An Agent’s Perspective:
As the President of our Medicare Insurance agency, I’ve been through many Annual Enrollment Periods (AEP), but 2025 truly stood out as a year of unprecedented challenges. From October 15th to December 7th, my days were filled with back-to-back appointments with clients, group meetings and assisting our team as they helped clients as well.
2025 Fall Recap: This year, the number of Medicare Advantage plans as well as Stand Alone Part D Rx plans decreased across the country as well as where we live in Yakima County. Hospital systems are narrowing the scope of Medicare Advantage Plans they will contract with as well. We have seen that in Yakima, as well as nationally.
In 2026, the Inflation Reduction Act is capping the out-of-pocket limit (what consumers pay at the pharmacy counter/mail order) to $2100. The risks are much greater on the insurance companies that run the plans once someone crosses that $2100 threshold. The few plans that remain, are generally not paying brokers to assist people in finding the best plan for them.
This creates even more pressure on agents like us. We need to be nimble with our time, as we still want to help those that need help, while also showing people how they can easily self-enroll on the Medicare.gov website themselves. In 2026, there will be reduced costs on some of the most popular expensive drugs such as Eliquis and Xarelto due to price negotiations mandated by the Inflation Reduction Act.
2025 Fall Recap: We saw several regulatory changes, including updates to maximum out-of-pocket limits and adjustments to Medicare Advantage marketing guidelines. Staying current with each change and translating that information into understandable advice was vital. Many clients expressed anxiety about their premium increases with Medicare Supplement rates. Most of our clients on Medicare Supplements know they can review their options year-round. Patience and empathy proved more important than ever, as we reassured seniors while keeping them accurately informed.
While the workload felt heavier, the human connections made it all worthwhile. We helped lifelong clients transition their coverage to better fit their changing health needs. We celebrated with grateful families discovering new benefits and offered comfort to those worried about rising healthcare costs. Our role went beyond “insurance agent”—we became an advocate, educator, and sometimes even a friend.
Looking Ahead
The 2025 AEP reminded me that while Medicare remains a lifeline for millions, navigating it is rarely easy—especially as the landscape continues to evolve. For agents like us, the challenge is to keep learning, stay adaptable, and put the client’s needs first. Despite the long hours and occasional frustrations, we are proud to help seniors make confident decisions about their healthcare.
As we close the chapter on this year’s Open Enrollment, we are grateful for the trust our clients placed in me and look forward to guiding them through whatever the future brings.
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