Medicare Renewal Compensation: Everything You Need to Know


Figuring out how much you’ll make for each Medicare renewal requires some research (Medicare Communications & Marketing Guidelines, Section 110.6.2). Here is the information you need about renewal compensation below.

What Is the Max Brokers Can Make From Medicare Renewals?

The maximum a broker can earn from renewal compensation is 50 percent of the current fair market value (FMV). For 2019, the maximum renewal compensation for the following products (and locations) is as follows.

Product National Connecticut, Pennsylvania, DC California, New Jersey Puerto Rico, US Virgin Islands
Medicare Advantage $241 $271 $301 $166
Prescription Drug Plans $37 $37 $37 $37
Cost Plans $241 $271 $301 $166

Keep in mind that these are the maximum amounts that an insurance company is allowed to pay you for a product renewal. It could be less!

Will Brokers Get a Separate Compensation Amount for PDPs?

If your client enrolls in an MA-PD plan, you will only be paid the MA compensation amount. However, if your client enrolls in both a Cost Plan and a stand-alone PDP, compensation should be paid for both enrollments.

3 Ways Brokers Can Get Paid for Renewals

Regardless of when your client initially enrolled in Medicare, renewed their existing coverage, or switched to a new plan, the compensation year for that plan starts on January 1 and ends December 31. Brokers may receive prorated renewal compensation under these scenarios:

  1. Any year following the initial year of compensation.
  2. A beneficiary enrolls in a new “like plan” within the same parent organization or between two different parent organizations; or
  3. A beneficiary enrolled in an MMP switches to an MA plan or an MA-PD plan (and vice versa), if applicable per state MMP policy.

If any of these scenarios have not been met, you may not receive prorated renewal compensation.

Learn How to Double or Triple Your Revenue With Excelsior

Excelsior’s regional sales directors are currently teaching brokers how to increase their revenue through compliant cross-selling. To learn more about the Excelsior team and how we can help you, contact us.


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References
https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/CY2019_Medicare_Communications_and_Marketing_Guidelines.pdf | https://gallery.mailchimp.com/cea74ed6fe4ca4f3a21ed7661/files/00fc0d53-a82c-4eb1-84d7-c09a69275a18/2019_CMS_MA_Compensation.pdf | https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/Downloads/2017-Agent-BrokerTraining-and-Testing-Guidelines.pdf | https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/Downloads/MMPEnrollmentPPT.pdf

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