2025 Maximum Broker Commissions for Medicare Advantage & Medicare Part D

Medicare Advantage and Part D commissions will look very different for agents and brokers in 2025.

While broker commissions are increasing for the 10th year in a row, the Centers for Medicare & Medicaid Services’ 2025 Medicare Final Rule significantly changed the payment structure for Part C and D sales.

Here’s what you need to know.

What’s Changing with Medicare Agent Compensation for 2025?

In an effort to eliminate financial incentive for agents to enroll beneficiaries in one plan versus another, CMS is further standardizing Medicare Advantage and Part D compensation rules for agents by:

• Eliminating separate administrative fees
• Setting a clear, fixed amount for any MA sale and any Part D sale
• Capping agent and broker non-salary compensation
• Prohibiting enrollment incentives that may bias agent recommendations

Going forward, there will be a set agent compensation rate for Medicare Advantage and Part D sales. This rate will be adjusted annually based on the fair market value (FMV). This means that commissions for MA and PDP enrollments in a specific geographical area will no longer vary carrier to carrier. Additionally, carriers must pay the commissions at the FMV.

We expect that these changes will also affect and eliminate health risk assessments (HRA) fees, AHIP reimbursements, and enrollment-based bonuses offered by plans.

Like others in the industry, we are waiting for more clarification on these changes from CMS.

Medicare Part D Commissions

How are agents compensated under CMS rules for Medicare Part D? For 2025 Part D sales, the commissions include a one-time $100 increase in the FMV for initial enrollments and a one-time $50 increase in the FMV for renewals.

• Initial commissions will increase from $100/member/year to $209/member/year, a 109% change YOY.
• Renewal commissions will increase from $50/member/year to $105/member/year, a 110% change YOY.

Medicare Advantage Commissions

For 2025 Medicare Advantage sales, the commissions include a one-time $100 increase in the FMV for initial enrollments and a one-time $50 increase in the FMV for renewals.

These numbers are broken out by state/region:

• For CA and NJ, 2025 initial Medicare Advantage commissions will increase from $762/member/year to $880/member/year, a 15.49% change YOY. 2025 renewal Medicare Advantage commissions will increase from $381/member/year to $440/member/year, a 15.49% change YOY.
• For CT, PA and DC, initial Medicare Advantage commissions will increase from $689/member/year to $805/member/year, a 16.84% change YOY. Renewal commissions will increase from $345/member/year to $403/member/year, a 16.81% change YOY.
• For Puerto Rico and the U.S. Virgin Islands, initial MA commissions will increase from $418/member/year to $528/member/year, a 26.32% change YOY. Renewal commissions will increase from $209/member/year to $264/member/year, a 26.32% change YOY.
• In all other states, initial MA commissions will increase from $611/member/year to $726/member/year, a 18.82% change YOY. Renewal commissions will increase from $306/member/year to $363/member/year, a 18.63% change YOY.

(By comparison, Medicare Advantage commission increases ranged from 1.46% to 1.77% for 2024.)

Have additional questions about the Medicare commission changes? We’re here to help. Please contact your sales specialist for personalized assistance.