This may be the year when many of the fears that have kept Medicare plan sellers up at night really come true.
George Kalogeropoulos, the chief executive officer of HealthSherpa — a company that runs a system that helps many Medicare plan agents sell the plans — said via email that agents are now facing real disruption.
The annual enrollment period for Medicare Advantage plan coverage and Medicare Part D prescription drug coverage for 2026 started Oct. 15 and is set to end Dec. 7.
Insurers said in the summer that they were unhappy with the new drug plan product design rules and facing much higher-than-expected medical claim costs. The plan issuers reacted by raising prices, cutting plan menus, pulling out of some markets, shutting down their Medicare plan operations and, in some cases, coping with worries about plans already on the shelves by zeroing out agent commissions.
When issuers zero out the commissions, that means agents who are willing to help clients sign up for Medicare plans without getting paid usually lose access to the sales systems aimed at professionals. Instead, the agents have to do their best to help clients enroll using slower, less detailed systems aimed at ordinary consumers.
A year ago, agents were worried about the turmoil they saw in the market then. But most clients ended up getting coverage for 2025 that was comparable to what they had in 2024.
"We think the disruption this year is going to be less recoverable," Kalogeropoulos said. "Agencies are experiencing a heavy renewal workload, having to get existing customers into new plans due to carrier exits."
Because the agents are having to work so hard to help existing clients stay covered, they have little capacity to help new clients get covered.
The information systems that make Medicare sales possible are working well, and HealthSherpa's own volume is much higher than it was a year ago, Kalogeropoulos said.
He thinks conditions are better in most markets for the clients than for the agents.
Except in a few states, like Alaska and Vermont, typical clients still have access to a choice of plans, he said.
But he predicted that, if conditions for agents continue to be poor, conditions for the consumers will deteriorate.
"Neutral marketplaces plus transparent compensation policies preserve consumer choice and channel stability," he said.
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