Transforming AEP from an acquisition event to a retention-led growth strategy

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.

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.

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.

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.

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.

- CMS benchmark rates have been cut, forcing plans to scale back benefits, narrow networks, or increase premiums.

- Several national insurers have signaled potential declines in Medicare Advantage membership.

- Cost pressures, including rising drug prices and higher medical utilization, are reducing margins across the board.

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.

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, it enhances your performance metrics and reduces churn-related inefficiencies.

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.

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 a lower cost and with a higher long-term return.

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.

Tactics to consider:

- Educational email campaigns in September

- Early access to plan comparison tools

- SMS reminders that prepare members for renewal or plan updates

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

- Ensure agents are trained in empathy and plan literacy

- Align agent scripts with current benefit changes and pain points

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.

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, behavior, and satisfaction

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


‍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.

‍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.

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