This week’s series covers:
- Medicare Advantage in 2025 sees Part B savings rise as benefits shrink
- ACA Marketplace rule public comments close soon
- HIPAA security updates under review by OCR
Missed Last Week’s Healthcare.com Roundup? Here’s what happened:
- March 19, 2025
- March 12, 2025
- March 3, 2025
- February 25, 2025
- February 13, 2025
- February 5, 2025
- January 31, 2025
- January 22, 2025
- January 15, 2025
- January 8, 2025
Medicare Advantage Trends for 2025: Part B Savings Grow, Supplemental Benefits Decline
KFF data reveals shifts in Medicare Advantage benefits, including fewer extra perks but more premium rebates.
Most Medicare Advantage (MA) plans will continue to offer core benefits like vision (99%), dental (98%), and hearing (97%) coverage.
However, the availability of supplemental benefits is declining, with over-the-counter (OTC) allowances dropping from 85% in 2024 to 73% in 2025 and meal assistance falling from 72% to 65%.
Meanwhile, Part B premium rebates are increasing, with 32% of plans offering them in 2025, up from 19% in 2024. Technology-based benefits, such as remote access tools and telemonitoring services, are also declining, while home safety features like bathroom safety devices are becoming more common.
Why This Matters
For consumers, the reduction in supplemental benefits may result in higher out-of-pocket costs, but increased Part B rebates could offset some expenses. For health insurance agents and brokers, the changes highlight the need to help consumers navigate plan options and find the best balance of cost savings and coverage.
Comments for the Proposed Rule on ACA Marketplace Integrity and Affordability Close Soon
Public input is due by April 11, 2025, on key Affordable Care Act (ACA) updates impacting eligibility, enrollment, and coverage rules.
The proposed rule introduces changes to ACA enrollment procedures, including modifications to overdue premium payment policies and eligibility redeterminations. It reinforces income verification methods for premium tax credits and cost-sharing reductions while updating penalties for noncompliance with tax documentation.
A significant policy shift excludes Deferred Action for Childhood Arrivals (DACA) recipients from “lawfully present” status for coverage eligibility. Additionally, Essential Health Benefits (EHB) plans would have adjusted actuarial value limits and a prohibition on coverage for sex-trait modification procedures.
Why This Matters
For consumers, these changes may affect eligibility for subsidies and enrollment options, making it crucial to stay informed.
For health insurance agents, brokers, and carriers, the rule presents new compliance requirements and potential shifts in market dynamics, requiring proactive adjustments to enrollment strategies.
OCR Reviews Public Comments on Proposed HIPAA Security Rule Updates
The Office for Civil Rights (OCR) is evaluating feedback on major cybersecurity changes to HIPAA regulations.
OCR received 4,745 comments on its proposed updates to the HIPAA Security Rule, which would remove the distinction between “required” and “addressable” security measures. The changes would mandate comprehensive written security policies, stricter technology standards, and updated compliance timelines. Industry groups have pushed back, citing cost concerns and unrealistic implementation deadlines, with multiple associations urging the administration to reconsider. Meanwhile, OCR has restarted its HIPAA audit program after an eight-year pause, targeting 50 healthcare entities and business associates for cybersecurity assessments.
Why This Matters
For consumers, stronger cybersecurity measures could enhance protection against data breaches but may also lead to higher administrative costs for healthcare providers. For health insurance agents, carriers, and distributors, stricter compliance rules may require updates to data security protocols and additional training.
Last Week, our team at Healthcare.com launched Autopilot.
See the official press release below.
PRESS RELEASE
FOR IMMEDIATE RELEASE
Healthcare.com Unveils Autopilot™ – The First AI-Driven Enrollment Acquisition Platform for Health Insurance Distributors
Now available to select trusted partners, Autopilot™ revolutionizes health insurance & Medicare distribution with AI-powered efficiency and smarter enrollment solutions.
New York – March 26, 2025 – Healthcare.com, a digital healthcare platform, is excited to announce the official launch of their high-intent enrollment platform, Autopilot™ by Healthcare.com. Designed with health insurance distributors in mind, Autopilot™ offers groundbreaking features and benefits aimed at intelligently matching high-intent health insurance consumers on Healthcare.com with distributors through proprietary technology and data. Through trusted integrations with partners and over 100M data points, Autopilot™ provides better data transparency, aligning the consumer, distributor, and carrier while optimizing the value chain and universally driving better outcomes.
Healthcare.com has been piloting Autopilot™ with an initial set of forward-thinking distributor partners over the past two annual enrollment periods with industry-leading success. These efforts are culminating in the full release of Autopilot™ in 2025. Autopilot™ uses Healthcare.com’s large proprietary data sets to predict the intent of each individual consumer and aligns that intent to each individual distributor – resulting in a consistency of outcomes and elimination of waste generating an ROI that significantly surpasses rules-based legacy solutions.
“Autopilot™ represents the future of health insurance distribution, leveraging AI and proprietary data to drive efficiency, transparency, and superior outcomes,” said Sean Taylor, CEO of Healthcare.com. “Built on top of our expansive ecosystem of health insurance consumers, Autopilot™ enables distributors to precisely target enrollments, optimize their books of business, and continuously refine their strategies for growth. By aligning consumer intent with distributor capabilities, we are enhancing enrollment experiences and empowering consumers with clearer, more personalized pathways to coverage.”
Autopilot™ has expanded into all health insurance verticals including Medicare Advantage, Medicare Supplement, ACA, and other U65 health insurance products, improving not only the outcomes for distributors but also providing unmatched consumer experiences. Customers can feel confident that when matched with one of Healthcare.com’s trusted distribution partners, it’s the ideal match for their individual needs.
“We have been very happy with the results since partnering with Healthcare.com,” said Aimee Brown, Vice President of Performance Marketing at Spring Venture Group, a leading Medicare insurance brokerage. ”They are the only partner we trust to set value-based pricing for the Autopilot leads delivered to us.”
The next evolution of customer acquisition is here, and Healthcare.com invites health insurance and Medicare distributors across the U.S. to join the industry’s first enrollment acquisition platform proudly launching March 2025. To learn more about the platform, please visit www.healthcare.com/autopilot.
For media inquiries, please email Ben Hochstetler, Vice President of Business Development, at bhochstetler@healthcare.com.
About Healthcare.com®
Healthcare.com is a leading digital platform connecting millions of health insurance consumers with coverage options provided by a nationwide network of enrollment partners for health insurance and Medicare plans. Healthcare.com also develops and markets a portfolio of direct-to-consumer health insurance and supplemental insurance products from multiple “A” rated carriers under the brand Pivot Health. To date, Healthcare.com has raised over $200M in funding, and is backed by prominent venture capital, growth equity, and strategic investors. Founded in 2014, the company is headquartered in Miami. For more info, visit www.healthcare.com.
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