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Why Offer Medicare HDG Plans

The question; why offer Medicare HDG Plans, because the Medicare market is changing rapidly. Agents must stay ahead of the curve to remain successful. Many major carriers are scaling back their Medicare Advantage (MA) offerings and even cutting commissions on some plans. This leaves agents with fewer options to present to clients. This is where HDG Plans can make all the difference.

The Current Landscape of Medicare Advantage

In recent years, Medicare Advantage has been one of the most popular plan options among seniors. However, for the last couple years, carriers are:

• Pulling plans from the market – especially PPOs, which have traditionally been popular for their provider flexibility.
• Reducing commissions – some carriers are paying no commission on certain MA products, leaving agents with fewer options to offer.
• Tightening supplemental benefits – carriers are scaling back some of the extra benefits that once attracted clients, making MA plans less competitive.

For agents, this creates a challenge: how do you provide value to your clients while maintaining a sustainable business model?

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Why HDG Health Plans Stand Out

HDG Health Plans provide a strong alternative that agents should be offering. Here’s why:

1. Plan Stability

Unlike some Medicare Advantage carriers that are exiting markets or restructuring benefits, HDG Health Plans are built for long-term stability. This ensures agents can confidently enroll clients without worrying about sudden disruptions.

2. Expanded Client Options

As carriers discontinue PPOs and other MA plans, seniors need reliable choices that meet their healthcare and financial needs. HDG offers products that can help fill the gaps left by Original Medicare. This gives agents a competitive edge in retaining and growing their book of business.

3. Consistent Compensation

With some carriers cutting or eliminating commissions on MA plans, agents need products that continue to provide fair, reliable compensation. HDG Health Plans recognize the value of the agent’s role and support them with commission structures that make sense.

4. Strong Value Proposition for Clients

Carriers design HDG Plans with seniors in mind, balancing affordability, access to care, and flexibility. This makes them attractive alternatives for clients who may be frustrated with shrinking MA networks or reduced plan options.

5. Ability to seek care from most providers

Unlike MA plans, Medicare supplements allow the enrollee to seek care form any provider that accepts Medicare. This can be a huge advantage to any enrollee.

Agents learn why and how to sell ancillary products – watch a quick YouTube video

The Opportunity for Agents

As the Medicare market shifts, agents who adapt quickly will come out ahead. By offering HDG Health Plans, agents can:

• Differentiate themselves from competitors still relying heavily on shrinking MA offerings.
• Provide solutions to clients facing plan cancellations or limited coverage options.
• Build a more stable book of business with products that pay fairly and retain members long-term.

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The Medicare Advantage space is in transition, and relying solely on it may leave both agents and clients at a disadvantage. By incorporating HDG Health Plans into your portfolio, you can protect your business, serve your clients more effectively, and position yourself as a trusted advisor during a time of change.

Now is the time to diversify your offerings, and HDG Health Plans should be at the top of your list.

Final Rule CY 2026

On April 4, 2025, CMS released the final rule CY 2026, covering Medicare Advantage (MA), Part D (Prescription Drug Plans), Medicare cost plans, and Programs of All-Inclusive Care for the Elderly (PACE). In this post, we go over some key points of the CMS final rule 2026 to keep agents up dated.

Key Provisions

• Prescriber and Prior Authorization Adjustments: MA plans can only reverse inpatient admission approvals if there’s clear evidence of fraud or error, preventing sudden post-approval denial
• Appeals Expansion: Decisions affecting appeals now apply if made during, after, or before services begin
• Insulin & Vaccine Cost-Sharing Protections: No deductible and capped cost-sharing (either less than or equal to $35 or 25% of price) for insulin; rules go live in CY 2026. Adult ACIP recommended vaccines under Part D do not charge cost-sharing or a deductible.
• Medicare Prescription Payment Plan: Monthly OOP drug payment options become standard. Automatic renewals apply unless beneficiaries opt out.
• Medicare Drug Price Negotiation Program: Pharmacies must enroll in CMS’ data Module. PDE submission timeline for selected drugs is shortened to 7 days (was originally 30).
• Medical Loss Ratio (MLR) Changes: Certain federal subsidies (selected drug subsidy, IRASA, etc.) are excluded from MA/Part D calculations
• Payment Updates: MA plan payments increased by 5.06% on average. This raises carrier reimbursement by over $25 billion. Because of late year FFS data inclusion, the effective growth rate grew to 9.04%.
• Full phase-in of medical-education cost adjustments in MA risk model

What Didn’t Make it Into the Final Rule

• Anti-obesity medication coverage remains excluded.
• No finalized rule on AI guardrails or formal health equity assessments

Implications for Medicare Agents

Plan Design and Marketing Impact

The improved payment rates and stronger benefits (e.g., capped insulin costs, free vaccines) make MA/Part D plans more attractive to beneficiaries—enhancing your ability to recommend compelling, cost-effective options.

Client Conversations and Value Messaging

You can emphasize zero cost-sharing for critical needs like adult vaccines and insulin, and promote payment flexibility via monthly prescription cost installment plans—boosting engagement with clients, especially those on tight budgets.

Administrative & Compliance Updates

• Prepare for stricter documentation requirements, especially for prescription payment plans and MLR-related tracking.
• Expect increased scrutiny on marketing practices, including proof that compensation adheres to CMS limits.

Watch a YouTube video on CMS Medicare Final Rule Proposal 2026

Compensation Boosts (Broker Commissions)

Although not part of the CMS final rule, standard compensation data from CMS shows a significant increase in 2026:

• MA Plans:
  • National initial commissions rise 10.9% (e.g., from $626 to $694).
  • Renewal commissions up 10.9% (e.g., $313 to $347).
  • In CT, PA, DC: initial rises to $781, renewal to $391
  • View a more detailed commission explanation – click here
• Part D Plans:
  • Initial commissions up 4.6% ($114).
  • Renewal commissions up 3.6% ($57)
• Sponsoring organizations must submit these updated commission rates to CMS and maintain payment records.

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Summary Final Rule CY 2026

Capped insulin costs, vaccine cost-sharing elimination, and flexible payment options empower agents to provide more affordable, client-focused solutions.

Higher broker commissions reward agents, but with greater compliance expectations.

Marketing oversight and fiduciary responsibility pressures are rising; agents must prioritize ethics and accuracy in representation. Agents should stay vigilant; future enforcement or reform may impact compensation and operational protocols.

Stay updated on agent events and information

As an agent, your role is stronger than ever. Stay informed, compliant, and focused on client outcomes. Although 2026 promises to be a challenge, agents who put together a good strategy and work with integrity, can thrive while supporting clients’ health and financial well-being.

What Value Based Care Means

Healthcare has been shifting away from the “fee-for-service” model, and Medicare is at the center of that transformation. Traditionally, doctors and hospitals were paid based on the number of tests, procedures, or visits they provided, regardless of whether patients got healthier. What Value Based Care means is a little different. VBC rewards providers for improving patient health and keeping costs down.

The Basics of Value Based Care

Value Based Care is about quality over quantity. Instead of simply paying for services rendered, Medicare ties payments to outcomes such as:

• Better health results – like reduced hospital readmissions or better management of chronic diseases.
• Improved patient experience – including communication, accessibility, and overall satisfaction.
• Lower overall costs – through preventive care, care coordination, and reduced unnecessary treatments.

How Medicare Uses Value-Based Care

Medicare has introduced several programs and models to encourage providers to embrace VBC. Some of the key examples include:

• Accountable Care Organizations (ACOs): Groups of doctors, hospitals, and other providers who work together to give coordinated, high-quality care to Medicare patients. If they save money while meeting quality goals, they share in those savings.
• Bundled Payments for Care Improvement (BPCI): Instead of billing separately for every service, providers receive a single payment for an entire episode of care, like a hip replacement or heart surgery.
• Hospital Readmissions Reduction Program (HRRP): Hospitals receive rewards for keeping patients healthier after discharge and avoiding costly readmissions.
• Medicare Advantage Plans (MA): Many MA plans already use value-based arrangements with providers to improve preventive care and manage chronic conditions.

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Why Value-Based Care Matters

For Medicare beneficiaries, Value-Based Care means:

• More preventive services: Encouragement to get screenings, vaccines, and wellness visits.
• Better coordinated care: Doctors and specialists share information to avoid duplication and gaps.
• Healthier outcomes: The focus is on managing conditions and preventing complications, not just treating problems when they arise.

For the healthcare system overall, VBC helps reduce wasteful spending and ensures taxpayer dollars are used more effectively.

Watch a YouTube video on SEP changes for Dual, Partial Dual & LIS members

The Future of Value-Based Care

Medicare’s long-term goal is to have most of its payments tied to value instead of volume. This means more providers will be incentivized to deliver patient-centered care that is proactive, efficient, and focused on health rather than procedures.

Value-Based Care is Medicare’s way of rewarding healthcare providers for keeping patients healthier, not just for doing more. As this model continues to grow, beneficiaries can expect better care coordination, more preventive services, and a stronger focus on long-term health.

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The Value of Cancer Insurance – Why Medicare Agents Should Offer It

When working with Medicare clients, it’s easy to focus on the basics; Original Medicare, Medicare Advantage, Part D, and Medigap plans. However, one area that often gets overlooked is cancer insurance. The value of cancer insurance is something that should not be overlooked. This type of supplemental coverage can be a valuable addition to a client’s overall healthcare strategy, offering peace of mind and financial protection when it’s needed most.

Why Cancer Insurance Matters for Medicare Clients

While Medicare provides solid coverage for hospital stays, doctor visits, and treatments, it does not cover all of the costs associated with a cancer diagnosis. Beneficiaries may face:

• High out-of-pocket costs for chemotherapy, radiation, or specialty medications.
• Prescription drug expenses, especially for oral cancer drugs under Part D.
• Costs outside of Medicare coverage, such as lodging, transportation, and home assistance.

Cancer insurance offers clients a lump-sum benefit or scheduled payments that they can use however they choose; whether for medical bills, experimental treatments, or everyday living costs.

The Benefits for Medicare Clients

1. Financial Protection: Cancer treatments can be lengthy and expensive. A supplemental policy can help fill gaps and reduce financial stress.
2. Flexibility: Benefits are often paid directly to the policyholder, so they decide how to use the funds.
3. Peace of Mind: Clients know they have extra support if faced with a cancer diagnosis.
4. Complements Medicare: Even with a Medigap or Medicare Advantage plan, out-of-pocket costs can add up quickly.

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Beyond Medical Bills: Everyday Expenses Cancer Insurance Can Help Cover

One of the biggest advantages of cancer insurance is that it isn’t restricted to healthcare bills. Many policies allow beneficiaries to use the funds however they need. This flexibility can help cover:

• Travel expenses to and from treatment centers.
• Lodging and meals if treatment requires staying overnight away from home.
• Lost income if the policyholder or a spouse reduces work hours to accommodate treatments.
• Childcare or caregiver costs for clients who need extra support at home.
• Home modifications (ramps, stair lifts, etc.) if mobility becomes an issue during treatment.
• Everyday bills like utilities, rent, groceries, or car payments, so clients don’t fall behind financially while focusing on recovery.

These are real-world expenses that traditional health insurance, including Medicare, does not cover, but cancer insurance can help pay for.

Why Agents Should Offer Cancer Insurance

For agents, cancer insurance is more than just an add-on product; it’s an opportunity to:

• Protect your clients’ financial wellbeing by addressing a risk area that Medicare alone doesn’t fully cover.
• Build stronger client relationships by showing you’re thinking beyond the basics.
• Diversify your portfolio and increase cross-selling opportunities with products that provide real value.
• Differentiate yourself from other agents by offering a more comprehensive healthcare strategy.

Take a look at our YouTube video on why and how to sell ancillary with Medicare in 5 mins

Riders That Can Enhance Cancer Insurance

Many carriers offer optional riders that make cancer insurance even more customizable. Some examples include:

• Heart Attack & Stroke Rider: Expands coverage to other major health events.
• Return of Premium Rider: Refunds premiums if the client never files a claim.
• Wellness Rider: Pays a small benefit for completing preventive screenings (mammograms, colonoscopies, etc.).
• Intensive Care Rider: Provides additional benefits for ICU stays.
• Hospital Confinement Rider: Offers daily benefits for hospital stays, helping offset non-covered costs.

The Bottom Line

Cancer insurance may not be top-of-mind for your clients, but it should be. With the rising cost of treatment and the financial gaps left by Medicare, this coverage can make all the difference. Not only can it help cover medical expenses, but it also provides funds for everyday living costs that traditional health insurance never touches.

For agents, offering cancer insurance, especially with customizable riders, means providing a higher level of service, protecting clients’ financial futures, and strengthening your business.

Agents stay up-to-date on the latest events and information

Helping your clients prepare for the unexpected is one of the most valuable things you can do. Adding cancer insurance to your portfolio ensures you’re offering them the complete protection they deserve.

Lead Sources for Medicare Agents

For Medicare agents, building a steady stream of quality leads is key to growing your business. Knowing where to find prospects and how to approach them can make all the difference. Below, we explore common lead sources including details on the types of leads that vendors provide, so you can decide what works best for you.

Referrals from Existing Clients

Satisfied clients can be your best source of warm leads. When they recommend you to family or friends, those referrals often come with built-in trust.
Tip: Always politely ask for referrals after helping a client enroll successfully.

Community Events and Educational Seminars

Hosting or participating in local events (grass roots marketing) helps you connect with Medicare-eligible individuals looking for information.
Offer free educational seminars on Medicare basics or plan options to build credibility and become a valued local resource.

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Partnerships with Professionals

Collaborate with financial advisors, elder law attorneys, local doctors, pharmacies and other professionals who work with a similar client base.
Note: Provide them with clear information about your services so they can confidently refer clients and vice versa.

Online Marketing

Many seniors and their families research Medicare options online before contacting an agent.
It is a great idea to build a website with educational content, optimize for search engines, and use targeted ads on platforms like Facebook or Google.

Watch a quick YouTube video – How to Manage and Grow a Medicare Book

Purchased Leads and Lead Vendor Options

Lead vendors offer various types of leads to help agents connect with Medicare prospects. Understanding the types can help you choose the best fit for your sales style:

• Live Transfers:
  The vendor screens a prospect live and then immediately transfers the call to you. This means the lead is “hot” and ready to talk, but you must be ready to take the call in real time.
  Best for agents who can handle calls on-demand and want high conversion rates. These are the most costly, but delver the best return on investment.
• Warm Transfers:
  Similar to live transfers, but the prospect has been pre-qualified and warmed up before being transferred. Sometimes these calls are scheduled ahead of time to ensure availability.
  Good for agents who want quality leads but prefer some control over scheduling. These leads usually have a higher price, but the conversion rate is good.
• Direct Leads (Contact Info Only):
  The vendor provides contact details (phone number, email) of prospects who have expressed interest in Medicare plans. You then reach out on your schedule.
  Works well for agents who prefer to set their own pace but requires effective follow-up. Leads of this type are usually less expensive, but have a lower close rate. It’s worth a try if you’re on a budget.
• Internet or Web Leads:
  These leads come from online forms where prospects request information or quotes. These can be fresh but vary in quality. The cost depends on the source and varies.
  Best combined with quick follow-up to maximize conversion.

Note: Choose vendors with verified leads and transparent refund policies. Respond promptly to leads, especially live and warm transfers, since timeliness impacts conversion.

Here are a couple videos from some of our lead vendors:

Learn more about Medicare Express Leads

See what Lead Star has to offer agents

Local Networking Groups

Join your local chamber of commerce or senior-focused groups (senior centers) to build local connections. Be sure you focus on building relationships, not just sales pitches.

Current Book of Business

Cross-selling and annual plan reviews with existing clients can generate repeat business as well as maintaining your book of business. It is a good idea to stay in touch with your current clients through newsletters, birthday cards or check-in calls

Agents; don’t miss important events and information; click here for details.

A diverse lead generation approach works best. Combining referrals, community outreach, online marketing, and vendor leads. Additionally; understanding the nuances of lead types like live and warm transfers gives you flexibility and steadiness throughout the year.

Navigating Medicare Clients with a Power of Attorney

When working as a Medicare agent, you’ll occasionally encounter clients who have a Power of Attorney (POA) in place. This often happens when a beneficiary is unable to make healthcare or financial decisions on their own due to age, illness, injury, or cognitive decline. In this post, we will discuss best practices when writing clients with a POA. Knowing how to handle these situations correctly is critical, not only for compliance, but to protect your client’s best interests and your professional integrity.

Understand the Type of POA in Place

Not all powers of attorney are the same. The POA document may grant authority over:

• Healthcare decisions only – The designated person can make medical choices but may not be authorized to enroll or disenroll the client from Medicare plans.
• Financial matters only – The person can manage finances, including paying premiums, but may not have authority over healthcare decisions.
• Durable Power of Attorney – Remains valid if the client becomes incapacitated and may include healthcare and/or financial authority, depending on the document.

It is important to request and review a copy of the POA before proceeding. Make sure it specifically covers the actions that will take place; choosing coverage, signing enrollment forms or authorizing plan changes.

Verify Legal Authority Before Taking Action

Carriers and CMS have strict rules about working with someone other than the Medicare beneficiary. Each plan carrier may require:

• A copy of the POA on file
• A completed Authorized Representative form
• Verification that the POA is active and valid

Do not rely on verbal claims alone—documentation is key. Acting without proper proof can create compliance issues for you and enrollment problems for your client.

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Communicate Clearly and Respectfully

When a POA is in place, you may need to adjust your communication style:

• Speak directly to the authorized individual about plan options, but keep the beneficiary engaged if they are able to participate.
• Avoid discussing personal health or financial information with anyone not listed on the POA or other authorized documents.
• Be patient; these situations often involve extra steps and emotions.

Document Every Interaction

For your protection and for compliance purposes:

• Keep a record of all communications with both the beneficiary and the POA.
• Note when and how you received POA documentation.
• Record all decisions made and who made them.

Watch a YouTube video on what you need to know before a Medicare sale

Stay Compliant with CMS and Carrier Guidelines

Remember: CMS rules still apply, even if you’re working through a POA. Follow the same protocols for:

• Scope of Appointment (SOA) forms
• Plan comparisons and benefit explanations
• Enrollment timelines and eligibility checks

The Bottom Line

Handling clients with a Power of Attorney requires patience, diligence, and a solid understanding of legal authority. By verifying documentation, following compliance procedures, and maintaining respectful communication, you can protect your client’s interests while safeguarding your own professional standing.

Agents, click here for up-to-date events and information

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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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.

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

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

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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 Educational Event Guidelines – CMS Rules for 2026

As an agent, you will find that hosting an educational event is a great and inexpensive way to get out there and meet potential clients. However, it is imperative that you understand Medicare educational event guidelines before you do anything.

Define: Educational Marketing

CMS draws a firm line:

• These events must be “educational” in name and intent, not promoting a specific plan, carrier, or agent.
• Avoid mentioning brand names, plan details, incentives, or statements such as “call me to enroll.”
• Agents also must not imply in any way that they work for Medicare itself.

Must Include Event Disclaimers

Advertisements and invites must clearly state:

• “For accommodations of persons with special needs at meetings call [insert phone and‑TTY number].”
• “This event is for educational purposes only and no plan‑specific benefits or details will be shared.”

Content & Tone: Fact‑Based & Neutral

• Cover Medicare basics; Parts A, B, C, D, eligibility, enrollment windows, general plan types.
• Share objective tools, e.g., comparisons, eligibility calculators, and CMS (Centers for Medicare & Medicaid Services) resources.
• No steering: Personal recommendations or showing plan-specific premiums/benefits are prohibited.

Compliant Location & Registration

• Host events in public venues (e.g., libraries, community centers); not in private offices or health‑care settings, unless you use a common area.
• You may use a sign in sheet, however attendee use has to be optional.
• Be sure to register your event with the plan sponsor/MA organization if required (per MA/Part D compliance rules).

No Sales or Enrollment Activities

• Sales-focused tactics are forbidden; no enrollment scripts, plan comparisons, or benefit highlights.
• Do not take a SCOPE of appointment.
• It’s OK to show general enrollment periods and eligibility rules, but not to finalize or process enrollment.

Watch a YouTube video on Medicare Educational Seminar Best Practices

What agents can do

• Distribute generic materials such as business replay cards for attendees to request you contact them, but do not provide plan brochures or enrollment forms.
• Provide a light snack; keep in mind the value of the food must not exceed $15 per person.
• Offer promotional items as long as their value is $15 or less per person. Make sure they don’t include any plan information. They can however, include a carrier name, logo or toll free number.
• Provide your business cards for anyone who may want to contact you at a later date to schedule an appointment.
• Answer general questions; do not discuss specific plan details.

2026 CMS Rule Updates: What Agents Should Know

Expanded ADVERTISING Definition

For 2026, CMS is broadening what counts as “marketing.” Any general message that could sway enrollment now requires pre‑approval from CMS.
That means even “purely educational” ads could get flagged; plan carefully.

Click here to view the CMS 2026 fact sheet for the proposed final rule

Agents as Fiduciaries

Following the Senate Wyden report, there’s talk of requiring brokers to act as fiduciaries, disclose compensation, and limit lead-gen tactics. CMS may follow up, so transparency is key.

AI & Marketing Guardrails

CMS is reviewing proposals to ensure AI tools used in marketing are fair, transparent, and not deceptive. If you use chatbots or scripts, make sure they’re compliant.

CMS and IRA‑Driven Part D Changes

Though not directly event-related, these changes may impact your educational content:

• New Prescription Payment Plan (PPP) options—agents should know monthly cap letter tactics.
• Drug cost-sharing updates (insulin, vaccines)—beneficiaries now get these at $0 through Part D.

Agents stay up-to-date on the latest events and information

Best Practices for Agents

What Agents Should Do Next

1. Review and update event invites to include disclaimers and explicitly label them as educational.
2. Audit presentation materials to ensure neutral content; avoid any plan-specific information or persuasive language.
3. Train your team on the updated 2026 rules: no endorsements or marketing disguised as education.
4. Pre-submit ads if they could influence plan choice; especially media buys or mailers.
5. Stay informed on regulatory changes regarding fiduciary status and AI tools.

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

In 2026, CMS is cracking down on the gray line between education and marketing. Agents must commit to clear, plan-neutral, fact-based events backed by proper disclaimers, transparent content strategy, and due diligence in marketing approach. Staying well-prepared now lays the foundation for trust, authority, and compliance down the road.