Medicare’s annual open enrollment period recently drew to a close. The average senior had more than 40 plans to choose from in 2024. Many enlisted the help of licensed Medicare agents to navigate the process and compare options. 

Unfortunately, expert advice may be in short supply during the next open enrollment period. Insurers are moving to deprive seniors of access to agents. Aetna, Cigna, UnitedHealthcare, Centene, Humana, and Anthem recently announced that they would no longer pay commissions for new enrollments in select Medicare Advantage and Medicare Part D prescription drug plans. 

Licensed agents are critical to Medicare’s enrollment infrastructure. More than three-quarters of seniors say they prefer working with an independent agent. If insurers cut them out, millions of seniors could end up in plans that put their health at risk.

In addition to traditional Medicare, there were nearly 4,000 privately administered Medicare Advantage plans available nationwide in 2024. One of the reasons Medicare Advantage plans have become popular is that beneficiaries see them as one-stop shopping. They tend to offer seniors low out-of-pocket costs and extra perks. Most include prescription drug coverage. Many cover hearing and vision care, too.

The trade-off is that Medicare Advantage plans tend to confine seniors to narrow provider networks and may require doctors to seek prior authorization before delivering care. There is also a risk that a plan may be discontinued in future years or in certain markets. In rural or remote areas, there may not be any Medicare Advantage plans available.

The federal government pays Medicare Advantage insurers a capitated rate per enrollee per month. Determining that payment is complicated. However, it’s adjusted according to the beneficiary’s health risks, among other factors.

Simply put, insurers make money if their beneficiaries’ claims are below those government payments. If enrollees consume more care than insurers project, then they may lose money. As a result, some insurers are trying to avoid attracting enrollees who might be particularly costly. 

Cutting commissions may seem like a cost-saving measure, but it undermines the critical support agents provide. Agents cannot afford to work without fair compensation. Without the opportunity to earn commissions, they are unable to dedicate the time and expertise required to help seniors navigate and understand the complex array of healthcare options available to them.

For example, agents routinely perform needs assessments for their customers. They may help a senior understand whether a plan they’re considering includes their doctors in its network, offers affordable cost-sharing for a drug they need, or represents a better deal than the other plans on the market. They educate seniors on how plans address preferred providers, hospitals, networks, and lifestyle factors such as travel plans or snowbird-style residency in more than one state. 

Agents help seniors understand enrollment periods and potential penalties for late enrollment. They can also estimate total costs of specific plans — including premiums, deductibles, co-pays, and out-of-pocket maximums — and offer advice on tax-efficient and state or region-specific options. 

Agents of record serve as year-round advocates for seniors, offering independent guidance free from the influence of large insurers. They often assist seniors in resolving coverage issues and claims, reevaluating plans during open enrollment to ensure they continue to meet individual needs and providing guidance to explore better options if necessary.

Without agents, many seniors would spend hours on an insurer’s impersonal 1-800 number to get answers to their questions, to contest denials of care, or to address other issues. And there’s no guarantee that they’ll see any resolution.

Simply put, agents play an indispensable role, and seniors trust them deeply. Seniors are 26 times more likely to reach out to their independent agent than to use tools offered by the Centers for Medicare and Medicaid Services. They’re twice as likely to check on an issue with their agent rather than calling their insurance carrier. Of seniors who reached out to an agent, 84% were “highly satisfied” with the help they received.

Aetna, Cigna, UnitedHealthcare, Centene, Humana, and Anthem are not blind to these realities. Cutting commissions is a straightforward strategy to discourage enrollment in plans that may be the best fit for certain seniors. 

That’s obviously not in their interests. Picking a suboptimal plan can cost a senior thousands of dollars a year and prevent them from getting the care they need.

Medicare beneficiaries who have worked with agents understand the value they bring. Our leaders cannot allow big insurance companies to deprive seniors of access to agents’ expert counsel.