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AEP 2026

The Gospel According to Kevin

Introduction

Overall, AEP is shaping up to be strong this year. While we’ll need to play a bit of defense, there are also plenty of opportunities on the table. Humana is rolling out multiple easily switchable duplicate plans, which means we need to stay ahead of other agents.

Keep in mind, these are my thoughts based on limited early information — things may shift as more details are released.

The good news: there’s a healthy amount of change this year. Enough to create opportunities, but not so much that it should feel overwhelming for those of us focused on maintaining our books. Remember: it’s always easier to keep a member than to find a new one.

For those still in the early stages of building your book: control what you can. Get in front of as many eligible people as possible and keep pushing forward — the right opportunities will reveal themselves if you stay consistent.

My Thoughts on the Companies

1. Humana

Humana is rolling out multiple new plans this year, creating a lot of duplicate options compared to what clients already have.

  • Action: Call these members early. Even if you don’t recommend a switch, make sure they know about the new options. If you don’t, another agent will.
  • Why it matters: Other agents will use these new plans as a reason to convince your clients to switch.
  • Highlights: Humana’s new plans are competitive and remain one of the few carriers still offering Tier 3 medications with no deductible.

Priority: Proactively manage Humana clients to prevent unnecessary turnover.


2. Cigna

Most of us primarily sell the $125 giveback plan, and those members should be contacted early in AEP.

  • Action: Call these clients first to review changes. The plan overall is looking slightly better this year. And they will still have a great Giveback
  • Watch out: A new $300 deductible now applies to Tier 3 medications. Double-check whether your clients are affected.
  • Perspective: Even with this deductible, Cigna remains competitive — it’s still lower than most carriers, and just two months of the giveback nearly covers the cost. Should be the fun and easy list to call

Priority: Call Cigna members first to explain the deductible change and reinforce the value of their plan.

3. UnitedHealthcare (UHC)

Overall, UHC plans have declined slightly this year. While the changes aren’t catastrophic, they stand out more because Humana and Cigna have improved in comparison.

  • Action: Call UHC clients to review their plan changes and gauge how they feel. Use this as an opportunity to position alternatives if needed.
  • Highlights: UHC is not the strongest option for cost-conscious clients this year. Humana may be a better fit in those cases — unless the member needs access to Baylor providers, where UHC maintains an advantage.
  • Pending: Final comparison with BCBS will determine exactly how UHC stacks up in your market.

Priority: Middle — don’t ignore UHC clients, but call Humana and Cigna members first.

4. WellCare

WellCare’s lineup this year appears simplified: just two standard MAPDs (Simple and Giveback) alongside approximately 11 Dual SNP options.

  • Action: Take time to review the Dual SNP plans and identify which ones are worth presenting and which can be disregarded.
  • Highlights: WellCare remains a solid choice for clients using Parkland and continues to offer decent overall benefits.
  • Perspective: Compared to competitors, WellCare is stable but not standout. It performs about the same as in past years — reliable, but without dramatic improvements.

Priority: Lower — stable clients can be called later, unless they’re in Parkland or on a Dual plan where a change may be beneficial.

5. Aetna

Aetna’s lineup continues to underperform compared to major competitors.

  • HMO: Their single HMO option is priced similarly to UHC but comes with a smaller network — Humana will easily outcompete it.
  • PPOs: Aetna offers three PPOs. Two are overpriced and not competitive, while one could possibly compete with UHC, though not strongly.
  • Duals: The Dual plan is very weak this year. Since Aetna had a good Dual option previously, it’s important to review these members and move them to a stronger plan. Most Dual members value extra benefits, and better alternatives exist.

Action:

  • Check in on Aetna clients to confirm they’re satisfied, but plan to move most elsewhere.
  • Unless a member is strongly attached to Aetna, Humana will likely be the better fit this year.

Priority: Medium — call Aetna clients to transition them proactively before they’re targeted by other agents.

Blue Cross Blue Shield (BCBS)

********ALL BCBS PLANS UNCOMMISSIONABLE FOR TEXAS*******

  • Context: BCBS has historically been unremarkable – if they stay that way, we have nothing to worry about. If they come out with great plans at the same time, we will need to talk more.
  • Watch for: If BCBS plans look better than UHC, they may be a viable choice this season. If they are the same or weaker than UHC, there won’t be much reason to prioritize them.
  • Status: Awaiting plan details — update will be provided as soon as available.

Priority: TBD — review once plan information is confirmed.

Molina

There has been little to no buzz around Molina’s plans this year, and based on past performance, expectations remain low.

  • Context: Historically, Molina has not been competitive in benefits or network strength.
  • Action: Unless there is a significant and unexpected change, there is no reason to prioritize Molina clients for retention or new sales.
  • Perspective: Continue to treat Molina as a last-resort option only.

Priority: Low — no immediate action needed unless major updates are released.

Baylor Scott & White

This may be the year to watch Baylor Scott & White plans.

  • Context: With UHC getting more expensive and being one of the only carriers that consistently works with Baylor, BSW could capture attention if their pricing is competitive.
  • Action: Monitor members who receive most or all of their care at Baylor. If BSW releases a strong-priced plan, these clients may be good candidates to switch from UHC.
  • Perspective: Too early to call, but this could be an important niche option for Baylor-loyal members.

Priority: TBD — keep on radar as plan details emerge.

Wellpoint

Saw some limited information on a webinar – GOOD NEWS – Their plans are commissionable again

  • Context: Bad network, but good copays and extra benefits – this would be for someone who is very low income who does not qualify for Medicaid, and has several health issues who doesn’t mind having a limited network to get savings.
  • Action: None of us have many wellpoint members, but since they are now commissionable we can consider them.
  • Perspective: These plans are for a super-specific type of person. I wouldn’t worry about them, just know they exist.

Priority: Low -no one has many clients with Wellpoint and they have nothing groundbreaking

Medicare Supplements (Med Supps)

None of us currently carry a large Med Supp book, but these clients should still be addressed early.

  • Context: Med Supp premiums have been rising quickly across the board, which may open opportunities to transition some members into Medicare Advantage plans where appropriate.
  • Action: Prioritize contacting Med Supp clients sooner rather than later.
    • Review their medications and coverage needs.
    • Identify if switching to a strong MAPD could save money while still meeting their needs.
  • Perspective: While we don’t actively target Med Supps, they can be vulnerable to rising costs and outside agents.

Priority: Medium — reach out early to check meds and explore MAPD opportunities.

Standalone PDPs

As in prior years, PDPs are expected to have the most volatile changes this AEP.

  • Action: Check in on PDP clients early to review their medication lists and ensure they’re not hit with unexpected cost increases.
  • Pro Tip: Whenever possible, pair a Med Supp with a PDP. PDP-only clients often generate very low commissions — in many cases, they barely cover costs and can take up valuable time.
  • Perspective: Treat PDP-only clients as a lower priority for long-term book value, but still review early to prevent them from being poached by other agents.

Priority: Medium — check quickly, but focus more heavily on MAPD clients where retention and revenue impact are greater.

HOW I WOULD USE THIS INFORMATION

🗺️ NTXMA Call Priority Map — AEP 2026

Internal Use Only — Advisor Playbook

📌 Reminder: We cannot legally discuss specific 2026 plan benefits until October 1st. However, we can and should call clients in September to:

  • Update their info (medications, doctors, pharmacies).
  • Hint at changes (“Your plan is one we’ll want to review right away” vs. “Your plan looks stable, we’ll review later in the season”).
  • Set expectations so we’re ready to move aggressively on October 1st.

👉 The goal is to have every priority client prepped so we can take off like savages on 10/1.

🔴 High Priority (Call First)

These members face the biggest changes or competition risk.

  • Humana
    • Many duplicate/new plans → competitors will target your clients.
    • Still one of the only carriers with no deductible on Tier 3 meds.
    • Call early so they hear from us first.
  • Cigna ($125 Giveback Plan)
    • Plan looks slightly better overall.
    • New $300 deductible on Tier 3 meds — check if affected.
    • Still strong value: 2 months of giveback almost covers the deductible.
  • Standalone PDPs
    • Most volatile changes year to year.
    • Review early to prevent surprises.
    • Pro tip: Pair with Med Supp whenever possible; PDP-only clients are low commission.

🟡 Medium Priority (Call After Red)

These members need attention but aren’t as urgent as High Priority.

  • Aetna
    • Weak HMO (Humana will crush it).
    • PPOs overpriced, except one borderline competitive with UHC.
    • Dual plan is terrible — move members off it.
    • Unless client loves Aetna, move to Humana.
  • UHC
    • Slightly worse this year, more obvious since others improved.
    • Cost-conscious clients may prefer Humana (unless tied to Baylor).
    • Wait for BCBS comparison to see full picture.
  • Med Supps
    • Premiums rising quickly.
    • Opportunity to switch to MAPD for savings.
    • Review meds and explore options.

🟢 Lower Priority (Stable or Niche)

  • WellCare
    • 2 standard MAPDs (Simple & Giveback) + many Dual SNPs.
    • Solid choice for Parkland members.
    • Stable but not standout → call later.
  • Molina
    • Expectations remain poor; not competitive.
    • Only address if necessary.
  • WELLPOINT
  • Bad network with good-looking copays and benefits
  • Nothing new or nothing to worry about

⚪ TBD / Watch List (Pending Updates)

  • BCBS
    • Still contracting — watch closely.
    • Could gain ground with Baylor alignment.
    • If better than UHC → worth considering; if worse, ignore.
  • Baylor Scott & White
    • May be a good UHC alternative for Baylor-heavy clients.
    • Keep on radar for members loyal to Baylor providers.

✅ Execution Plan

  1. September (Pre-Oct 1st):
    • Call all High Priority clients (Red) to update meds/doctors, set expectations, and hint at urgency.
    • Touch Medium Priority (Yellow) if time allows.
  2. October 1st:
    • Hit the ground running — start locking in High Priority cases.
    • Roll into Medium/Low/TBD groups as the month progresses.
  3. Always Document:
    • Every call → update CRM entry, pipeline stage, and next task.

Bottom Line: If we don’t call our clients first, another agent will. This map is our playbook to stay one step ahead.