Independent Insurance Agents spend countless hours preparing for the Annual Election Period to help their clients. They attend carrier rollouts and learn about the new plans changes for the year ahead. Agents are not allowed to charge for their services; they work for free and then earn a commission when helping Medicare beneficiaries enroll in plans. Considering the time and investment independent agents make in their business, they don’t earn high commissions on their valuable work for seniors.
Independent Agents are dealing with unprecedented changes trying to help their clients with Drug plan reviews or Medicare Advantage plan reviews. Almost all Drug Plans have gone non-commissionable, and effective Nov 9th, a major Drug plan has removed its plans from all quoting platforms except Medicare.gov. This has severely crippled agents’ ability to help their clients, some agents have quit helping even their Medicare Supplement clients with Drug plan reviews.
Some Medicare Advantage plans have gone non-commissionable in 2026. They filed their plans with CMS - Center for Medicare and Medicaid Services as if they were going to be paying commissions on them and then pulled the commissions. They essentially are saying that they do not want more business. This has made it very difficult for independent agents to help their clients. It’s sort of like tip toeing through landmines difficult.
There are not enough SHIP agents to help all the non-technical savvy seniors who need help with their plans. If you want to help agents help you, please see the contact information at the end of this article and request that Nebraska follow other states that are issuing cease and desist orders and raising awareness for these unfair trade practices.
Stand Alone Prescription Drug Plan Important Changes
Premiums and formularies change. If you don’t review your drug plan between Oct 15-Dec 7th, you won’t get another chance until the next Annual Election Period.
Drugs expected to have lower pricing in 2026:
Eliquis, Xarelto, Januvia, Jardiance, Farxiga, Enbrel, Stelara, Imbruvica.
Entresto - there’s a generic available for this now, called sacubitril/valsartan, but as of this writing not all drug formularies have it loaded into their systems.
Fiasp and NovoLog: Insulin will still be at the $35 copay, IF the Drug or Medicare Advantage plan has it on their formulary.
The maximum allowable Part D deductible will be $615, up from $590 in 2025. However, some Part D plans will have lower deductibles or none. This is where having a knowledgeable agent can help you get the right plan based on what your annual expenses would be for both your premiums and the costs of your prescriptions. You could possibly get on a Drug plan or Medicare Advantage plan that caps your Drug maximum out of pocket at far less than the $2100 if you get on the right plan.
Prescription Payment Plan: In case you missed it last year, Medicare enrollees in Part D prescription plans and Medicare Advantage plans with prescription coverage have the option to pay out-of-pocket costs in monthly installments rather than all at once at a pharmacy. This means a $2,100 bill in January becomes a $175-a-month payment through the Medicare Prescription Payment Plan.
If you were already in the payment plan, you’ll be reenrolled automatically unless you opt out or change to a new Part D or Medicare Advantage plan. If you do change plans and want to continue a payment plan, just contact your new drug plan. It’s best to do this before you fill your first prescriptions on the new plan. Neither your pharmacy nor your agent can help you with this, you must call the number on your card.
Medicare Advantage Plan Important Changes
Some Medicare Advantage plans have left the market. If your plan has left the market, you will be without insurance coverage in 2026 unless you pick a new plan. When a Medicare Advantage plan leaves the market, you have 2 options: Pick a new Medicare Advantage plan, or you will have guaranteed issue into a Medicare supplement plan and then you can pair it with a Drug plan, and Dental and Vision plans if desired.
2026 NE Plan/Contract Terminations (all counties)
- SmartFit HMO-POS (H7149-009)
- Value Plus HMO-POS (H7149-008)
- Enhanced Select PPO (1608-082)
Service Area Reductions:
- Signature HMO-POS (H7149-001): 6 COUNTIES EXITED- Burt, Cuming, Dodge, Otoe, Jefferson & Washington
- Signature PPO (H1608-012): 6 COUNTIES EXITED Burt, Dixon, Holt, Otoe, Saunders & Washington
- Signature Extra PPO (1608-038): 6 COUNTIES EXITED: Burt, Dixon, Holt, Otoe, Saunders & Washington
There is an HMO-POS Medicare Advantage plan that is now requiring a referral to see specialists. Even if those specialists are in network and you’re already seeing them. Again, review with your local independent agent, or check your Annual Notice of Change carefully.
A Medicare Advantage plan has expanded into the Omaha metro starting in 2026. It is a PPO plan, and CHI is its first major network. This Medicare Advantage company is a privately owned company that historically has had star ratings at or above the industry average. (CMS uses a 5-star quality rating system.)
Grocery and Utility benefit for DSNP- Dual Special Needs Clients
Per CMS, Medicare Advantage plans are no longer able to offer Grocery and Utility benefit to DSNP- Dual Special Needs Clients UNLESS the beneficiary has one of the SSBCI Conditions -Supplemental Special Benefits for Chronically Ill. Please work with your agent to make sure you still qualify.
Many Medicare Advantage Plans have eliminated or reduced the non-Medicare ancillary benefits.
Remember that if you’re on a Medicare Advantage plan already, and you missed important changes to your plan, you have an Open Enrollment Period from Jan 1st through March 31st to make a one-time plan change effective the first of the following month. Medicare Advantage beneficiaries with qualifying Chronic Conditions can make changes any time of the year.
Medigap- Medicare Supplement Plan Changes
Please remember that you can shop for a Medigap plan any time of the year, but in Nebraska, underwriting questions will be asked unless you’re Guaranteed Issue – turning 65, leaving a qualified group health plan, or your Medicare Advantage plan exits the market. Some beneficiaries might have to consider a Plan N, High Deductible G, or Innovative G to keep premium costs down.
Part B
Nothing has been officially announced yet, but speculation is that the Part B premium will rise from $185 to $206.50. With that, the Part B deductible is likely to rise. And of course IRMAA (Income Related Monthly Adjustment Amount for high income earners)
Protecting Choice Through Independent Guidance-How You can help
The Idaho Department of Insurance (DOI) issued emergency cease-and-desist orders to at least two major carriers. These insurers are accused of deliberately limiting access to MA applications (both online and paper) and withholding or eliminating broker commissions for new enrollments even though those commissions were built into approved premium rates. At the time of this writing, several other states have followed Idaho’s lead.
Medicare exists to ensure older adults and people with disabilities can access health care without undue financial hardship. When distribution changes make coverage harder to compare or remove the people who help seniors make informed choices, the program’s promise erodes. Seniors shouldn’t have to become health policy experts to secure the care and medications they need. Restoring transparent choices and reliable counseling isn’t just a market nicety — it’s a matter of equity and dignity.
If you believe in fair trade for your Medicare options, please write or call the Nebraska Department of Insurance at 1526 K St Suite 200, Lincoln, NE 68508 or call (402) 471-2201. Tell them Mary the Medicare Lady sent you.