The reshaping of the Medicare Advantage market

The landscape for selling health care to seniors, particularly Medicare Advantage plans, is experiencing substantial changes, forcing financial advisors and insurance agents to reconsider their strategies and approach during Medicare’s annual enrollment period.

Traditionally, Medicare Advantage has offered an opportunity for agents due to predictable commissions and the growing popularity of these plans among seniors. However, recent changes — most notably, the elimination or drastic reduction of commissions by certain carriers — have introduced a new layer of complexity to the sales process.

Medicare Advantage plans, designed as an all-in-one alternative to Medicare, typically include coverage for hospital stays, doctor visits, prescription drugs and additional benefits such as dental, vision and hearing. This coverage has driven their popularity. Enrollment in Medicare Advantage has steadily climbed, and, today, nearly half of all Medicare beneficiaries own such policies, a trend projected to continue as the senior population expands.

For advisors and agents, however, the drive to sell Medicare Advantage plans has hinged not only on the benefits but also on consistent compensation. Recent developments, though, including major carriers reducing or completely removing commissions, have shaken this industry. Agents who counted on the stable annual renewals and upfront commissions now face uncertainty. As one agent who contacted InsuranceNewsNet said: “While the companies may feel that they no longer need agents to write their coverage, Medicare beneficiaries would tell a different story if asked their opinion. … How can we serve the public if we are not getting paid?”

Why are carriers reducing or removing commissions? Among other things, insurers are contending with increased regulatory oversight and tighter profit margins. Regulators are also paying closer attention to sales practices to ensure seniors make well-informed decisions. The enhanced oversight, combined with rising health care costs, has driven the cost-cutting measures that are impacting agent commissions.

Despite these shifts, Medicare Advantage continues to be highly attractive for seniors. Financial advisors and insurance agents must determine how to adjust sales strategies for the new realities — if they still want to participate in the market. 

While some carriers are eliminating commissions, others continue to provide compensation and support for agents. According to medicaresupp.org, initial year Medicare Advantage commissions are $705/member/year (2025). This is a 2.3% increase from $689/member/year (2024). Renewal commissions are $353/member/year (2025).

Advisors will be evaluating carrier partnerships not only on commission structures but also on stability, quality of customer service, and support. 

Advisors and agents may consider diversifying their portfolios to make up for the commission losses. Ancillary products such as supplemental health insurance, prescription drug plans and long-term care solutions can enhance value to clients while helping agents maintain revenue streams. This holistic approach may also help strengthen client relationships.

Technology is another factor reshaping Medicare sales. Using advanced customer relationship management systems, automated enrollment tools and digital marketing strategies can help grow client reach. Advisors leveraging technology will  be able to reach those tech-savvy seniors who may prefer digital interaction.

Seniors navigating Medicare options may find the task confusing and possibly overwhelming. Agents who offer clear, unbiased educational content — whether through seminars, webinars, blogs or personalized consultations — will build credibility and trust for seniors seeking these plans in a market that’s more competitive for the remaining commission dollars. 

Advisors and agents who can adapt to these industry shifts, emphasizing service, education and additional product offerings, may be able to continue to find success in the Medicare Advantage market. But as the agent asked: “How can we serve the public if we are not getting paid?” 

John Forcucci
Editor-in-chief