Medicare Agent Commissions Differ Sharply Between Advantage and Original Medicare
During Medicare open enrollment, agents can earn $694 in the first year and $347 annually for each beneficiary kept in a private Medicare Advantage plan. They receive no commission for guiding someone into Original Medicare. The article notes that switching from Advantage back to Original Medicare may require medical underwriting, and free SHIP counselors offer guidance without plan-based compensation.
Medicare open enrollment begins tomorrow. Insurers, not beneficiaries, pay agent commissions, and CMS publishes the amounts. A first-year payment rewards new Advantage enrollments, while renewals reward retention. Original Medicare has no carrier, so it pays no commission. Medigap may compensate agents under separate state rules, though many Advantage agents do not sell it.
Switching from Advantage back to Original Medicare often requires medical underwriting, so Medigap insurers can deny coverage or raise prices after the six-month window. SHIP counselors provide free guidance and receive no plan-based pay. Advantage's in-network out-of-pocket maximum excludes Part D drug costs and out-of-network care, and the 2026 Part B premium is $202.90 monthly.
This disclosure could shape how Medicare beneficiaries approach enrollment calls, especially those losing Advantage plans or turning 65. Greater awareness of commission differences may prompt more questions about networks, drug costs, and Medigap underwriting. It may also increase demand for free SHIP counseling. Agents could face more scrutiny, while insurers may see enrollment patterns shift if beneficiaries weigh unbiased guidance more heavily. The broader effect may be modest but could improve informed decision-making and reduce surprises when switching coverage.