The Medicare Advantage landscape is shifting. Carrier exits, contract consolidations, benefit shakeups, and CMS rule changes are disrupting the playing field in ways that even seasoned agents haven’t seen before. For insurance professionals, this presents a major opportunity. Agents who understand how to pivot, stay informed, and proactively support their clients can not only weather the storm—they can grow their book of business while others scramble to adjust. In this post, we’ll break down what’s market disruption and how you can turn it into an opportunity.
What’s Driving Disruption in the MA Market?
Market shifts can stem from multiple angles, and often more than one at a time:
- Carrier exit or consolidations
- Changes in plan benefits or premium increases
- Network terminations or provider group changes
- Regulatory updates (CMS marketing rules, Inflation Reduction Act, etc.)
- New competitive entrants (especially tech-savvy carriers or providers)
When these changes hit, agents are often on the front lines. The key is not just to react but to have strategies in place to adapt and grow.
STRATEGIES to Employ for Carrier Exits/Plan Exits
Provider-Based Marketing
Leverage provider relationships to stabilize lead flow and build trust.
Identify provider groups affected by network changes and offer to help patients transition plans or find new coverage.
Key phrase “Let me help you retain and/or grow your patient panel.”
Tactics:
Establish Provider Partnerships: Build alliances with:
- Independent primary care groups, specialists, and clinics (especially those aligned with MA-heavy groups like Oak Street Health, CenterWell, or Cano Health).
- DENTISTS: understand your plans dental benefits
Offer to Grow and Retain their Patient Panel: This tactic is what a provider wants to hear. They don’t want to lose patients through Service Area Reductions if clients are forced to change PCP if they are not in-network the patients new plan.
Research what carriers the provider has in-network: Go prepared! Make sure you have a robust portfolio that aligns with the providers preferred carriers.
Provider Education: Offer value by educating front-office staff on MA plans accepted, SEP rules, and patient Q&A guidance.
Co-Branded Materials: Use CMS-approved co-branded marketing flyers in clinics to generate inbound leads.
Health Event Collaboration: Host wellness days, health fairs, or educational seminars at provider locations.
Understand Your SEP Option
When a plan completely exits the market, this is called a Service Area Reduction (SAR’s). If a specific plan ID is set to terminate 1/1/2026 your beneficiaries get a Special Election Period.
A Service Area Reduction (SAR) SEP is triggered when:
- A Medicare Advantage or Part D plan reduces its service area
- Example: A carrier discontinues a plan in several counties. Beneficiaries in those counties receive non-renewal letters from CMS/carriers in October, informing them that their plan will not be available in the upcoming year.
SEP Timing & Duration
- If the plan ends December 31:
- The SEP begins December 8 and ends February 28 (or 29 in leap years).
Coverage for enrollments made in:
- December will start January 1.
- January will start February 1.
- February will start March 1.
Diversify Your Carrier Portfolio
Don’t rely on a single carrier. This ensures you’re ready when a plan terminates or is downgraded. Ensure you’re contracted with multiple competitive plans in each market, especially those with: Contracting with multiple strong carriers in each market
- Focusing on plans with:
- High star ratings
- Competitive and stable benefits
- Strong network partnerships
- Positive member retention metrics
Retention Strategies: Retain More Clients with Proactive Outreach
Retention is the backbone of a strong book of business. Here’s how to stay connected year-round:
Proactive Member Check-Ins:
- Schedule mid-year and annual reviews
- Use tech tools like Sly Broadcast to send mass voicemails
- Reach out on:
- Birthdays
- Annual physical reminders
- Plan anniversaries
- Automate where you can with email platforms, social media, or direct mail
- Run satisfaction surveys using tools like SurveyMonkey
- Send monthly newsletters to stay top-of-mind and educate clients on their plan benefits and usage
Even a short call can prevent a client from drifting to a competitor.
Final Thoughts
Disruption in Medicare Advantage is inevitable. But with the right mindset and playbook, it can also be an opportunity for massive growth, especially for agents aligned with a proactive, resource-rich FMO.
Whether you’re already part of our team or considering joining, NCC is here to support you with the tools, training, and partnerships to thrive in market conditions.
Need help building your plan diversification strategy or connecting with local providers?
