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Preparing for AEP 2026: Boost Your Sales, Retain Clients, and Grow Your Book

The 2026 Annual Enrollment Period (AEP) isn’t just another enrollment season; it’s a golden opportunity to build stronger client relationships and grow your business. With more non–commissionable Prescription Drug Plans (PDPs) and Medicare Advantage (MA) plans in the market, preparing for AEP 2026 is more difficult than ever.

Here’s how you can maximize earnings, protect your clients, and position yourself as the go-to Medicare resource this AEP.

Turn Non-Commissionable Plans Into Revenue Opportunities

Yes, some PDPs and MA plans won’t pay you. But don’t let that stop you from helping your clients:

• Be the expert they trust. Walk them through all available options; even the ones you don’t get paid for. This honesty builds loyalty and keeps them coming back every year.
• Leverage the conversation. Once you’ve solved their drug plan or MA needs, introduce other solutions that can better protect them and generate income for you.
• Think lifetime value, not one commission. The client you help today (even for free) could be the one who buys a Medigap plan, final expense policy, or ancillary product tomorrow.

Promote Medicare Supplements

Medicare Supplements are a powerful tool for agents looking to grow their book with long-term, commissionable business.

• High Deductible Plan G (HDG): Sell the benefits of lower premiums, network freedom, and great cost protection once the deductible is met. Perfect for healthy, budget-conscious clients.
• Plan G or Plan N: Offer predictable out-of-pocket costs and peace of mind. Great for clients leaving MA plans or worried about networks shrinking.
• Target switching opportunities: Use the Medigap Open Enrollment period, guaranteed issue rights, and birthday rules where available to win new clients.

Cross-Sell Ancillary Products to Increase Income

Every client interaction is a chance to protect more of their health and finances. Cross-selling not only grows your revenue; it keeps competitors out of your book.

Products to focus on this AEP:

• Hospital Indemnity Plans – Cover MA plan hospital copays and reduce client financial stress.
• Cancer, Heart & Stroke Policies – Offer lump-sum protection for serious illness expenses.
• Dental, Vision & Hearing Plans – Fill in coverage gaps Original Medicare doesn’t touch.
• Final Expense Life Insurance – Help clients plan for end-of-life costs and leave a legacy.

Watch a YouTube video – Why and how to sell ancillary with Medicare in 5 minutes

Strengthen Client Retention with Education

AEP isn’t just about selling — it’s about proving you’re the trusted Medicare expert year-round.

• Send an AEP prep email or postcard to let clients know you’ll review their coverage.
• Host a quick webinar or local seminar on “What’s New for 2026.”
• Offer annual policy reviews to make sure they’re always in the best plan for their situation.

Education keeps your name top of mind and positions you as the advisor they call before making a move.

The agents who win this AEP will be those who combine client-first service with smart product recommendations. Help with the non-commissionable PDPs and MA plans, but don’t stop there; present Medigap, HDG, and ancillary products that protect your clients’ health and finances while boosting your bottom line.

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

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Your clients get better coverage, you get stronger renewals, and your book of business grows. That’s a win-win AEP strategy.

Why Sell Critical Illness Insurance

When it comes to protecting clients from financial hardship, health coverage alone isn’t always enough. The big question is; why sell critical illness insurance. The answer is: as an insurance agent, you already know the cost of a serious illness can go far beyond hospital bills. That’s where this insurance comes in. Offering this valuable coverage to your clients not only strengthens their financial safety net, but also helps your business grow.

What Is Critical Illness Insurance

Critical illness insurance is a supplemental policy that provides a lump-sum cash benefit if the policyholder is diagnosed with a covered illness such as:

• Heart attack
• Stroke
• Cancer
• Organ failure
• Major surgery

Unlike health insurance, which pays doctors and hospitals, critical illness insurance puts money directly in your client’s hands to spend however they need.

Why Agents Should Offer It

Fill a Major Coverage Gap

Even clients with excellent health insurance can face substantial out-of-pocket costs; deductibles, co-pays, non-covered treatments, travel expenses for care, and lost income during recovery. Critical illness benefits can bridge that gap, giving clients peace of mind.

Protect Clients’ Financial Well-Being

A major diagnosis can derail a family’s finances. This coverage can help with:

• Mortgage or rent payments
• Childcare
• Utility bills
• Transportation to treatment
• Alternative or experimental treatments not covered by insurance

Helping your clients plan for these “hidden” costs builds trust and shows you care about their full financial picture.

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Create a New Revenue Stream

Critical illness policies are generally affordable and easy to quote. Adding them to your portfolio can boost your sales without requiring significant additional effort. Many carriers offer simplified underwriting and electronic applications, making the process smooth for both you and your clients.

Cross-Sell Opportunities

Critical illness coverage is a natural add-on for clients purchasing:

• Health insurance
• Medicare Advantage or Supplement plans
• Life insurance
• Disability income insurance

By bundling solutions, you create a comprehensive protection plan and increase client retention.

Watch a quick YouTube video on why sell ancillary products with Medicare

Stand Out from Competitors

Many agents overlook supplemental health products. Offering critical illness insurance shows that you go beyond the basics and are committed to providing complete risk protection for your clients.

Positioning Critical Illness Insurance with Clients

When discussing this coverage, focus on real-life scenarios and emphasize flexibility:

• “If you were diagnosed with cancer tomorrow, would you have enough savings to cover your expenses while you focus on getting better?”
• “This policy gives you cash you can use however you want – not just on medical bills.”

Simple, empathetic conversations often lead to meaningful sales.

Selling critical illness insurance is more than an opportunity to increase commissions – it’s a way to help clients face one of life’s biggest challenges with confidence. By offering this coverage, you can:

• Strengthen your client relationships
• Provide real financial security
• Build a more resilient, profitable business

Stay up-to-date on Medicare agent events and information

Helping clients prepare for the unexpected is what great agents do. Critical illness insurance is an essential piece of that puzzle.

Compliant Medicare Sales Events: A Guide for Agents

Hosting Medicare sales events is a powerful way to educate beneficiaries, build trust, and grow your Medicare business; but compliance must always come first. The Centers for Medicare & Medicaid Services (CMS) has strict rules about how these events are marketed, set up, and conducted. We go over how to conduct compliant Medicare sales events, Staying compliant protects you from regulatory issues, safeguards beneficiaries, and helps maintain carrier confidence in working with you.

Step 1: Choose the Right Type of Event

Start by deciding what kind of event best serves your audience:

• Formal Sales Events – Structured, scheduled presentations where you review plan-specific information with an invited audience.
• Informal Sales Events – More casual setups, like a table, booth, kiosk, or RV, where you only share plan information if a beneficiary asks for it.

Your choice will determine how you promote the event and the materials you’ll need.

Step 2: Select the Time and Location

After choosing the event type, decide when and where to host it. CMS requires that all sales events:

• Be registered with the carriers you are representing before adverting for it.
• Be held in a public setting where beneficiaries are not actively receiving health care services.

Approved locations include:

• Common entryways and vestibules
• Waiting rooms
• Hospital or nursing home cafeterias
• Community, recreational, or conference rooms

These locations are considered neutral spaces that allow beneficiaries to attend without disrupting care.

Step 3: Market Your Event the Right Way

How you advertise is just as important as what you present. CMS has specific rules for marketing Medicare sales events:

• No mandatory RSVPs – You cannot require attendees to provide personal contact information just to attend.
• Use accurate language – Don’t label the event “educational,” since educational events have different compliance rules. Instead, disclose which products or plans you’ll discuss.
• Include all required disclaimers – Every flyer, invitation, ad, or mailer must include:
  • “Not affiliated with or endorsed by the government or federal Medicare program.”
  • The accommodation statement: “For accommodation of persons with special needs at sales meetings call [insert phone and TTY number].”

If your event involves marketing Medicare Advantage or Part D plans, you must also include the appropriate TPMO (Third-Party Marketing Organization) disclaimer on all event materials:

• If you market fewer than all plans in the area: “We do not offer every plan available in your area. Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.”
• If you market all plans in the area: “Currently we represent [insert number of organizations] organizations which offer [insert number of plans] products in your area. You can always contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) for help with plan choices.”

You can promote your event online, through direct mail, social media, or other media channels, just ensure all ads are carrier-approved and compliant.

Step 4: Handling Cancellations

Life happens. You may need to cancel an event due to a family emergency, weather conditions, or other business priorities.

While CMS does not require sales event cancellations to be submitted through HPMS, you should follow these best practices (and your carrier’s policies):

• Notify the carrier or FMO as soon as possible.
• Post a cancellation notice at the event location if feasible.
• If attendees preregistered, notify them promptly through phone, email, or mail.
• Reschedule when appropriate and advertise the new date clearly.

Clear communication helps maintain your professionalism and demonstrates respect for beneficiaries’ time.

Step 5: Run a Compliant Event

Once your event begins, compliance remains front and center:

• Use only CMS-approved materials – Benefit highlights, plan comparisons, and enrollment forms must be pre-approved.
• Stay unbiased and low-pressure – Present information clearly and allow attendees to make their own decisions.
• Provide optional sign-in sheets – Attendees must never be required to share personal information.
• Read required disclaimers at the start – Identify the plans you represent, note that other plans may be available, and clarify that attendance does not obligate enrollment.
• Document everything – Keep a record of your event details, materials used, and sign-in sheets (if any) in case of a CMS audit.

Visit our YouTube channel and review the Medicare AEP marketing rules

Why Compliance Matters

Compliance ensures beneficiaries receive accurate information without feeling pressured. It also protects you from regulatory violations and maintains your reputation as a professional, trustworthy agent.

Tips for a Successful Event

• Prepare and rehearse – A smooth, professional delivery builds credibility.
• Know your material – Be ready to answer common Medicare questions with confidence.
• Engage attendees – Allow time for Q&A and use simple examples to explain benefits.
• Follow up responsibly – Only contact beneficiaries who gave permission to be called.

Stay up-to-date on Medicare agent events and information

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Compliant Medicare sales events not only meet regulatory standards — they build trust, improve client relationships, and set you apart as a professional. By marketing correctly, including the right disclaimers, handling cancellations professionally, and following CMS rules during the event, you’ll grow your business while staying protected.

Medicare Advantage Unused Benefit Rules – What Agents Need to Know

Medicare Advantage (MA) plans can be a great choice for clients; especially because of their extra perks like dental, vision, hearing, OTC allowances, and fitness memberships. But these benefits often go unused, which can lead to client dissatisfaction and plan switching. Recently, CMS has put some Medicare Advantage unused benefit rules in place.

Here’s what you need to know to guide your clients.

Key Points About Unused Benefits

• Most benefits expire monthly, quarterly, or annually; no rollovers.
• OTC allowances are among the most commonly missed benefits.
• Dental/vision/hearing dollars disappear at year-end if not used.
• Provider networks matter — clients must follow plan rules or they risk missing out on some benefits.

CMS’ Mid-Year Notification Rule

CMS recently finalized a rule requiring MA plans to send personalized mid-year notices (June 30–July 31) showing members which supplemental benefits they haven’t used and how to access them.

However, enforcement is paused for 2026, so most plans will not send these reminders. Some may do so voluntarily, but agents should not assume clients will get them.

Watch a YouTube video: Why agents should include ancillary products with MA sales

Why This Matters for Agents

• Client Retention: Clients often switch plans because they feel they aren’t getting value; even when benefits were available.
• Education Opportunity: Helping clients understand and use their benefits builds trust and keeps them engaged.
• Competitive Edge: Agents who proactively remind clients about OTC orders, dental visits, and other benefits stand out.

Agents click here to begin a new contract or add a carrier to existing Crowe contract.

Agents

• Review each client’s benefits during mid-year check-ins.
• Send reminders about quarterly OTC allowances and annual dental/vision appointments.
• Explain provider network requirements to avoid frustration.
• Track CMS updates; when they enforce the rule, you can align your outreach with plan notices.

Stay updated on agent events and information

Even with CMS’ rule delayed, agents can fill the gap by educating clients and helping them use the benefits they signed up for. Proactive communication strengthens client relationships, improves satisfaction, and keeps your book of business stable.

2026 Medicare Part D Costs & Drug Price Negotiations

Medicare Part D (the prescription drug benefit) has seen some major changes recently. For 2026, several provisions are coming into play that affect what enrollees pay, how much Medicare pays, and how drug prices are negotiated. Below are the key updates to the 2026 Medicare Part D costs.

Key Changes in Medicare Part D for 2026

Here are some of the most important cost‐related changes that beneficiaries should know:

What Is the Drug Price Negotiation Program

Under the Inflation Reduction Act of 2022, Medicare now has the power to directly negotiate prices for certain high-cost drugs covered under Part D (and later also Part B). Previously, Medicare was more restricted in its ability to force manufacturers to lower prices for prescription drugs.

Here’s how the negotiation program works in broad strokes:

• Each year, a certain number of “single-source” brand drugs (i.e. those without generics or biosimilars) that have been on the market for a set minimum time become eligible for negotiation.
• Medicare (through CMS) makes an initial offer (“maximum fair price” or MFP) based on drug spending, clinical benefit, manufacturer costs, price in comparable drugs, etc. Manufacturers can counter. There are meetings and data sharing to arrive at a negotiated price.
• If agreement is reached, the negotiated price becomes effective as of a certain date. For the first set of drugs, prices begin for 2026

Watch a quick YouTube video on the Medicare Prescription Payment Plan

Which Drugs & Savings with Negotiation in 2026

• The first round of negotiation selects 10 Part D drugs.
• For 2026, these negotiated prices go into effect starting January 1, 2026.
• The discounts negotiated are substantial: for those 10 drugs, reductions range from 38% to 79% off list price.
• Estimated savings: If those new prices had been in effect earlier (e.g. in 2023), Medicare would have saved about $6 billion in overall drug spending on those drugs. For beneficiaries, out-of-pocket savings for those 10 drugs in 2026 are projected to be about $1.5 billion.

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How Negotiations & Costs Interact: What This Means for Beneficiaries

• Lower list/transaction prices for selected drugs should directly reduce what beneficiaries pay (especially in the initial and gap phases), because coinsurance or cost sharing is often a percentage of drug cost.
• The out-of-pocket cap ($2,100 in 2026) limits how high total costs for drugs can go in a year, making unexpected high drug bills somewhat more predictable.
• The negotiation program may also influence which drugs are placed on formularies or on preferred tiers, as plans respond to the new negotiated prices.
• However, the savings from negotiated drugs apply only to those drugs selected for negotiation; many other drugs will still be under traditional pricing structures.

Some Caveats & Things to Watch

• The negotiated max fair price is not always simply a percentage cut—there are statutory minimum discounts, comparisons with existing net prices, evaluation of alternatives, etc. Some drugs may see smaller reductions depending on existing rebates or other discounts.
• The program phases in over years: more drugs will be subject to negotiation in 2027, 2028, etc. So the full effects take time.
• Courts and industry challenges may affect implementation or enforcement.

Stay up-to-date on agent events and information

For 2026, people with Medicare should expect higher costs including; premiums, deductibles and out‐of‐pocket thresholds compared to previous years. Although there will be relief for certain high‐cost drugs thanks to the new Medicare drug price negotiation program. If you’re taking one of the drugs selected for negotiation, the discounts will reduce what you pay. Over time, broader negotiation and other reforms aim to make more drugs more affordable for all Part D enrollees.

The Medigap Free Look Period and How to Use It

When clients are considering a Medicare Supplement (Medigap) plan, they want to be sure they’re making the right choice. Fortunately, Medicare gives beneficiaries a way to try out a new Medigap plan without fully giving up their old one; it’s called the Medigap Free Look Period.

As an agent, knowing how this works helps you guide clients through transitions confidently and avoid gaps in coverage.

What Is the Medigap Free Look Period

The Medigap Free Look Period is a 30-day window that allows Medicare beneficiaries to try out a new Medigap policy while keeping their current one.

This is helpful when a client isn’t sure if the new plan will meet their needs; for example, if they are switching from a Plan F to a Plan G or moving to a carrier with a lower premium.

Watch a YouTube video on Medicare Supplement Underwriting (GI & Non-GI States)

How the Free Look Period Works

Here’s how the process goes step by step:

1. Apply for the New Medigap Plan
   • Your client must be accepted by the new Medigap plan (and if underwriting is required, they must pass).
2. Keep Paying for the Old Policy
   • Even after the new plan starts, your client must keep paying premiums for their old Medigap policy during the 30-day free look period.
   • This ensures there’s no gap in coverage if they decide to go back.
3. Evaluate the New Coverage
   • Over the 30 days, your client can use the new Medigap plan and see how it works with their needs.
4. Decide Whether to Keep It
   • If they like the new plan, they can cancel the old one after the 30 days.
   • If they don’t, they can cancel the new plan and keep the old one; no harm done.

Important Things to Remember

• Two Premiums Are Due: Clients will pay two Medigap premiums during the free look period; one for the old plan and one for the new. This is often the biggest surprise for beneficiaries, so prepare them ahead of time.
• Coverage Overlap Is Intentional: The goal is to avoid any lapse in coverage while deciding which plan to keep.
• Act Within 30 Days: If the client decides to go back to their old policy, they must notify the new carrier before the free look period ends.

Why Agents Should Talk About It

Educating clients about the Medigap Free Look Period builds trust. Many people hesitate to switch plans out of fear of losing coverage or making the wrong choice. When you explain that they can try a new plan risk-free, you help them feel confident in making a change. That helps position you as a knowledgeable, client-first agent.

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

The Medigap Free Look Period is a great tool to help beneficiaries compare coverage and costs without the stress of losing their existing plan. As an agent, you can guide them through the process, set clear expectations about paying two premiums, and help them decide which plan is the best long-term fit.

Empower your clients with this knowledge; it may be exactly what they need to take the next step toward better coverage and savings.

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What Is a Medicare Authorized Representative

Navigating Medicare can sometimes feel overwhelming; especially when it comes to forms, appeals, or plan decisions. That’s where a Medicare Authorized Representative comes in. If you need help dealing with Medicare, you can officially appoint someone to act on your behalf. But what is a Medicare authorized representative, and what are the limits to their authority? Let’s break it down.

What Is a Medicare Authorized Representative

A Medicare Authorized Representative is a person you choose to act for you in handling certain Medicare matters. You can name a trusted family member, friend, caregiver, or even a professional (like an attorney) to represent you.

To make this official, Medicare requires you to complete the “Appointment of Representative” form (CMS-1696) or provide a written statement that includes specific details. Once approved, Medicare recognizes this person as your representative for the issues you’ve specified.

What an Authorized Representative Can Do

When properly appointed, your authorized representative can:

• Communicate with Medicare on your behalf – including discussing claims, coverage, and appeals.
• File appeals or grievances – if you disagree with a coverage or payment decision.
• Submit plan enrollment or disenrollment requests – depending on your needs.
• Receive notices and correspondence from Medicare related to your case.
• Help you gather and send supporting documentation for appeals or claims.

Essentially, your representative steps into your shoes for specific Medicare-related matters, making the process less stressful for you.

What an Authorized Representative Cannot Do

It’s important to understand the limits of this role. A Medicare Authorized Representative cannot:

• Make medical decisions for you – They are not the same as a healthcare proxy or power of attorney for medical treatment.
• Automatically handle all financial or legal matters – Their authority is limited to Medicare issues.
• Act indefinitely without renewal – Representation typically applies to specific cases or timeframes and may need renewal if ongoing.
• Override your wishes – You remain in control, and you can revoke their authority at any time.

If you want someone to handle broader decisions about your finances or healthcare beyond Medicare, you would need a power of attorney or similar legal document.

Watch a YouTube video on Medicare enrollment periods

How to Appoint a Representative

1. Fill out Form CMS-1696 – This form is available on Medicare.gov or from your plan.
2. Submit the form – Send it to your Medicare Advantage, Part D, or other Medicare-related plan, or directly to Medicare if it’s about Original Medicare.
3. Wait for confirmation – Once accepted, your representative can begin acting on your behalf.

Why Appointing a Representative Can Help

Having a Medicare Authorized Representative can be especially useful if:

• You’re appealing a denial of coverage.
• You need help managing the paperwork.
• You have a trusted advocate who understands your situation.
• You want extra peace of mind that someone is handling your case correctly.

Agents stay up tp date on events and information

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

Bottom line: A Medicare Authorized Representative is your advocate in dealing with Medicare, but their authority is limited to Medicare-related issues. They can help with forms, appeals, and communication, but they cannot make medical decisions or handle unrelated legal or financial matters.

Medicare Supplement Underwriting Explained

When clients start exploring Medicare Supplement (Medigap) plans, one topic that often causes confusion is underwriting. Unlike Medicare Advantage plans, which don’t require medical underwriting, Medigap coverage can involve health-related questions and approval requirements; depending on when and how someone applies. That is why we hope, Medicare supplement underwriting explained will provide an understanding of the process so agents can better assist clients.

What Is Medicare Supplement Underwriting

Underwriting is the process insurance companies use to determine whether to accept an applicant for a Medigap policy, and sometimes the determine the premium amount. This process often involves answering health questions, reviewing prescription history, or even checking recent hospitalizations.

Not every applicant will face underwriting, many people qualify for guaranteed issue rights or are in their Medigap Open Enrollment Period, which means they can get a plan without medical review.

When Is Underwriting Required

Underwriting typically comes into play in these situations:

• Applying outside the Medigap Open Enrollment Period (which lasts six months after a beneficiary first enrolls in Part B at age 65).
• Switching from one Medigap plan to another outside of specific state-mandated open enrollment or “birthday rules.”
• Losing coverage without qualifying for guaranteed issue rights.

In these cases, insurance carriers can:

• Approve coverage at the standard rate,
• Charge a higher premium,
• Impose a waiting period for pre-existing conditions, or
• Deny coverage altogether.

Guaranteed Issue Rights (No Underwriting Required)

There are special circumstances where a beneficiary can enroll in a Medigap plan without facing underwriting, such as:

• Losing employer or union coverage.
• Their Medicare Advantage plan leaving the service area or ending coverage.
• Moving out of a Medicare Advantage plan’s service area.
• Taking advantage of certain state-specific enrollment protections (like California and Oregon’s Birthday Rule, or Missouri’s Anniversary Rule).

During these times, carriers must offer coverage, regardless of health status.

Watch a quick YouTube video on Medicare Supplement Underwriting

Common Health Questions in Underwriting

While exact questions vary by carrier, underwriting often includes:

• Recent heart attacks, strokes, or cancer diagnoses.
• Use of oxygen, dialysis, or organ transplants.
• Height, weight, and mobility concerns.
• Hospitalizations in the past 90 days.
• Use of certain expensive medications.

Carriers typically ask about conditions that are costly and ongoing. Clients with stable, controlled conditions may still qualify.

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Why Agents Should Understand Underwriting

As an agent, knowing the underwriting rules helps you:

• Advise clients on the best time to apply for Medigap coverage.
• Set realistic expectations about approvals, denials, or higher premiums.
• Protect clients by helping them avoid losing a plan they may not be able to requalify for later.

Stay up-to-date on Medicare agent events and information

Underwriting for Medicare Supplements can be straightforward if clients apply at the right time, but tricky if they wait too long or want to change plans later. By understanding the process and knowing when underwriting applies, you can help your clients secure coverage that supports their health and budget without unexpected roadblocks.

Medicare’s 2026 Drug Price Negotiations: A New Era of Affordability

Starting January 1, 2026, Medicare will implement its first-ever negotiated prescription drug prices; a historic change that could lower costs for millions of beneficiaries. In this post, we discuss Medicare’s 2026 Drug Price Negotiations. This is a direct result of the Inflation Reduction Act of 2022, which for the first time gave Medicare the authority to negotiate the prices of certain high-cost medications.

Why This Matters

For decades, Medicare was prohibited from negotiating directly with drug manufacturers. Instead, it relied on private Part D plan sponsors to manage drug costs. The 2026 negotiations mark a turning point. Medicare will now establish a Maximum Fair Price (MFP) for select drugs, reducing both what the government pays and what beneficiaries spend at the pharmacy counter.

• Projected Medicare savings: About $6 billion in 2026
• Projected out-of-pocket savings for beneficiaries: About $1.5 billion

The First 10 Drugs Negotiated for 2026

CMS chose these drugs because; they are some of the highest-cost Part D medications. In addition; there are no generic or biosimilar medications available, and are widely prescribed.

1. Eliquis – blood thinner for preventing stroke and blood clots
2. Xarelto – blood thinner for reducing risk of clotting
3. Januvia – diabetes medication (DPP-4 inhibitor)
4. Jardiance – diabetes, heart failure treatment (SGLT2 inhibitor)
5. Farxiga – diabetes, heart failure, kidney disease treatment (SGLT2 inhibitor)
6. Entresto – heart failure medication
7. Enbrel – rheumatoid arthritis and autoimmune conditions
8. Stelara – psoriasis, Crohn’s disease, ulcerative colitis
9. Imbruvica – blood cancers (leukemias and lymphomas)
10. NovoLog / Fiasp – fast-acting insulin for diabetes

How Beneficiaries Will Benefit

• Lower copays and coinsurance: Out-of-pocket costs will drop for patients taking these medications.
• Broader affordability: Even if you don’t take one of these drugs, Medicare’s overall savings help stabilize Part D premiums.
• Expanded impact in future years: In 2027 and beyond, CMS has scheduled more drugs for negotiation.

Watch a YouTube video on the Inflation Reduction Act and Changes to Medicare

What Comes Next

• 2027: Fifteen more high-spend drugs are already set to be negotiated, with prices effective January 1, 2027.
• 2028 and beyond: CMS will continue expanding the program, selecting additional drugs each year.
• Rulemaking: Starting in 2026, the program shifts to a formal rulemaking process, adding more transparency.

Challenges and Legal Pushback

The pharmaceutical industry has filed multiple lawsuits challenging Medicare’s new authority, arguing that price negotiations are unconstitutional. At the same time, new legislation has delayed or exempted certain blockbuster drugs, such as Keytruda, from early negotiation. While these challenges could affect the program’s scope, the 2026 savings are locked in and moving forward.

What You Should Do

• Review your Medicare Part D plan during open enrollment to ensure it covers your prescriptions at the lowest cost.
• Talk to your agent if you take any of the drugs on the 2026 negotiation list, you could see meaningful savings.
• Stay informed about future negotiation cycles, as more medications are added each year.

Agents:

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Stay updated on agent events and information

Medicare’s 2026 drug price negotiations represent a historic shift in prescription drug policy. For the first time, Medicare is actively reducing the cost of some of the most expensive and widely used medications in the program. While legal and political challenges remain, the immediate savings for beneficiaries and taxpayers are significant—and this is only the beginning.

United American HDG Plan Sales – Why Consider Them This AEP

Why Add UA Now

The Annual Election Period (AEP) for Medicare runs each year from October 15 through December 7. It’s the window when beneficiaries can enroll in, switch, or drop Medicare plans. With all the changes to Medicare plans this year, agents might want to consider United American HDG Plan Sales.

What is a High-Deductible Plan G (HDG)

United American’s HDG plan offers the same benefits as a standard Plan G after enrollees meet the deductible ($2,870 in 2025). That means once the deductible is met, the plan pays 100% of Medicare-approved services, including:

• Hospital costs and Part A coinsurance
• Skilled nursing facility coverage
• Part A deductible
• Part B coinsurance and excess charges
• 80% of foreign travel emergencies

Because of the higher deductible, monthly premiums are significantly lower, making HDG an attractive choice for cost-conscious beneficiaries.

Watch a quick YouTube video on High Deductible Plan G

Why choose United American’s HDG plan this AEP

Fewer Medicare Advantage options, especially PPOs

Carriers are withdrawing some Medicare Advantage plans from the market, particularly PPOs, and many agents are reporting fewer plan choices this AEP. In some areas, commissions on Medicare Advantage plans are also being reduced or eliminated. For beneficiaries who want stability, freedom of provider choice, and nationwide access, an HDG plan offers an excellent alternative.

Great value for cost-conscious consumers

HDG balances affordability and coverage; lower monthly premiums without sacrificing comprehensive protection once the enrollee meets the deductible.

Nationwide flexibility

Unlike Medicare Advantage, which often restricts members to networks, United American’s HDG allows you to visit any provider that accepts Original Medicare, with coverage that travels across state lines.

Financial strength and trust

United American has been selling Medicare Supplements since 1966 and maintains strong financial ratings, including an A (Excellent) from A.M. Best. Their history of stability reassures clients looking for long-term reliability.

Consumer-friendly features

Guaranteed renewable: You can’t be canceled as long as premiums are paid.

30-day free-look period: Cancel within 30 days if not satisfied.

Switching flexibility: Start with HDG and, at your second anniversary, move to a standard Plan G without underwriting if you decide you want richer coverage.

Why HDG makes sense in today’s market

With Medicare Advantage options shrinking, especially PPOs, and rising uncertainty in benefits and provider access, many beneficiaries are reconsidering Medigap. HDG is a way to:

• Keep premiums affordable
• Retain freedom to choose providers nationwide
• Have peace of mind that coverage won’t change annually the way MA plans often do

Sample Comparison: Is HDG Worth It

• High Deductible Plan G: Lower monthly premium, pay the $2,870 deductible first, then full coverage.
• Standard Plan G: Higher premiums, but no deductible. Total yearly cost could be higher even with no deductible, depending on your health needs and provider use.

If saving on monthly cost is a priority—and you’re able to manage the deductible if needed—HDG offers strong value, especially during this AEP when you have the flexibility to enroll.

GET CONTRACTED

Contracting for UA is easy; just email lisa@croweandassociates.com, she will request the contract for you.  Those looking for a GA level contract will need to have a minimum of 5 sub agents and 100 Medicare supplement cases on the books. Call our office at 203-796-5403 with any additional questions.

If you would like to contract with Crowe for carriers other than UA; click here

Stay up-to-date on Medicare agent events and information

This AEP presents a unique opportunity. With fewer Medicare Advantage choices and increasing restrictions, United American’s High-Deductible Plan G stands out as a cost-effective, flexible, and stable solution. For beneficiaries who value freedom of choice, reliable coverage, and the ability to control their long-term costs, HDG is a smart move this enrollment season.