What it Really Takes to Become an Independent Medicare Insurance Agent – The Hard Truth

The average person has no idea about all the requirements it takes to become a licensed Independent Medicare Insurance Agent.  Most people think anybody can become an Insurance Agent with just a few hours of study and a selling mentality.  Sounds easy, right?

Fortunately for the consumer looking for Medicare, the hard truth is much more complicated.  The fact is that becoming a licensed Independent Medicare Insurance agent is an incredibly challenging job.

Not only do agents offering Medicare plans have to complete state licensing training and exams, but they are also required to complete ongoing certifications prior to each licensing renewal in their state.  They must complete these ongoing certifications for every single carrier plan they offer, which means multiple certifications for multiple plans.

If an agent offers plans in another state other than their resident state, they must hold a non-resident license in that state as well.

The only time an agent does not have to worry about multiple certifications is if they are a “captive” agent, meaning they are employed by a large carrier.  These agents typically work in a Telesales department and are only prepared to discuss the plan of their employer, meaning they will generally only have one carrier to offer.

Whereas an Independent Agent represents a variety of plans and can discuss the different options available based on your needs instead of trying to fit you into a single carrier plan option.

What are the certification requirements for Medicare Insurance agents?

To offer Medicare Advantage plans or Part D prescription drug plans, agents are required to complete annual training.  The most common and widely accepted certification training is AHIP (Americas Health Insurance Plans), which agents are required to complete on an annual basis to be in good standing with most insurance companies.

AHIP has become the Gold Standard in Medicare Advantage certification. The course is comprised of 5 modules with quizzes and a final exam with a minimum passing grade of 90%. In addition to the AHIP certification, agents are required to be appointed and complete certifications for each carrier they would like to represent.

Again, if this is a captive carrier agent, they only have to be certified in that plan.

How much time does it take to complete your certifications every year?

Each agent must have state licensing, a national AHIP certification, a carrier specific certification and possibly market specific training.  An agent could spend as much time as 40 hours doing certifications each and every year, if they have a broad portfolio.  Compared to a captive agent who only spends time certifying for one carrier.

The average Independent Medicare Insurance Agent is anything but average and belongs to an elite group of dedicated, committed and highly trained professionals.

What happens if an agent does NOT complete the certifications?

If an agent fails to complete the certification or doesn’t receive a passing grade, they will not be able to offer that product for that calendar year. They would also forfeit any renewal commissions in most cases.  It is in an agent’s best interest to get certified every year so they don’t forgo commissions.

What happens if an agent has an allegation?

An explanation of the event is required by the agent. Depending if the allegation is founded or unfounded would determine the actions imposed on the agent.  There are a number of actions that could be levied, including loss of license, carrier contract termination, loss of commissions, additional oversight and corrective action plans.  Medicare is very stringent and has put in processes to protect consumers from fraud and abuse more than any other type of insurance industry.

How much money does an agent make from a plan?

The agent compensation is dependent based on the enrollee’s plan year. The compensation is structured to pay more for a first-year or new-to-Medicare than renewal years. This changes each year and is set by the Center for Medicare and Medicaid Services.

In most cases the commission structure doesn’t change, plans have the option to pay less than the rate set by CMS, however, most do not, making the compensation the same across all Medicare Advantage & PDP plans in a particular state.  Renumeration can vary by state.  But this structure eliminates any temptation to make recommendations based on compensation.

The compensation could vary for captive agents and they might even earn less than an independent broker/agent.  The independent agent will have a broader portfolio providing the consumer more choices than a captive agent, therefore increasing the chances of higher earning potential.

What is the biggest misperception about Medicare agents?

There is an extra cost or fee to use an Independent Agent.  The consumer may think they will save money by going direct to the carrier. The consumer may also believe agents are driven by commission; however, the commission structure is designed to take that out of the equation with all MAPD plans paying the same commission to the agent.

The fact is that most agents are in the business to help people with what can be a confusing process. It’s the number one reason why most get into the Medicare business to begin with.

Consumers might want to interview a few agents to make sure they are working with an experienced professional.  Following are a few questions to ask:

  • How long have you been in the business?
  • Are you a captive agent or independent agent?
  • What carriers do you represent?
  • Do you focus on Medicare plans or offer other products?
  • How will you help me find the right plan for my needs?

In order to get the most out of your Medicare, to shop the broadest selections of plans that meet your specific needs, contact an Independent Medicare Insurance Agent.  They will be your biggest healthcare advocate and help you navigate the world of Medicare, prescriptions, carriers and providers.  They often have deep relationships and knowledge of situations that are very beneficial as a client.

You don’t want to be out there trying to move the mountain by yourself, instead you want somebody who can do the heavy lifting for you.  Enlist the aid of an Independent Medicare Insurance agent, you’ll be happy you did!

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