Success with Medicare Sales as an Insurance Agent

As the baby boomer generation reaches retirement age in ever-increasing numbers, there’s a corresponding increase in sales opportunities for trend-savvy insurance agents. The United States Census Bureau notes that by 2030, all baby boomers — a group defined as those born after World War II from 1946 to 1964 — will be 65 years old or older.

At an estimated 73 million individuals, this “grey tsunami” will need to take advantage of Medicare health insurance programs in droves. By getting into Medicare sales now, either as a new agent or an experienced one seeking a new chapter in your career, you can set yourself up for success in this field.

Why Explore Medicare Sales

As we shared earlier, our rapidly aging population will have advanced healthcare needs, meaning you’ll have no shortage of potential clients — even if you elect to start selling Medicare part-time during the annual enrollment period (AEP). Health insurance alone can be complex, but add to that Medicare’s unique coverage options, such as Medicare Advantage (Part C), Prescription Drug Coverage (Part D) and Medicare Supplements, and it’s an even more intricate process.

Elders navigating this process for the first time or securing renewals will need assistance determining the best policy for them: That’s where you can help. According to insights from The Commonwealth Fund, nearly one-third of beneficiaries age 65 and older elicit the assistance of an insurance broker or agent when selecting their coverage.

On top of a bevy of new clients, there’s also the potential revenue to consider. The Centers for Medicare and Medicaid Services (CMS) annually sets national commission maximums for Medicare agents and agencies. These amounts differ depending on your state of residence and are calculated using the cost of living and other factors.

So, how much money can you make selling Medicare? Generally, CMS has set the national maximum commission in 2025 for first-time enrollment in Medicare Advantage plans at $626 per beneficiary. However, that amount is as high as $780 in California and New Jersey, with renewal years equaling about half that. For Part D coverage, agents can expect to make $109 in commissions for first-time enrollments and $55 per renewal.

Opportunities in Medicare Sales

Medicare’s coverage options provide consumers with comprehensive insurance solutions to ensure their needs are met. As an insurance agent, these also give you greater opportunities to generate Medicare sales. Here is a brief overview of each:

• Original Medicare (Parts A and B) – Part A covers hospital costs and other inpatient care, such as a nursing facility stay, as well as long-term hospital, hospice or part-time home care. Part B, meanwhile, covers outpatient care costs, such as doctors’ visits, essential medical supplies and preventative care. Find a detailed breakdown here.
• Medicare Advantage (Part C) – Medicare Advantage is a private insurance product covering Medicare Parts A and B, plus optional coverages for prescriptions, dental and vision. These plans can fall into different classifications depending on the patient’s need and carrier offerings, such as a health maintenance organization (HMO), preferred provider organization (PPO), private fee-for-service (PFFS) and special needs plans (SNPs).
• Medicare Part D – Medicare Part D only provides coverage for prescription drugs. Medicare prescription coverage typically places drugs into different levels, known as “tiers,” in their formulary, according to medicare.gov. All drug plans generally must cover at least two options per category.
• Medicare Supplement Insurance (Medigap) – This extra insurance policy, purchased from a private health insurance company, can help elders pay their share of out-of-pocket costs. Usually, people must have Original Medicare to buy a Medigap policy.

Once you’ve met your state licensing requirements, you can sell Medicare insurance as an independent agent. Alternatively, you can work with a field marketing organization (FMO) to establish relationships with top carriers offering Medicare products, such as Aetna, Humana and UnitedHealth Care.

Getting Started in Medicare Sales

Now that we’ve covered the basics of Medicare coverage, you’re probably asking yourself: How do I start selling Medicare insurance? To begin, you must carry a life and health insurance license as required by your state’s department of insurance. In most states, you’ll only need a health insurance license. However, some states, such as North Carolina, require a specific license to sell Medicare products.

Here are the basic steps to getting your life and health insurance license:

• Complete all pre-licensing exam requirements – These can vary depending on your state. Most courses require a certain number of education and classroom hours, plus an in-class test to determine your readiness for the state exam. You must pass to receive a certificate of completion. The cost of these courses can vary from state to state, but a basic course ranges from $50 to $250.
• Pass the licensing exam – Now that you’ve hit the books and passed your readiness test, you can take the licensing exam. Exams are multiple-choice and administered electronically.
• Apply for a license – Once you’ve passed the exam, you can send your application and any required paperwork to your state’s department of insurance.

But what if you’re already licensed? In that case, you can explore your options as an independent agent or by selling with an FMO, also known as an independent marketing organization (IMO). FMOs provide valuable resources for agents by acting as a liaison between them and carriers. Many offer enhanced training programs and other resources to help their agents clinch sales, such as in-person workshops and seminars to digital solutions like online courses and webinars. They can also provide web-based technology solutions to make standard processes more efficient, such as quoting and enrolling clients or analyzing and comparing competitive products.

Succeeding in Medicare Sales

Whether you’re dipping your toes into the idea of selling Medicare part-time or are ready to commit yourself to this new venture, here are some tips to help you start your career right:

• Familiarize yourself with the marketing rules for health plans – Medicare is a government insurance program, so you must adhere to its rules for selling it. Offering cash incentives, appearing at a consumer’s home unannounced and attempting to sell non-health-related products can result in regulatory action.
• Stay on top of program changes – Medicare is a constantly evolving program meant to meet the needs of our country’s aging population. As those needs change, so too does the program. Remaining aware of coverage alterations that could impact your clients goes a long way to building their trust and positioning yourself as an essential resource.
• Know your products – Your clients don’t want coverage that’s simply “good enough.” They want peace of mind, knowing their medical needs will be met as they age. With comprehensive knowledge of Medicare and its available endorsements, you can craft an affordable insurance solution that helps access critical services and support. Conversely, a knowledge gap can lead to costly errors and unhappy clients, harming your reputation and financial success. Take advantage of training and continuing education (CE) opportunities to ensure your information is up-to-date.
• Stay organized – The Medicare AEP is brief, running from Oct. 15 to Dec. 7, with new coverage choices going into effect on Jan. 1. That’s a short window to onboard new clients and help current ones renew their policies. Successful agents will stay organized and efficient, alerting their clients to the opportunity well before that window, for a manageable busy season.
• Retain clients to make the most of renewals – Retention is key for ensuring your financial success, whether as an independent agent or one partnered with an FMO. Ways to retain clients can include policy-focused efforts by helping them understand all their benefits or notifying them of program changes before they take effect. At the same time, personal touches, such as birthday or anniversary cards, can bridge the gap between agent and client, enhancing their loyalty to you while giving you a reason to touch base throughout the year.
• Protect your business – Everyone makes mistakes. However, as a Medicare insurance agent, a single mistake can seriously impact your clients’ finances and happiness. Protect your business against claims from unhappy clients alleging real or perceived errors, omissions and negligence with Errors and Omissions (E&O) Insurance from the National Association of Professional Agents (NAPA).

E&O insurance is an essential professional liability policy designed to safeguard your finances, business and reputation from the harmful effects of litigation — your carrier and state might also require it. Lawsuits can be stressful, eating up your time and money through attorney’s fees, court appearances and any settlements or judgments. By covering these costs, NAPA’s policy makes it easy to focus on the ongoing needs of your business during this time. NAPA also offers special coverage for agents exclusively selling Medicare products for $27.42 per month. Or, if you’ve been licensed for less than two years, you can secure E&O coverage starting for just $26.25 per month. Alternatively, if you’re keen on selling Medicare in partnership with an IMO/FMO, use our search tool to see if we have a dedicated program for them.

As more baby boomers become eligible for Medicare en masse, getting ahead of this rising tide can mark the beginning of a lucrative career. With these tips and comprehensive professional liability protection from NAPA, you can start selling Medicare products with confidence.

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