The Medicare Annual Enrollment Period (AEP) is officially underway, and for many agents, the focus has shifted from preparation to execution. Client appointments are filling up, applications are rolling in, and the pace is only going to speed up through December 7.
As the pace increases, it’s easy to rely on assumptions, previous reviews, and familiar routines. But this year’s enrollment season brings new plan changes, compliance considerations, network shifts, and technology tools that deserve a second look.
As you work with clients this AEP, take a few minutes to double-check seven areas that could have a significant impact on both your clients and your business.
1. Double-Check Provider Network Before Recommending a Plan
A common mistake during AEP is assuming that a client’s providers are still participating in the same network they used last year.
Medicare Advantage plans continue to evolve, and network changes can occur from one year to the next. A plan may appear attractive based on premiums, copays, or supplemental benefits, but those advantages can quickly lose value if a client’s preferred physicians, specialists, hospitals, or healthcare systems are no longer in-network.
This is especially important in markets experiencing provider disruptions or carrier network changes.
Agent Tip:
Before recommending a plan, verify:
- Primary care physicians
- Specialists
- Hospitals and health systems
- Preferred pharmacies
- Other providers important to the client’s care
Taking a few extra minutes to confirm network participation can help prevent surprises and client frustration.
2. Double-Check Prescription Drug Coverage and Costs
AEP is the perfect time to revisit prescription drug coverage, even for clients who are satisfied with their current plan.
Medications, formularies, pharmacy networks, and drug tiers can change from year to year. A plan that provided excellent coverage last year may have very different costs next year.
Instead of focusing solely on monthly premiums, agents should help clients understand their total healthcare expenses and how prescription costs may affect their budget.
Agent Tip:
Review the following during every client appointment:
- Current medications
- Formulary coverage
- Preferred pharmacy options
- Estimated annual drug costs
- Any recently prescribed medications
A thorough prescription review can uncover opportunities for savings and help ensure clients are enrolled in a plan that truly meets their needs.
3. Double-Check Your Compliance Process
When AEP gets busy, many agents begin operating on muscle memory. Unfortunately, compliance requirements aren’t an area where assumptions should be made.
Enrollment procedures and regulatory requirements can change, making it important to confirm you’re following the latest CMS and carrier guidance.
Ask yourself: Are you running this AEP using last year’s compliance workflow?
If the answer is “maybe,” now is a great time to revisit your training materials, carrier communications, and enrollment procedures.
Ensuring your compliance process is up to date protects both you and your clients throughout the enrollment season.
Check out this blog post to complete a compliance checkup on your process!
4. Double-Check Plan Availability
Throughout AEP, carriers may adjust service areas, product offerings, and enrollment availability. Relying on information gathered earlier in the season can sometimes lead to missed details or outdated assumptions.
Before presenting plan availability and benefit options, confirm that the plan is still available and appropriate for the client’s location and circumstances.
Agent Tip:
Verify:
- Service area availability
- Enrollment status
- Carrier updates or market changes
- Product availability within the client’s county
An extra verification step can help avoid enrollment issues and ensure you’re presenting accurate options.
5. Double-Check the Tools Available in IntegrityCONNECT
Many agents are so focused on daily enrolments that they often overlook valuable resources already available within IntegrityCONNECT (our technology resource that helps you do more than quote and enroll!).
Tools like Plan Comparisons and Plan Insights can help simplify plan evaluations and strengthen client conversations. Additionally, AI Outreach offers the opportunity to engage eligible clients, schedule appointments, and maintain communication throughout the enrollment season.
If you haven’t explored these resources recently, now is the time to revisit them inside IntegrityCONNECT.
Agent Tip:
Spend a few minutes reviewing:
- Plan Comparisons
- Plan Insights
- AI Outreach campaigns
- Client engagement features
- Reporting and business management tools
You are likely to discover a full suite of resources that help you work more efficiently during the busiest time of the year, but you don’t just have to take our word for it…log in to IntegrityCONNECT and see for yourself!
6. Double-Check Permission-to-Contact Records
Successful client outreach starts with accurate data, and sometimes agents don’t realize they lack permissions or have incomplete client records until they try to launch a campaign or contact clients during a time-sensitive enrollment opportunity.
Before you need the information, take a moment to review your contact records and identify anything that needs updating.
Agent Tip:
Audit your database for:
- Permission-to-contact status
- Current phone numbers
- Text messaging permissions
- Email addresses
- Incomplete contact records
Having clean, accurate client data makes outreach efforts more effective and helps ensure no opportunities are missed during AEP.
7. Double-Check Your Existing Book of Business
While AEP creates excitement around new enrollments and opportunities, some of the most valuable conversations you’ll have this season may be with clients you already serve.
Existing clients often need guidance navigating network changes, prescription updates, plan adjustments, or other coverage questions. A proactive review not only helps strengthen relationships but can also improve retention and generate future referrals.
Remember, AEP is a service season, not just a time to maximize written business.
Prioritize Clients Who:
- May be affected by network or provider changes
- Have significant prescription drug needs
- Haven’t completed a plan review this year
- Have experienced major healthcare changes
- Have been difficult to reach in recent months
- May benefit from post-enrollment follow-up
This AEP, investing time in your current clients can be just as impactful as pursuing new business.
Pay Attention to the Details This AEP
The most successful agents during AEP aren’t necessarily the busiest; they’re the ones who consistently pay attention to the details.
Before your next appointment, take a moment to double-check provider networks, prescription coverage, compliance requirements, plan availability, client data, and the tools available to support your efforts. Small checks today can help prevent issues later in the season.
At Tidewater, we’re committed to helping you make the most of AEP with the technology, training, resources, and support you need to serve your clients with confidence. Stay focused, stay prepared, and know that we’re here to help every step of the way.
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