NAIFA's Medicare Collective (MC)

Why Smart Agents Are Reassessing Medigap and Part D Coverage

Written by AmeriLife | Dec 23, 2025 3:56:56 PM

Imagine a consumer you've worked with for years calling to ask a familiar question: "Should we still keep this Medigap plan? It just feels expensive." You sit down together, review the coverage, and compare it to newer Part D options. The math tells a surprising story: their total projected costs are trending down, not up.This scenario mirrors what recent data has suggested. Milliman's 2025 Retiree Health Cost Index shows a 65-year-old couple on Original Medicare with Medigap and Part D facing about $388,000 in lifetime premiums and out-of-pocket costs — a 1.4% decrease from 2024. Other coverage paths ticked upward.

The drop may be small, but the message to licensed agents is clear: now is the time to revisit Medigap and Part D with those you serve to see how those programs may reduce

Stephanie Kirk 
Founder of Secure Benefits, part of the Senior Resource Group, an AmeriLife company

 

estimated healthcare costs.

What the new numbers tell us

Milliman's index helps us translate the shift in projections into better planning. For Medigap households, the slight decline reflects a rare easing in assumed future spending. For those of us working in this industry, it means opportunity.

When we see modest relief in projected lifetime costs, we shouldn't assume it was simply luck. We should assume there's a window of opportunity. Use this to re-engage those who haven't reviewed their supplemental coverage in years and to demonstrate how small changes in coverage combinations can compound over decades.

Even shifts of just a few percentage points can capture our industry's attention because they challenge the assumptions we've made about the inevitability of rising costs.

Ground truth for planning ahead

Consumers need clarity, not noise. Anchor your conversations in the facts that shape every household's decision.

Those numbers let you pivot from data to direction. You're not just forecasting the future. You're showing how coverage choices interact with real, current costs.

Why a Medigap and Part D review matters now

After 15 years of working with licensed agents and consumers, I've learned that the best reviews come during calm periods, not during crises. Milliman's modest decline gives us precisely that.

Three reasons to act:

  1. Predictability creates peace of mind. Medigap stabilizes exposure to medical costs as people age. That steadiness is worth as much as any tax advantage.
  2. Prescription plans keep evolving. Annual Part D reviews uncover silent price changes and coverage shifts.
  3. Compounding magnifies impact. A 1% to 2% change in lifetime costs compounds into real dollars over 25 years. Revisit assumptions now, not after premiums spike again.

When Medicare Advantage still fits

Medicare Advantage continues to serve many consumers well. Some prefer managed networks and built-in extras. The role of a trusted agent is to help them see both sides — the upfront savings versus long-term flexibility and provider access.

Framing both paths honestly builds trust and retention.

A framework for agents

I coach new producers to apply three lenses when reviewing an individual's coverage:

  1. Health trajectory: Project utilization, not just past claims.
  2. Budget stability: Compare expected annual costs under everyday and high-use scenarios.
  3. Medication: Align current prescriptions with next year's Part D formularies and copays.

These lenses move the conversation from "Which plan is cheaper?" to "Which plan fits your life?" That shift earns loyalty.

Turning insight into habit

Data doesn't build trust. Consistent follow-through does that. Make reviews a repeatable process.

  • Quarterly: Update your internal cost slide deck with reputable figures, like those of CMS.
  • AEP/OEP: Dedicate a "Part D Review Day" for Medigap households.
  • New-to-Medicare: Lead with predictability, not price.
  • Compliance: Document every recommendation and rationale.

The opportunity in front of us

No projection guarantees the future, but patterns point us toward better service. The 2025 data give licensed agents a moment to reconnect and strengthen relationships that may have gone quiet.

When families see that you're watching these shifts and translating them into practical action, they stop viewing you as a salesperson and start viewing you as a lifelong guide.

So, call five households this week and rerun their Part D. If nothing changes, you've still earned trust. If something does, you just paid for the call.

Stephanie Kirk is the founder of Secure Benefits, part of the Senior Resource Group, an AmeriLife company.