time. As long as they’re willing to go through underwriting if required.

Switching Medicare Supplement plans isn’t something to rush into, but with the right timing and a good understanding of the process, it can be a good idea for your health and finances. Whether it’s finding more appropriate coverage or simply lowering monthly costs, reviewing options regularly ensures your Medicare Supplement plan continues to meet your needs. It is best to speak with a licensed Medicare agent who can guide you through the options and find the best fit for your needs.A

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Agents helping clients navigate this process; be sure they understand the importance of timing and potential underwriting challenges. They must understand how their health status could impact their options.

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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)

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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.

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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.

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What Medicaid Covers: A Guide for Dual Eligibles and Younger Beneficiaries

Medicaid is a vital safety net program that helps millions of Americans access health care, especially those with limited income or resources. While many associate Medicaid with lower-income families or children, it also plays a critical role in helping people on Medicare; often referred to as dual eligibles, afford the care they need. This post will answer the question; what does Medicaid cover.

Whether you’re on Medicare and Medicaid or qualify for Medicaid under age 65, it’s important to understand what the program covers and how it can help you.

Who Qualifies for Medicaid

Medicaid eligibility is based on income and household size, but each state runs its own Medicaid program within federal guidelines. In general, you may qualify if you:

• Have a low income and limited assets
• Are pregnant
• Are a child or teenager
• Are disabled or blind
• Are 65 or older
• Receive Supplemental Security Income (SSI)
• Receive Medicare and meet your state’s Medicaid income limits (dual eligible)

Many adults under 65 who qualify for Medicaid do so through the Medicaid expansion under the Affordable Care Act.

Medicare agents; watch a YouTube video on SEP changes for Dual, Partial Dual and LIS members

What Medicaid Covers

Medicaid coverage varies by state, but all states must cover a core set of benefits, including:

For Everyone (All Beneficiaries)

• Doctor visits
• Hospital services – in-patient and out-patient
• Emergency care
• Lab and X-ray services
• Nursing facility services
• Preventive care and screenings
• Prescription drugs (in most states – not all)
• Family planning services
• Mental health and substance use disorder services

Click here for a full list of mandatory benefits that Medicaid must cover

Additional Coverage for Medicare Beneficiaries

If you qualify for both Medicare and Medicaid, Medicaid helps cover costs Medicare doesn’t. Depending on your income level and the Medicaid program you qualify for, it may pay for:

• Medicare Part A and B premiums
• Medicare deductibles, coinsurance, and copays
• Long-term care services, such as nursing home care
• In-home support services
• Non-emergency transportation to medical appointments
• Dental, vision, and hearing benefits (varies by state)

This extra help is incredibly valuable, especially for seniors or those with disabilities who may struggle to afford out-of-pocket Medicare costs.

Medicaid and Long-Term Care

One of Medicaid’s most significant benefits is long-term care coverage. Medicare only covers short-term skilled nursing or rehab, but Medicaid may pay for:

• Extended nursing home care
• Assisted living in some states
• Personal care services at home

Many people spend down their assets to qualify for Medicaid when they need these services, as they can be extremely expensive without coverage.

Learn about alternatives to long term care insurance

Medicaid for Younger Adults and Children

For individuals under age 65 who don’t yet qualify for Medicare, Medicaid may provide:

• Comprehensive pediatric care through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit
• Maternity and postpartum care
• Birth control and reproductive health services
• Support for individuals with disabilities, including waivers for home- and community-based care

How to Apply

Individuals can apply for Medicaid at any time of year through their state’s Medicaid office or through Healthcare.gov in participating states. Those on Medicare with a limited income may also qualify for a Medicare Savings Program (MSP); a Medicaid-administered program that helps pay Medicare costs.

Medicare beneficiaries who don’t qualify for full Medicaid may qualify for partial assistance through MSP; Medicare Savings Programs. These programs offer different levels of help such as: QMB, SLMB, or QI. These programs can make a major difference in managing healthcare expenses.

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Need help applying or understanding what you qualify for? Your local Medicaid office, a Medicare agent, or a SHIP (State Health Insurance Assistance Program) counselor can provide free, unbiased guidance.

Drug Plan Formulary Tiers Explained – Understanding Your Prescription Cost

If you have either a Part D prescription drug plan or a Medicare Advantage plan that includes drug coverage; you’ve probably heard the term “formulary tiers.” But what exactly are these tiers, and how do they affect what you pay at the pharmacy? In this post “Drug Plan Formulary Tiers Explained” we break it down to provide a better understanding of how drug coverage works and ways to save money.

What Is a Formulary

A formulary is simply a list of prescription drugs that your Medicare drug plan covers. Each plan creates its own formulary and categorizes the drugs into different tiers based on cost and type.

Understanding the Tier System

Most Medicare drug plans divide their formularies into five tiers, though some may have more or less. Here’s a general breakdown:

Tier 1: Preferred Generic Drugs

• These are the lowest-cost medications.
• Usually includes common generic drugs that treat routine health conditions.
• Lowest copayment.

Tier 2: Generic Drugs

• Generic drugs that aren’t in Tier 1 but are still less expensive than brand-name options.
• Slightly higher copayment than Tier 1.

Tier 3: Preferred Brand-Name Drugs

• Brand-name drugs that the plan has negotiated lower prices for.
• These may be more expensive than generics, but cost less than non-preferred brands.

Tier 4: Non-Preferred Drugs

• These can include both brand-name and generic drugs.
• They are more expensive and not favored by your plan.
• Higher copay or coinsurance.

Tier 5: Specialty Drugs

• These are high-cost drugs used to treat complex or chronic conditions such as cancer, multiple sclerosis, or rheumatoid arthritis.
• Usually require prior authorization.
• Highest out-of-pocket cost.

Why Tiers Matter

Your copayment or coinsurance depends on the tier your drug falls into. For example, a Tier 1 medication might cost nothing or just a few dollars, while a Tier 5 drug could cost hundreds, even with insurance.

Knowing your plan’s formulary can help you:

• Choose lower-cost alternatives.
• Talk to your doctor about switching to a lower-tier drug.
• Avoid unexpected expenses.

What If Your Drug Isn’t Covered

If your medication isn’t on your plan’s formulary, you have options:

• Request a formulary exception from your plan.
• Ask your doctor if a similar drug is covered.
• Use a discount program or Canadian pharmacy such as The Canadian Medstore, which offers medications at reduced prices for certain drugs not covered or affordable under your plan.

Watch a quick YouTube video to learn more about the Canadian Medstore

Tips for Managing Costs

• Before you sign up for a plan, contact a local Medicare agent to compare plans to find one that best fits your medication needs and budget.
• Review your plan’s formulary each year during the Annual Enrollment Period (AEP).
• Use preferred pharmacies that may offer lower costs.
• Consider applying for Extra Help if you may qualify based on income.

Understanding how formulary tiers work can help you make smarter choices about your prescriptions and potentially save money. Don’t hesitate to speak with a Medicare advisor or pharmacist if you need help reviewing your options.

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Need help comparing Medicare drug plans
I’m here to help. Contact me for a no-cost, no-obligation review of your coverage options.

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What Medicare Plan N Covers: Is It the Right Supplement for You

When it comes to supplementing Original Medicare (Part A and Part B), Medigap Plan N is one of the more popular options. It offers strong coverage at a lower premium than some other Medigap plans. This makes it an attractive choice for many Medicare beneficiaries. We will go over what Medicare Plan N covers, and why someone might choose it over other options.

What Medicare Plan N Covers

Medigap Plan N is a standardized Medicare Supplement Insurance plan, which means the benefits are the same no matter which insurance company offers it. Here’s what Plan N covers:

1. Medicare Part A Coinsurance and Hospital Costs – Covers up to an additional 365 days after Medicare benefits are used up.
2. Medicare Part B Coinsurance or Copays – Covers most of the 20% coinsurance beneficiaries would otherwise pay. This excludes copays; up to $20 for doctor visits and up to $50 for ER visits that don’t result in admission.
3. Blood (First 3 Pints) – Covers the cost of the first three pints of blood needed for a medical procedure.
4. Part A Hospice Care Coinsurance or Copays
5. Skilled Nursing Facility Care Coinsurance
6. Medicare Part A Deductible – Plan N covers this cost, which can save you over $1,600 per admission in 2025.
7. Emergency Medical Care During Foreign Travel – Covers 80% (up to plan limits) for medically necessary care during international travel.
   

What Plan N Does Not Cover

There are a few out-of-pocket costs you may still be responsible for:

1. Medicare Part B Deductible – You’ll need to pay this annually ($240 in 2025).
2. Part B Excess Charges – If your doctor does not accept Medicare assignment and charges more than Medicare-approved amounts, Plan N does not cover those excess charges.
3. Copayments – As mentioned earlier, you’ll pay small copays for some office and emergency room visits.
   

Why Choose Medicare Plan N

Here are some reasons why Plan N might be the right choice for you:

Lower Monthly Premiums

Plan N generally has lower premiums than Plan G or Plan F. This makes it a budget-friendly option for those who want solid coverage without a high monthly cost.

Predictable Costs

Aside from the Part B deductible and occasional copays, your out-of-pocket costs are minimal. This makes it easier to plan financially, especially for healthy individuals who don’t visit the doctor often.

Access to Nationwide Coverage

Like all Medigap plans, Plan N allows you to see any provider in the U.S. who accepts Medicare; no networks or referrals needed.

Foreign Travel Coverage

If you travel abroad, the emergency coverage provided under Plan N gives you added peace of mind.

Ideal for Healthy Retirees

If you’re in good health and don’t mind paying occasional small copays, Plan N can offer significant savings while still covering major expenses.

Watch a quick video on Medicare enrollment periods

Is Plan N Right for You

Plan N is best for those looking to balance good coverage with lower monthly premiums. It’s especially attractive if you don’t anticipate frequent medical visits and prefer to avoid the higher costs of Plan G or Plan F.

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As always, it’s important to review personal health needs, provider preferences, and budget with a licensed Medicare agent to determine if Plan N is your best fit.

Understanding the Medicare SHIP Program

When navigating the complexities of Medicare, having expert, unbiased help can make all the difference. That’s where the State Health Insurance Assistance Program (SHIP) comes in. SHIP provides free, personalized counseling and assistance to Medicare beneficiaries and their families. Whether you’re enrolling for the first time or reviewing coverage options, Understanding the Medicare SHIP Program can be a valuable resource.

What Is SHIP

SHIP stands for State Health Insurance Assistance Program. Funded by the federal government and administered at the state level, SHIP offers free, objective, and confidential help to people with Medicare.

Each state has its own SHIP, staffed by trained counselors who are not affiliated with insurance companies. Their goal is to help Medicare beneficiaries make informed decisions based on individual needs; not sales goals.

Medicare beneficiaries may use SHIP in conjunction with their Medicare agent to access additional support with Medicare issues such as:

What Services Does SHIP Provide

• Understanding Original Medicare (Parts A and B)
• Comparing Medicare Advantage (Part C) and Part D drug plans
• Reviewing Medigap (supplemental insurance) options
• Explaining Medicare Savings Programs and Extra Help
• Appealing Medicare denials and billing errors
• Transitioning from employer insurance to Medicare
• Understanding coverage for long-term care

SHIP can provide guidance tailored to each specific situation.

Who Can Use SHIP

SHIP services are available to:

• Current Medicare beneficiaries
• People turning 65 soon or new to Medicare
• Caregivers or family members assisting someone with Medicare
• Individuals under 65 who qualify for Medicare due to a disability

There is no cost for SHIP counseling, and there is no pressure to choose a specific plan.

Need help getting diabetic supplies; watch a quick YouTube video to access assistance

How to Find SHIP Help

To contact your local SHIP office, visit www.shiphelp.org and use the locator tool. You can also call 1-877-839-2675 to be directed to your state’s SHIP.

Appointments may be available by phone, in-person, or virtually; depending on location and preference.

Why SHIP Matters

For beneficiaries who do not have a trusted Medicare agent; Medicare can be overwhelming when you’re trying to choose the right plan for your needs or help a loved one through the process. SHIP counselors offer unbiased, trusted advice. They exist solely to help Medicare beneficiaries make informed choices and avoid costly mistakes.

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Those unsure about Medicare coverage, billing, or eligibility; or just need someone to walk through the options; SHIP is an excellent place to start.

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.