Reduce churn this AEP with retention-led acquisition

The Annual Enrollment Period (AEP) has traditionally been treated as a sales window, a chance to drive up membership numbers through aggressive acquisition. But in 2025, that playbook no longer delivers the same returns. Today, the most successful plans view AEP as a downstream moment in an upstream relationship: a culmination of months of education, trust-building, and service design that helps members feel confident long before they’re asked to choose.

Medicare Advantage growth is slowing. Plans are facing financial pressures, tighter CMS benchmarks, and increased regulatory attention. Many major insurers are reducing plan offerings, exiting markets, or even projecting membership declines.

‍The ripple effects are everywhere: slimmer supplemental benefits, narrower networks in certain geographies, and more cautious pricing. Members feel that change as uncertainty- “Will my doctor still be in-network? Will my insulin still be covered?” and uncertainty is a leading indicator of churn.

In this environment, retention is no longer a by-product of a good acquisition campaign. It’s a deliberate strategy and for health plans that want to remain competitive, it’s the smartest growth lever available. Retention crystallizes the business case: stable revenue, predictable medical loss ratios, and compounding satisfaction that feeds quality ratings and word-of-mouth.

In this blog, you’ll learn how to approach AEP 2025 as a strategic opportunity to retain high-value members, build trust, and stabilize your long-term growth without relying solely on costly acquisition efforts. We’ll translate that strategy into concrete operating moves- timelines, touchpoints, and talking points that your teams can implement in the next 60–90 days.

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‍What makes AEP 2025 different?

The 2025 AEP, which runs from 15 October to 7 December, is taking shape in a very different environment than past years.

Here are the defining factors:

• Medicare Advantage now accounts for over 54% of eligible beneficiaries- growth is flattening, and the market is saturated in many regions. In saturated markets, share shifts more than it grows. That means your at-risk members are your competitors’ best prospects.

• CMS benchmark rates have been cut, forcing plans to scale back benefits, narrow networks, or increase premiums. Members notice these adjustments most when they collide with daily routines- pharmacy counters, primary care visits, transportation to specialty appointments.

• Several national insurers have signaled potential declines in Medicare Advantage membership.
This changes consumer psychology: comparison shopping increases, and rumor-driven “I heard my friend switched” effects spike.

• Cost pressures, including rising drug prices and higher medical utilization, are reducing margins across the board. That puts pressure on service efficiency. When call centers get busier and hold times increase, perceived value declines even if benefits remain competitive.

In short, the market is not expanding fast enough to rely on acquisition alone. Member retention is now the primary way for many health plans to sustain profitability. Treat AEP like a risk window as much as a sales window; your goal is to reduce avoidable confusion, not just promote new features.

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‍Why retention should be your primary growth strategy

1.  Retained members are more valuable‍

A retained Medicare Advantage member generates significantly more long-term value than a new enrollee. These members:

• Are more likely to engage in preventive services
• Deliver better CMS quality scores
• Cost less to support over time

Retention not only protects your revenue, but it also enhances your performance metrics and reduces churn-related inefficiencies. Think about compounding effects: preventive engagement increases adherence, which improves outcomes and star measures, which unlocks bonus dollars, which you can reinvest into member experience, a flywheel acquisition rarely matches.

2.  Members are switching more often and for avoidable reasons‍

Members don’t always switch plans because of cost or benefit changes. In many cases, they leave due to:

•Lack of clear communication
• Confusion around coverage
• Limited personal support during decision periods

These are retention failures that can be prevented with better outreach, better tools, and more personalized engagement. Churn is often a communication gap masquerading as a benefit gap.  

3.  Acquisition costs are increasing‍

Health plans are spending more on acquisition while seeing lower conversion efficiency. In contrast, retention strategies, especially when supported by analytics, can be deployed at lower cost and with higher long-term return. AEP budgets stretch further when educational content, proactive nudges, and agent availability reduce inbound confusion and repeat contacts.

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‍Six retention strategies to focus on for AEP 2025

1.  Engage members before AEP begins‍

Early engagement builds trust. Plans that reach out before AEP begins are able to pre-empt confusion, reduce member anxiety, and direct traffic to the right support channels. Starting early allows your members to feel confident, make informed choices, and avoid last-minute pressure during the busiest enrolment period of the year.

2.  Use segmentation to personalize communication

Generic messaging doesn’t cut through. Members want to feel like their plan understands them not just as customers, but as individuals with specific needs.

Segment your communication by:

• Chronic condition (e.g., targeting diabetics with insulin coverage updates)
• Demographics or geography
• Preferred communication channels (email, SMS, phone, post)

Relevant messaging boosts engagement, improves satisfaction, and strengthens retention.

3.  Position licensed agents as trusted advisors

Licensed agents play a crucial role in member decision-making. They’re often the only human interaction a member has with your organization during AEP.

To make agents more effective:

• Offer virtual appointments or callback scheduling
Publish real-time availability with a guaranteed callback window. Reduce telephone tag, increase show rates.

• Ensure agents are trained in empathy and plan literacy
Role-play the three hardest conversations: network changes, drug tier shifts, and premium adjustments. Give them micro-scripts that validate feelings before explaining facts.

•Align  agent scripts with current benefit changes and pain points
Keep a living script library updated daily during AEP with FAQs, member-tested phrasing, and escalation paths.

A confident, well-informed agent can turn confusion into loyalty.

4.  Promote underused benefits with clear, accessible messaging

Many members don’t realize the full value of their plan. Highlighting lesser known but meaningful benefits can increase perceived value and reduce attrition.

These benefits include:

• Non-emergency medical transportation
• Access to wellness or nutrition coaching
• Over-the-counter drug allowances
• Telehealth services or care coordination support

Make these benefits prominent in your AEP materials, especially for members likely to be comparing alternatives.

5.  Focus on quality ratings and the member experience

CMS Star Ratings influence member perception, bonus eligibility, and retention. Even members who don’t fully understand Star Ratings use them as a signal of trust and quality.

To improve or maintain ratings:

• Close care gaps that affect your quality metrics
• Encourage satisfaction surveys and feedback
• Prioritize timely access to services and support

Plans with stable or improving ratings are better positioned to retain members even amid benefit changes.

6.  Use predictive analytics to identify at-risk members

Data can help you see churn before it happens. Predictive analytics can identify members at risk of switching based on:

• Recent claims activity or lack of engagement
• Negative call center experiences
• Low satisfaction or missing care interventions

Once flagged, these members can receive targeted outreach, tailored messaging, or escalated support to reduce the risk of switching.

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‍Aligning internal teams around retention

Retention is a business outcome, not a function. It requires collaboration across departments:

•Marketing must deliver segmented, clear messaging that reflects actual plan changes and member needs
•Agents need tools, training, and visibility to serve as trusted advisors
•Operations must be ready to handle questions, escalations, and coverage clarifications
• Analytics must be feeding the entire organization with actionable data on member risk, behaviour, and satisfaction

High-performing plans approach retention as a long-term strategic goal, not just something to measure during AEP.

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‍FAQs

Why is member retention more important than acquisition this year?
With market saturation and rising costs, acquiring new members is more expensive and less efficient than keeping existing ones. Retained members deliver higher lifetime value and improve performance metrics.

‍How early should engagement begin before AEP?
Start outreach at least four to six weeks before AEP opens. Early education reduces member confusion and increases plan loyalty before they begin exploring alternatives.

‍What role do agents play in retention?
Agents are often the most influential touchpoint during AEP. When equipped with empathy, knowledge, and access to relevant tools, they can reinforce member trust and answer questions that keep people from switching.

‍What are the most valuable benefits to promote?
Focus on underused but impactful benefits like telehealth, transportation, over-the-counter allowances, and wellness programs. These drive retention by reinforcing real-life value.

‍How can predictive analytics help with retention?
By analyzing behavior and satisfaction data, predictive models can identify at-risk members and enable proactive engagement, before switching becomes a serious consideration.

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‍Conclusion: AEP 2025 is your retention moment

The takeaway is simple: the health plans winning AEP aren’t just selling, they’re serving. They’re making it easier for members to understand their choices. They’re empowering agents to build trust. They’re reaching out before members even think about leaving.

In a saturated market, retention is no longer a passive outcome, it’s your most strategic move. If you get AEP right, you don’t just gain members- you build long-term loyalty, unlock downstream savings, and increase profitability.

In 2025 and beyond, retention isn’t just the end goal. It’s the growth strategy.
And AEP is your best stage to prove it- with clarity, empathy, and consistency.

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