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New Birthday Rule States:

Virginia:

Effective July 1, 2025, insurers must offer Medicare Supplement policyholders an annual open enrollment period beginning on the individual's birthday and ending 60 days after, where the individual can purchase any policy made available by any insurer in Virginia that offers the same benefits as the current coverage (does not include innovative benefits). In addition, insurers must notify individuals at least 15 days but no more than 30 days prior to the commencement of this annual open enrollment period.

Utah:

Effective May 7, 2025, insurers must offer Medicare Supplement policyholders an annual open enrollment period beginning on the individual's birthday and ending 60 days after, where the individual can switch to a comparable or lower tier plan offered by the same issuer as their current plan, without medical underwriting. 

Indiana:

This legislation has passed both the Senate and the House – on its way to the Governor to sign:
https://www.congress.gov/bill/119th-congress/house-bill/1226/all-info

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A Medicare agent might want to get RSSA (Registered Social Security Analyst) certified for several reasons:

• Enhanced Expertise: RSSA certification provides specialized knowledge in Social Security and retirement income planning, which is deeply connected to Medicare. This expertise allows agents to better advise clients on how their Social Security decisions impact their healthcare costs, Medicare premiums, and overall retirement security 
  
• Competitive Advantage: By becoming an RSSA, Medicare agents can differentiate themselves in a competitive market. They position themselves as trusted experts in both Medicare and Social Security, attracting more clients who seek comprehensive retirement planning 
  
• Increased Client Trust and Loyalty: Clients are more likely to trust and remain loyal to agents who can help them navigate complex Social Security and Medicare decisions. This trust can lead to better client retention and satisfaction 
  
• Cross-Selling Opportunities: Social Security planning naturally leads to discussions about other insurance products like Medicare Supplements, Medicare Advantage, annuities, and long-term care insurance. This can boost sales and provide more comprehensive solutions for clients 
  
• Avoiding Costly Mistakes: Proper Social Security planning helps clients avoid higher Medicare premiums, penalties, and coverage gaps. Agents can guide clients to make informed decisions, reducing the risk of costly errors 
  
• Strategic Medicare Planning: RSSA certification equips agents with tools like the RSSA Roadmap®, which integrates Social Security optimization into Medicare planning. This leads to better client outcomes and increased sales opportunities

Learn more: https://narssa.org/resources/industries/medicare/

P.S. Don't miss our webinar "Become a Registered Social Security Analyst" on June 26th!

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How do the carriers get a budget for their Medicare Advantage Plan designs each year?

The process begins with CMS releasing its advance notice, a document that outlines the agency’s planned changes to how it will calculate Medicare Advantage payment rates for the following calendar year. CMS must release the advance notice at least 60 days prior to release of the final rate announcement (published on or before the first Monday in April every year). The public is given 30 days to submit comments on the advance notice. 

Released alongside the rate announcement is a rate book that details the maximum amount Medicare will pay plans in a given area — what’s known as the benchmark. Insurers use these rates to develop and submit their “bids” to offer Medicare plans.

These bids represent their estimated costs of providing Medicare Parts A and B services to the average enrollee.

The benchmarks and the risk adjustment model — used to modify payments to account for enrollees’ health status — are the major items that CMS updates when calculating payment rates for the next year.

Learn more: https://www.commonwealthfund.org/publications/explainer/2024/mar/how-government-updates-payment-rates-medicare-advantage-plans