Key Takeaways

• Your clarity during Open Enrollment directly impacts how well your Medicare clients make coverage decisions. Avoid assumptions and explain terms precisely.

• The earlier you build understanding, the easier it is to align your client’s needs with the right plan during the October–December enrollment window.

Open Enrollment Demands Clarity, Not Complexity

Every year, from October 15 to December 7, Medicare Open Enrollment gives beneficiaries the opportunity to review and change their plans. For independent agents like you, this is not the time to speak vaguely or overload clients with jargon.

Clients rely on your guidance not just to enroll but to understand. That means you must strip away assumptions, avoid shorthand, and break down Medicare terminology in real, practical terms. Clear communication now prevents regrets later.

Set the Foundation Before October

Waiting until mid-October to educate clients is a misstep. By then, mailers are flooding their inbox, and confusion is already building. Start earlier in the year—as early as July—to begin educating your clients.

Break education into stages:

• July–August: Help clients assess how their current Medicare plan is working. Is the formulary meeting their prescription needs? Are they comfortable with the provider network? What expenses were unexpected?

• September: Share plain-language explanations of what might change in their plan and how the Annual Notice of Change (ANOC) affects them. Guide them through it. Don’t assume they’ll read it alone.

• Early October: Offer one-on-one sessions or review calls so they’re ready to decide once Open Enrollment begins.

Words You Think Are Clear… Aren’t

It’s easy to forget that terms you use every day may mean little or nothing to your clients. Avoid these vague terms—or explain them explicitly:

• “Out-of-pocket maximum”: Instead of leaving it as-is, say, “This is the most you could pay for covered services in a year before your plan pays 100%.”

• “Deductible”: Clarify it as, “The amount you pay first before your coverage starts paying for services.”

• “Coinsurance” and “copay”: Always provide dollar-based examples for these.

Make it your policy: if you say a term, define it. You’re not just enrolling them; you’re teaching them how to use their plan.

Don’t Rush the Plan Type Decision

Some clients enter Open Enrollment convinced they want to switch plans or stick with what they know. But if they don’t understand how their plan type actually works, they’re just guessing.

Be sure to clearly explain the differences between:

• Original Medicare (Parts A and B)

• Medicare Advantage (Part C)

• Medicare Part D (standalone drug plans)

• Supplemental insurance (Medigap policies)

Use neutral language. Avoid pressuring clients toward one type over another. Instead, tie each option to the client’s health priorities:

• Do they need freedom to choose any provider?

• Are they willing to trade flexibility for lower out-of-pocket costs?

• Is prescription drug coverage a major concern?

Build a Calendar for Open Enrollment Success

Clear conversations happen more easily when they’re planned. Develop an outreach calendar:

• September 15–30: Mail or email educational materials personalized to each client’s situation.

• October 1–10: Start proactive calls to schedule review appointments. Include time to answer questions, not just enroll.

• October 15–November 30: Conduct enrollment sessions. Prioritize accuracy and clarity.

• December 1–7: Handle final changes and corrections before the deadline.

This structure doesn’t just organize your time—it demonstrates professionalism that clients appreciate.

Watch for Signs of Client Confusion

You may think your explanation was clear. But did your client really understand?

Watch for these signals:

• They nod but ask the same question later.

• They agree too quickly without asking follow-ups.

• They express relief when you change the topic.

These are red flags that they’re overwhelmed. In those moments, slow down. Reframe. Ask open-ended questions like:

• “What part of that doesn’t make sense yet?”

• “Can you walk me through what you think this plan would do if you went to the hospital?”

If clients can teach back what you explained, they’re more likely to choose a plan they can live with.

Address Medicare’s Annual Changes Early

Every year brings changes. In 2025, Medicare has introduced several updates:

• Medicare Part B premium is now $185 per month.

• Part B deductible has increased to $257.

• Part D now has a $2,000 out-of-pocket drug cap, which ends the prior coverage gap.

Clients may assume nothing has changed—or assume everything has. Your job is to clarify. Make it specific:

• “You hit the donut hole last year, but this year, there’s no coverage gap. Once you reach $2,000 in out-of-pocket spending, your plan covers the rest.”

Clear comparisons between 2024 and 2025 help clients understand what to expect.

Make the Enrollment Appointment Count

Open Enrollment conversations should never feel like a transaction. This is a trust-building moment.

Here’s what a strong appointment includes:

• Review of current plan use: Ask what they liked and didn’t like this year.

• Clarity on expected medical needs: What’s changing in their health?

• Side-by-side explanation of options: Always include pros and cons.

• Leave-behind summary: Give them a printed or emailed summary of your discussion.

You’re not just guiding them to a decision—you’re preparing them to use their plan confidently in the year ahead.

Avoid These Common Clarity Pitfalls

Even the best agents can make these clarity mistakes:

• Rushing to enroll without review: A 10-minute conversation is rarely enough.

• Assuming client familiarity with Medicare terms: Even longtime enrollees may have misunderstood things for years.

• Skipping over ANOC letters: These notices contain essential changes that impact care and costs.

• Only focusing on monthly premiums: Clients also care about copays, networks, and prescription coverage.

You’re not just helping them pick a plan—you’re helping them avoid future frustration.

Keep Clarity Going After Enrollment Ends

December 7 isn’t the end of the relationship. Continue providing value:

• January–February: Send a “How to Use Your Plan” email or letter with tips on ID cards, finding in-network providers, and understanding EOBs.

• March–May: Offer check-in calls for those who had claims or billing confusion.

• June–August: Begin educational outreach about the upcoming ANOC letters.

Education is a year-round value proposition, not a seasonal sales pitch.

A Clearer Medicare Conversation Starts With You

Clients don’t always know what to ask—but you know what they need to understand. Clear, well-paced, and proactive education throughout the year makes you more than just an agent; it makes you their trusted Medicare resource.

If you want support turning that approach into a scalable business strategy, sign up on BedrockMD. We help professionals like you with client education tools, lead management, and training resources—all built to help you guide smarter Medicare conversations.