What will Medicare Advantage commissions look like in 2025?

After much ballyhoo, Medicare Advantage agents will see a higher-than-usual commission bump in contract year 2025. But don't splurge on caviar just yet - CMS made it clear in the 2025 final rule that this is a one-time deal.

CMS says the bump will offset payments agents can no longer receive, such as bonuses for completing Health Risk Assessments, reimbursements for training and certifications, and other administrative tasks. If that caught you off-guard, brush up on the changes to agent/broker compensation and the rest of the final rule. 

One more thing to keep in mind, though. Health plans must pay the full Fair Market Value listed below for all commissionable products this year. Like many other changes for CY2025, CMS sees this as an anti-steering measure.

Referral fees remain unchanged at $100 for MA plans and $25 for PDPs.

How will these changes impact insurance agents?

Of course, most health insurance agents see these commission increases as a valuable tool for growing and maintaining business in the senior market. But, this new hard cap may cause you to closely examine your budget line items. A few suggestions:

Secure carrier discounts on AHIP certification: Carriers can't directly compensate you for taking the AHIP for CY 2025, but they can arrange discounts -- just as they have in the past. Our partners at Humana and UnitedHealthcare both offer $50 off the list price of $175 when you sign up through their portals. And, if you need to add one or both to your portfolio, just click here.

Keep your marketing local: Consider hosting compliant Medicare 101 sessions in your local area, or finding communities where a small paid marketing investment might do you the most good. Our YouTube channel is full of videos to help see it through. 

Don't go it alone: No matter how long you've been in the insurance business, you know that spending time in carrier phone queues costs you money. Lean on our Medicare FMO for any servicing need, from ordering another OTC card to solving coordination issues. Whatever the issue, and no matter the difficulty, we're here to help.

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Need it straight from the horse's mouth? Read the memo from CMS.