Medicare, ACA, and Life Insurance News

Mutual of Omaha Medicare Supplement Tiered Rating: What Agents Need to Know

Written by www.psmbrokerage.com Admin | Wed, Aug 05, 2026 @ 09:56 PM

Mutual of Omaha is implementing a new Medicare Supplement Tiered Rating Program effective August 28, 2026.

The program creates additional opportunities for agents to place business by allowing certain applicants who may previously have been declined to qualify for coverage at an adjusted premium.

Here is what agents need to know before the program launches.

What Is Medicare Supplement Tiered Rating?

Under the new program, some applicants who do not qualify for the standard premium may still receive an offer of coverage with an adjusted premium.

Underwriting will evaluate the applicant’s complete health and insurance profile. Decisions will not be based on one specific:

  • Medical condition
  • Diagnosis
  • Prescription medication
  • Health event

The goal is to provide another path to coverage for applicants who may not have qualified under the previous underwriting guidelines.

Approval is not guaranteed. Each application will continue to be reviewed individually.

When Does the Program Begin?

The Mutual of Omaha Medicare Supplement Tiered Rating Program is scheduled to take effect on August 28, 2026.

Agents can continue using the existing electronic application and submission process. No additional steps are required when submitting the initial application.

When underwriting determines that an applicant qualifies for coverage at an adjusted premium, Mutual of Omaha will manage the offer and notification process.

Initial Participating States

The following states are approved for the initial release:

Alabama, Arizona, Arkansas, Colorado, Delaware, Georgia, Iowa, Kansas, Michigan, Mississippi, Nebraska, North Carolina, Ohio, Pennsylvania, South Dakota, Tennessee, Texas, and Wisconsin.

States with Birthday or Anniversary Rule provisions will be excluded from the program.

Additional states are still pending approval and may be added later. Agents should review the most recent Mutual of Omaha Medicare Supplement Underwriting Guide before submitting business.

How the Tiered Rating Process Works

Agents will continue to submit applications through the current e-App process.

When underwriting approves an applicant with an adjusted premium:

  1. Mutual of Omaha will send separate notifications to the client and producer.
  2. The notification will explain that coverage was approved at an adjusted premium.
  3. The client must accept or decline the offer.
  4. The client has 21 days from the date of the offer to respond.

Clients who receive the offer by email must use the link in the email to accept or decline coverage.

When a client email address is not available, a physical letter will be mailed.

The 21-Day Response Period

Clients have 21 days to accept or decline a tiered-rating offer.

After the 21-day period:

  • The offer expires.
  • No exceptions will be granted.
  • The original application will be canceled.
  • A new application will be required to pursue coverage.

Agents should monitor their email closely and contact clients promptly when an offer is extended.

What Happens When a Client Wants a Different Plan?

A tiered-rate offer only applies to the plan included in the original application.

For example, when a client applies for Plan G and decides the adjusted premium is too high, the client cannot automatically move to Plan N under the same offer.

A new application must be submitted for the different plan.

The new application will:

  • Go through underwriting again
  • Receive a separate underwriting decision
  • Potentially result in a different adjusted premium
  • Begin a new offer period when applicable

The original underwriting decision and rate adjustment will not transfer to the new plan.

How Is the Rate Increase Applied?

The tiered rate-up is applied as a percentage of the monthly premium.

Specific percentages are not being distributed broadly because the amounts may vary by state filing and may change over time.

The adjusted premium shown in the underwriting offer will be the amount the client must review and accept or decline.

How Should Agents Explain the Offer?

Keep the explanation clear and factual:

Mutual of Omaha reviewed your application and approved your coverage with an adjusted premium based on your overall health and insurance profile.

Agents can also explain that the tiered-rating program provides an additional opportunity for applicants who may otherwise have been declined.

Avoid suggesting that one specific condition, medication, or diagnosis caused the adjusted premium. Underwriting considers the applicant’s overall risk profile.

Can Previously Declined Applicants Reapply?

Yes. Applicants who were declined previously may submit a new application.

Depending on the reason for the previous decline and the applicant’s current health and insurance profile, the applicant may now qualify for coverage through tiered rating.

Every application will still be reviewed under the current underwriting guidelines, so an offer is not guaranteed.

This may be a good opportunity for agents to reconnect with previously declined clients who are still seeking Medicare Supplement coverage.

Will the e-App Process Change?

No. Agents should continue using the current Mutual of Omaha e-App and submission workflow.

There are no additional tiered-rating steps required at the point of sale.

The primary change occurs after underwriting reviews the application. When an adjusted-premium offer is extended, Mutual of Omaha will notify the client and producer separately.

Agents should verify that the client’s email address is accurate before submitting the application.

How Does Tiered Rating Affect Agent Compensation?

Agents will not receive commission on the increased premium amount associated with a tiered rate-up.

Mutual of Omaha will also no longer pay commissions on increased premium amounts associated with height-and-weight rate-ups.

However, the annualized new business premium, or ANBP, will count toward:

  • Mutual Sales Leaders qualification
  • Marketing credits

What This Means for Agents

The new tiered-rating program may help agents place more Medicare Supplement business by creating another potential outcome between standard approval and a full decline.

The most important steps for agents are:

  • Continue using the normal e-App process.
  • Confirm the client’s email address before submission.
  • Watch for underwriting offer notifications.
  • Follow up with the client immediately.
  • Remind the client that the offer expires after 21 days.
  • Submit a new application when the client wants a different plan.
  • Revisit previously declined applicants who may now have another opportunity to qualify.

Mutual of Omaha’s Medicare Supplement Tiered Rating Program is designed to expand access to coverage for certain applicants while maintaining the existing application process for agents.

Because state availability, underwriting rules, and filed rate adjustments may change, always consult the latest Mutual of Omaha Medicare Supplement Underwriting Guide for current program details.

Mutual of Omaha Medicare Solutions Contact List