Medicare brokers: The last line of defense for older Americans

The independent Medicare broker community is standing on the front line of a storm that’s reshaping how older Americans access health care.

Major carriers are quietly scaling back commissions, shrinking plan portfolios or leaving entire states altogether — and the ripple effects are starting to hit beneficiaries, not just agents.

These aren’t isolated moves or short-term adjustments. They represent a deeper problem: the erosion of a sustainable, consumer-centered Medicare distribution model.

Independent, licensed brokers are the backbone of Medicare education and enrollment. We are required by the Centers for Medicare and Medicaid Services to complete annual certification, maintain state insurance licenses, and comply with strict advertising and recordkeeping rules.

We do this not because it’s easy, but because it’s necessary to keep the process transparent, compliant, and safe for consumers. Yet the same system that relies on our expertise is now squeezing us out.

Across several states, brokers are watching long-standing commissions disappear altogether. Carriers, citing utilization costs and new drug-benefit liabilities, are trimming what they call “nonessential administrative expenses.” Translation: the licensed professionals who actually sit with clients, explain coverage and prevent costly mistakes.

Replacing licensed brokers with unlicensed “navigators,” call-center operators or volunteer state health insurance assistance program counselors might look efficient on paper, but it isn’t consumer protection — it’s a compliance risk waiting to happen.

SHIP and navigator programs provide helpful general information, but they are not licensed, certified or held accountable under state insurance law. They cannot offer detailed plan comparisons or verify whether a doctor, drug, or hospital is covered under a specific plan.

Medicare brokers bound to accuracy and ethics

Licensed Medicare brokers, by contrast, are legally bound to accuracy and ethics. We interpret plan documents, compare benefits and ensure that Medicare clients understand not just what’s covered, but what’s not. We stand between the beneficiary and an increasingly opaque marketplace.

When commissions vanish, that layer of protection vanishes with them. This issue isn’t about paycheck politics — it’s about fairness and consumer access. The same federal and state governments that demand licensed oversight cannot expect qualified professionals to operate indefinitely without compensation or a sustainable structure. Something has to give.

If the commission model continues to erode, the path forward must involve fee-based or advisory-style compensation — allowing brokers to be paid for expertise the same way accountants, financial advisors or attorneys are. It’s the only viable way to keep trusted professionals in the Medicare space.

Because when independent brokers disappear, the consequences won’t just be financial — they’ll be deeply human. Seniors will lose advocates who understand their medications, doctors and life circumstances. They’ll lose the people who make Medicare understandable. And that’s something this industry — and this country — cannot afford.

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Monica Ross-Williams, MBA, LIA, is the founding partner of MRW Solutions Group, based in Ypsilanti, Mich. Her firm provides Medicare education, health insurance and financial wellness support across Michigan and the Midwest. Contact her at [email protected].