eHealth CEO Fran Soistman calls for an extension of AEP

 

Medicare’s Annual Enrollment Period (AEP) is approaching quickly but healthcare policymakers still have time to score a big win for beneficiaries. This year’s enrollment season will be more dynamic than recent years, and extending AEP by a week or introducing a Special Enrollment Period (SEP) could significantly benefit millions. Beyond this year, restructuring the enrollment period to coincide with each beneficiary’s birth month - or an alternative approach - could provide lasting improvements.

The AEP process as it exists today does not take into consideration the significant growth that Medicare Advantage has experienced in the past ten years and no longer meets the needs of Medicare beneficiaries. In 2014, 15 million Americans were enrolled in Medicare Advantage. Ten years later that figure has reached 33 million. In the span of seven short weeks (October 15 through December 7), all current enrollees will be asked to review changes to their existing plan and new coverage options for 2025. An additional 30 million beneficiaries not enrolled in Medicare Advantage will also be eligible to shop.

Even in the best of times, AEP can be daunting. Beneficiaries often struggle to make sense of plan changes and coverage alternatives while being overwhelmed by TV ads, mailers, and high-pressure sales pitches. A recent survey revealed that 63% of beneficiaries feel overwhelmed by Medicare advertising.

This year will be even more challenging. Some insurers are expected to reduce core and supplemental benefits, increase monthly premiums, withdraw products or plans, and in extreme situations exit geographical markets. Some may even leave the Medicare Advantage program entirely. As a result, a greater number of beneficiaries will need to find new plans.

Additionally, the presidential election will distract beneficiaries in the early weeks of AEP, and the late Thanksgiving holiday will cause many beneficiaries to delay their decision-making until the final week of AEP, adding significant stress to an already stressful decision.

So, what can be done?

The Centers for Medicare and Medicaid Services (CMS) should extend this fall’s AEP through December 16th. Should an extension not be possible, they should consider offering a limited Special Enrollment Period. An extra week would give beneficiaries some distance from the distractions of the presidential election and Thanksgiving holiday, allowing them more time to review their coverage options for 2025.

This extension would also provide more time for beneficiaries to seek advice and help from licensed health insurance agents, which can result in higher levels of satisfaction with their coverage. A March 2024 eHealth study found that 66% of those who worked with a licensed agent were “very confident” in their choice of plan, compared to 55% of those who did not work with an agent.

Beyond this fall’s Annual Enrollment Period, policymakers should consider systemic improvements to the Medicare enrollment cycle. Rather than forcing more than 60 million beneficiaries to endure AEP all at once, why not restructure open enrollment to coincide with each beneficiary’s birth month?

Most people first enroll in Medicare on their 65th birthday. Maintaining a birth-month cycle for annual reviews would help beneficiaries remember and plan for their review, ensure access to licensed agents, and potentially reduce the amount of Medicare advertising they are subject to each year.

For those of us who serve the needs of Medicare beneficiaries, it is clear the current AEP model no longer supports the needs of 33 million Medicare Advantage members or those enrolled in Original Medicare. The Medicare population is expected to grow from 65 million to 80 million by 2030, creating even greater challenges in the future. This year presents a golden opportunity when the interests of consumers, policymakers, and industry all align. We can make Medicare work better for beneficiaries for the upcoming enrollment season and beyond.

What’s stopping us? With a few strategic adjustments, we can create a more straightforward, less stressful enrollment process and make a positive difference in the lives of millions of Medicare beneficiaries. 

 

Fran Soistman,
CEO of eHealth, Inc.