Impacts of the IRA on the Medicare Market

Chris Hagerstrom, Executive Director of Communication and Training

Categories:

ATTENTION: BIG Changes Coming to the Medicare Market

The Inflation Reduction Act of 2022 is bringing some major changes to the Medicare landscape that will impact all beneficiaries for years to come.  Are you ready to help your clients find their best-fit coverage? In brief, the IRA made or will make the following changes to the Medicare Part D Program:

  • $35 cap on covered insulin
  • Covers certain adult vaccines for no cost-sharing through Part D
  • Caps out-of-pocket spending ($2,000 in 2025)
  • Created the Medicare Prescription Payment Plan
  • Expanded Low Income Subsidy benefits
  • Caps Part D Base Beneficiary Premium Growth through 2029

The IRA will also implement a drastic shift of prescription drug costs onto the carriers, which will lead to higher premiums, higher deductibles, higher copays or increased tiers charging a coinsurance, slimmer formularies and less consumer choices.  It’s projected that ~77% of all Medicare beneficiaries will be shopping for new coverage this AEP, it’s time to get ready!

You can view a recording of our Impacts of the Inflation Reduction Act webinar for more details.

JSA’s Got You Covered!

To prepare yourself and your clients for these unprecedented changes, JSA has created the following resources to help you educate your clients and handle the increased shopping that’s expected this AEP.  The following IRA marketing materials are available for download on the AEP Action Plan page, with more customization capabilities on the ProShop Plus.

  • NEW 2025 Medicare Part D Medicare Scholar presentation
  • Flyers
  • Postcards
  • 2025 Part D infographic
  • Client Letters
  • Social Media Pieces
  • Pre-AEP videos
  • More coming soon!

Make sure you check out our AEP Action Plan resource page for all the details!

Visit the AEP Action Plan

Plus, we’re excited to announce that we’ve added the hottest AEP retention tool on the market to our MyHealthPlan quoting and enrollment tool – RetireFlo!

RetireFlo is a simple survey you can send to your clients via email or text, which allows them to update their prescriptions, doctors, hospitals, pharmacies, collect a signed SOA, and will automatically update their MyHealthPlan profile for easy appointment scheduling and quoting this AEP.

We’ve secured an exclusive discount you won’t find anywhere else, saving you 50% off the cost of a monthly or annual subscription using our special access code – JSA50 (case sensitive)!  You can sign up in the Account Overview of your MyHealthPlan profile.

Go to MyHealthPlan

Best Practices Heading into AEP

Any substantial change to the Medicare program has always given independent agents an amazing opportunity for growth during the AEP, and this change is no exception.  We suggest following this timeline through the start of the AEP to set yourself up for success, retain your clients, and give yourself time to grow your book.

July

  • Add any missing carriers to your portfolio.  You don’t want to get caught after October 1st trying to add contracts because of the changes to your current contracted plans.
  • Complete your certifications.  Start with AHIP or NABIP and move on to the carrier-specific courses.  Plus, many of these changes are covered in the 2025 curriculum.
  • Watch out for First Looks from carriers with high-level benefits

August

  • Attend as many carrier rollouts as you can.  They usually cover more benefits than what is release in the First Looks and may have more explanations on Rx changes and the Payment Plan
  • Add your clients to MyHealthPlan.  With the addition of Retireflo and the sheer amount of shipping that will occur this AEP, making sure you have profiles built for your clients will ensure a smooth transition from collecting data to scheduling one-on-one appointments.  Also, register for any of our upcoming RetireFlo demos to learn more about working with the new tool.

September

  • Send out your RetireFlo surveys.  This is going to be huge for all our partners, saving you about 15-30 minutes or more from each of your individual appointments.
  • As surveys are completed, start scheduling your one-on-one appointments with your clients during the AEP

Remember, the impacts of the IRA are going to be felt by all carriers and PDP/MAPD plans, so get ready for a busy selling season by taking the necessary steps to be fully prepared.

Chris Hagerstrom, Executive Director of Communication and Training

Chris Hagerstrom is the Executive Director of Communication and Training at Jack Schroeder and Associates, LLC. Through years of experience he has become an expert with Medicare, Life, Health, Annuities and Supplemental Health and how to successfully navigate the independent agent market.

Tags: