Medicare Answers Now

12/09/2025

Was this your last AEP? Have you had enough of the long hours and stress? Are you looking for an option that will let you continue to work part time if you want but free you up from the business owner responsibilities and provide you service staff so you have flexibility and can live your life the way you want without worry about your clients? We have solutions for you and now is the time to start exploring those options! Call us today to set up an appointment to discuss at 216-499-1600!

Field Marketing Organization that partners with insurance agents who work with Seniors & Medicare

11/15/2025

11/03/2025

Medicare Isn’t Broken Because of Agents, It’s Surviving Because of Them

Every day, Licensed Medicare Agents sit across kitchen tables, take late-night calls, and walk seniors through impossible choices, not because it pays well, but because we care.

The average agent writes about 40 Medicare Advantage plans a year and earns around $28.92 per member per month. Prescription Drug Plans? Zero compensation. Yet we keep doing it because that’s someone’s Gramma, and she deserves to be cared for!

New rules are written every year with the goal of protecting seniors, but enforcement remains inconsistent. The truly bad actors, offshore call centers and deceptive lead vendors, adapt easily, while the ethical, community-based agents doing the real work carry the compliance load.

The system itself is split in two:
🔹Medicare Advantage is federally regulated.
🔹Medicare Supplements are state regulated.
That gap creates confusion, inconsistency, and opportunities for abuse. And it’s seniors who pay the price.

Hospital systems are leveraging the media for contract negotiations, carriers are cutting plans midyear, and Star Ratings are declining, all of which leaves seniors scared and searching for answers.

It’s time to shift the narrative. Agents aren’t the problem, we ARE the backbone.

💬 If you’re an agent: Share your story.
📣 If you’re a policymaker: Reach out. Let’s create smarter enforcement and collaboration.
🤝 If you’re in healthcare leadership: Let's chat and figure out how to protect our seniors.

Because the Medicare system isn’t broken because of agents. It’s surviving because of them.

10/24/2025

Know more. Worry less.™

The Nomo Smart Care™ system helps older adults live confidently and independently. Our privacy-first system uses discreet motion and movement sensors, not cameras, to learn daily routines and notify you if something seems off, like a missed medication or a late start to the day. With automatic fall detection*, 24/7 emergency support, and real-time updates, the Nomo system provides peace of mind while helping your loved one stay independent. We are more than a safety system. We are a trusted partner in helping families stay connected and informed. Check it out at: https://nomosmartcare.com/?ref=tlc257

Want to know more and how to offer it to your clients? Register for an information webinar on Monday, November 10th at 3:00 pm. Est

Register at: https://us02web.zoom.us/webinar/register/WN_sd7f1ElSRseznFDvs4Rctg

04/11/2025

The American Medical Association gave a less than flattering review of those that volunteer with SHIPs on Medicare. Rather than point a finger and toss shade their way, NABIP has chosen to highlight the VALUE that licensed agents bring when working with beneficiaries.

JAMA Study Underscores the Vital Role of Licensed Medicare Agents in Helping
Seniors Navigate Coverage Decisions
Washington, D.C. —

A new JAMA Network study highlights the complexities seniors face when trying to navigate Medicare, and the need for highly trained, licensed professionals to help them make informed choices. The National Association of Benefits and Insurance Professionals (NABIP) believes the findings reinforce the value of working with licensed, certified Medicare agents who dedicate their careers to serving the needs of older Americans.

“Licensed Medicare agents are trusted guides in a complex system,” said NABIP CEO Jessica Brooks Woods CEO, MPM, PHR. “They are certified annually, held to rigorous standards, and uniquely qualified to offer personalized, accurate guidance.

This JAMA study reinforces what we already know—beneficiaries are best served by professionals with the training, experience, and accountability that licensed agents provide.”

The JAMA study, which utilized more than 300 “secret shoppers” at 131 State Health Insurance Assistance Program (SHIP) sites across 16 states, revealed the challenges seniors face when seeking Medicare guidance. Nearly 40% of SHIP contact attempts failed due to unreturned calls, and only 57% of completed interactions provided accurate and complete information.

While seniors seek Medicare guidance from a wide range of sources, not all sources provide the same level of consistency or accuracy. These findings highlight the critical importance of connecting Medicare beneficiaries with professionals who not only understand the nuances of plan options, provider networks, and prescription formularies, but are also equipped to tailor recommendations to each person’s unique needs.

“Our members are boots-on-the-ground experts in their communities,” said Brooks-Woods. “They know which
doctors are in-network, how to lower out-of-pocket costs, and what coverage works best for each individual. Their
success is built on trust and getting it right the first time.”

A recent JAMA Network study reinforces what we at NABIP already know: licensed Medicare agents are essential to helping seniors navigate the complex world of coverage decisions.

NABIP remains committed to empowering agents with the tools they need—like our Medicare Advantage Certification—to serve clients with excellence.

🔗 Medicare Advantage Certification: https://ow.ly/fG1850VyokB

🔗 Read our full press release: https://ow.ly/PWGa50Vyoky

01/01/2025

Interested in working with us? Book some time to talk using the link in the comments!

12/04/2024

Join me December 16th at Noon for the first course in my 3-part series that builds the foundation for your upcoming year. This is not just for beginners as we will be discussing best practices that have helped me build MULTIPLE businesses that are over a million dollars. Grab your notebooks and come prepared to learn how to take your business to the next level with steps on how to grow without totally being overwhelmed with the process.

Register at: https://us02web.zoom.us/webinar/register/WN_X54ne1ZQS5GJCDodXPNFEA

12/04/2024

Join me next Tuesday, December 10th at 10:00 a.m. EST for this one-hour webinar will consist of a thought-provoking discussion consisting of: Year in Review, Lessons Learned and Planning for Growth. This will be a highlight of things to think about before taking the Goal Setting and Business Planning webinar.

Register at: https://us02web.zoom.us/webinar/register/WN_NsU9UIcsR0m3m5em5dzYoQ

10/31/2024

Hello,

I know many of you are freaked out about what is happening right now in our industry and rightfully so. This is the first time where carriers have changed to non-commissionable on plans in the middle of AEP. It is also the first time that this many plans across the country have been deemed non-commissionable. Almost every single major carrier has some PDP or MAPD plan that doesn’t pay. So, I started asking questions and here’s what I know.

1. I need you to look at the industry as whole, not just our part in it.
2. Since COVID, our industry as drastically changed.
a. There is a shortage of hospital staff and those that are working are getting overtime, and hospitals have had significant increases to their costs to keep functioning. As their costs increase, they have gone back to their main sources of income – Medicare and the carriers and said pay us more! They have more control and weight with the carriers which is why you see all of this mess in the media about network negotiations. Keep in mind these negotiations are not regulated a ton.
b. In the last 2 years, the utilization of medical benefits has increased now that the COVID pandemic as “leveled” out. People are seeking medical treatment more AND people who could not afford insurance prior to getting on Medicare are now seeking treatment for their issues.
3. Next, you have the reimbursement rates that Congress approved to the carrier for administering Medicare Advantage plans has been reduced.
4. The STARs ratings that just came out 2 weeks ago had a drastic change from years prior. We went from 70+ plans with a 5-star rating down to only 7 for 2025 since 2022. The changing in the monies from STARs that is directly put back into the plans has significantly lowered since the Supplemental Benefits have been launched with plans. Since 2022 the number of plans with a 4-star rating or higher has dropped from 322 in 2022 down to 209 in 2025. This is hundreds of millions of dollars to the carriers.
5. Now comes the Inflation Reduction Act changes. This is a HUGE impact as the cost of medications are currently not regulated and can change on a whim. Add in more and more people are taking more meds and more costlier meds too. The “subsidy” that the government pays got lower, the carriers responsibility got way higher. Initially the average price for a standalone drug plan should have been $179.45 but when CMS saw that, they freaked and said no we will do a demonstration plan to subsidize that cost to something more manageable. The impacts to IRA are still significant to everyone including the beneficiaries since they do not know how CMS is going to pay for that subsidy….. It will fall on the taxpayers.
6. Now let’s talk about what is happening on our end. You have SHIPs and others screaming at legislators that we are money grubbing agents that only care about making a buck. You have a faulty study being used as the source of truth for this in addition to the various testimony. So now, you have a huge spotlight on us as to our value and need. Carriers made cuts all around this year. Last year there were a ton of layoffs. This year they came after our side of the puzzle. This does not mean we are out. The plans that are listed are NOT all of the plans on the market. There are 5,635 Medicare Advantage plans available for 2025. There are 474 Part D plans available nationwide.
a. Below you will find the list of the Aetna and Anthem plans that are affected. I have also attached the file of all of the plans that have Service Area Reductions for you.

So, what’s next? I want to be clear here. ANYTHING you sold prior to tomorrow WILL PAY COMMISSIONS, and anything that stays on the books as a renewal will pay commissions. Most of these plans are smaller in nature, except for the Ohio Anthem HMO plan. It is possible that next year commissions come back for new business. I think this is the carrier’s dumb way of trying to maintain the consumers they have already have on their books. But I also see it as being shortsighted for adding new market share.

I want you to also know that I have a meeting next week with Senator Ron Wyden’s office and rest assured that this will be brought up in the meeting. The best way that you can help me help you is to utilize the surveys. They have said they want to see the results when we have them, and it will also help us in so many other ways. I have attached a sample of a letter or email for you to use as well asking for the survey to be completed.

Dear valued client,

We appreciate the opportunity to assist you with your Medicare plans each year. As professional agents we try hard to provide you with the information you need to make informed decisions about plans and options. Often in the media agents and brokers are NOT portrayed in very good light. Also, the Centers for Medicare and Medicaid Services (CMS) the branch of the government that oversees Medicare does not distinguish between Agents and Brokers like us and the call centers that I know drive you crazy with unwanted calls. If you value, the ability to work with our agency we would like you to tell your legislators why we are important to you. We would appreciate it so much if you could take a few minutes to complete this short 5 question survey (see link below). The professional Association that we belong to the National Association of Benefit and Insurance Professionals (NABIP) will be forwarding the information from surveys to CMS and your legislators. Thank you in Advance for your time. We appreciate you!

Client Survey link https://www.votervoice.net/NABIP/Surveys/11551/Respond?

10/31/2024

Well, we need this like a hole in the head. So many of you have reached out and are panicked about what is happening. Let me try and explain. You cannot have this level of cuts throughout the ecosystem and not have everyone impacted. It absolutely stinks.

Between beneficiaries using their benefits more, hospitals demanding more from carriers, STARs money that is dumped back into the plans being cut/not awarded, and many other things, it makes sense that we would also be impacted. I am not OK with the fall out, but I also think that this is also where we need to work together to show the value and impact that agents make. As I have mentioned before, CMS and the governments source of "truth" comes from a study of 29 agents and what they are told by SHIPs and a poor CMS complaint tracking system. I am pushing for a more accurate study of Agents and Brokers that has feedback of no less that 1,000 brokers and also feedback directly from clients about their needs and experiences. If you want to help, let me know and I will add you to the list!

I would highly recommend that you also follow Jared Strock and Sam Melamed on LinkedIn so that you can stay in the loop about what is happening in our industry. There is so much more to this than just having products to sell.