CMS releases CY2027 commissions for Medicare Advantage

On June 1, the Centers for Medicare and Medicaid Services released updated commission figures for Contract Year 2027. The figures represent the maximum Fair Market Value that Medicare Advantage Organizations (or "carriers", as everyone likes to call them) can offer to agents and brokers. We'll talk numbers in a moment, but first, there's some old business we have to attend to.

Do carriers have to pay commissions for Medicare Advantage and Prescription Drug Plan sales?

In short, no. Commission payments are, and always have been, made at the discretion of each carrier. Carriers may pay all, some, or none of the Fair Market Value (FMV) that CMS establishes for the upcoming contract year. And, as many of us have found out, carriers may adjust that figure at any time: even in the middle of AEP.

Wait. Don't carriers have to report their commission figures to CMS each year?

Yes, but let's take a look at the wording of this requirement. Straight from the June 1 memo:

"42 C.F.R. §§ 422.2274(c)(5) and 423.2274(c)(5) require organizations to report to CMS whether the organization intends to use employed, captive, or independent agents or brokers in the upcoming plan year along with the specific rates or range of rates the plan will pay independent agents and brokers. In addition, if an organization pays referral fees, they must disclose the amount. The regulations state that organizations must provide this data to CMS by the last Friday in July which would be July 31, 2026, for the 2027 plan year."

That "range of rates" phrase is key. Looking at past filings, carriers report their possible payment lows ($0), and their maximums (generally, the FMV for that given year). That, plus the language in their agent agreements, gives them the wiggle room they need to make adjustments mid-year.

What happened to the rules about administrative payments, overrides, and FMO support?

In its CY2025 final rule, CMS attempted to cap agent payments for administrative tasks, override provided to Field Marketing Organizations, and some contract terms between carriers and their downlines. On July 3, 2024, a federal court issued a stay to those portions of the rule, pausing those regulations from going into effect until all lawsuits had been resolved. On August 18, 2025, the same federal court vacated these portions of the rule. As such, the industry is still playing under the rules in place for CY2024. 

The government did not appeal the court's decision to vacate the rule, nor has it attempted any rulemaking on this point since that decision.

What are the maximum agent commissions for Medicare Advantage plans and Prescription Drug Plans in 2027?

The Fair Market Value, as it always has, depends somewhat on geography. However, agents will be pleased to see significant increases across the board.

Referral fees remain unchanged at $100 for Medicare Advantage plans and $25 for prescription drug plans.

So what now?

The raise, of course, is welcome. CMS continues to demonstrate its belief that the work of agents and brokers is valuable to the Medicare ecosystem.

However, what really matters for most agents is whether carriers will pay the Fair Market Value for enrollments.

Of course, you're always going to do right by your clients. But it's also difficult to do uncompensated work. Now, more than ever, it's critical that independent agents carry appointments with multiple Medicare Advantage carriers, both local and national. As the recent past has taught us, anyone can change any commission at any time, and you'll want to be able to pivot in the middle of enrollment season. Scrambling to push a new appointment through while you have customers on the line is tough to do.

We should also note that the memo makes clear (again) that no organization can pay an agent/broker anything above the Fair Market Value for Medicare Advantage and PDP enrollments. Organizations, whether carriers or other field marketing organizations, that pay above and beyond Fair Market Value risk running afoul of federal anti-kickback laws. They also risk not only their books of business, but those of the health insurance agents under them.