Agent reviewing a plan with seniors

If you like helping people and are looking for a rewarding career with residual income, you may want to think about becoming a Medicare Agent. 

By learning how to navigate the Medicare system, you can: 

  • Build a career with residual 6 figure incomes in 5 years or less 
  • Build strong relationships while helping people get healthcare 
  • Work on your own time 

In this article, you’ll learn what it takes to start a career in Medicare and set yourself up for success. 

You – The Ideal Agent 

  • You are a people person 
  • You believe in healthcare 
  • You are analytical 
  • You want to build your own book of business of residual income 
  • You enjoy working on your own schedule 
  • You like to be part of a great team helping others 

You can build this business part-time with excellent results. Or you can build it full-time. This is up to you. 

If you are already in insurance, this may be a natural fit for you. Stay at home parents have found this to be a great career to build while raising their children. Teachers also do great with Medicare. 

Your People – The Market 

Did you know that a third of Americans qualify for Medicare and don’t even know it? That’s over 99 million people that need help! 

As a Medicare insurance agent, you will be working with and marketing to two groups: 

  • People who are turning 65 and will qualify for Medicare 
  • People who are under 65, disabled, and qualify for Medicare 

Your Role as a Navigator 

While you will be licensed to sell insurance plans, being a Medicare agent is really about finding out what is important to people, helping them understand the language of Medicare, and navigating the options with them. 

This article will break down the steps to becoming a Medicare agent and staying at the top of your game helping people navigate a complex system to find the healthcare that is right for them. This is a gift that keeps on giving to both you and your clients. 

Finding Your Team – Working With An Experienced Medicare Broker 

You want to find an experienced Medicare agent to work with, to help you get through all the steps to becoming a Medicare Insurance Agent and to provide support and knowledge of navigating the complex Medicare system. 

The benefit of working with an experienced Medicare broker is that they will have experience with multiple healthcare products. A Medicare broker is an independent agent as opposed to a captive agent. A captive agent only works with the products from the insurance company they work with, whereas an independent agent is not limited to one insurance company. 

Becoming a Medicare agent involves: 

  • Getting appointed with various insurance carriers and their products
  • Getting commission agreements 
  • Getting marketing support from an experienced team 

7 Steps to Becoming a Medicare Insurance Agent

  1. Get your state health insurance license (also known as your resident state health insurance producer license) 
  2. Complete AHIP Certification 
  3. Get errors and omissions insurance (E&O insurance)
  4. Contract with a Medicare Field Marketing Organization (FMO)
  5. Get contracted and appointed with multiple Medicare companies
  6. Complete your annual certifications
  7. Maintain your health insurance license continuing education

Licensing and Training 

Commitment to training is an essential component to the Medicare insurance agent career, not just part of the initial process to becoming a Medicare insurance agent. 

Health Insurance License: This is the first requirement and will provide you with essential training on how health insurance plans, including Medicare, work. 

Some of the important things you will learn in the health insurance license process are: 

  • Deductibles
  • Co-insurance
  • Claims adjudication and how it affects health plan members’ access to care
  • Networks like HMOs, PPOs, and Fee-for-Service
  • Healthcare laws
  • Professional ethics
  • Compliance

Many states require specific hours of study to take the health insurance license exam. You may have to meet two requirements to get your license to sell Medicare. 

Classroom Training for State Health Insurance License

You may find that your state requires and offers classroom training with an experienced licensed health insurance agent who can help you prepare and answer questions before you take the exam at the end. 

Time: One week  

Self-Study Health Insurance License Option 

Some states offer self-study through books or electronically. If you like to study at your own pace, this is a good option. Many of these self-study programs also provide a licensed professional who can answer your questions via chat or a toll-free number. 

Licensed to Sell Health Insurance 

Once you pass the exam, you are licensed to sell health insurance products in your state. This may take a few days.  

Licensed to Sell Life Insurance 

Many health insurance exam vendors also offer life insurance certifications. This is not required but it does give you another way to help people by offering a product they may need. 

AHIP Medicare Training 

What is AHIP? AHIP stands for American’s Health Insurance Plans. 

The next step after getting your license is to complete and pass AHIP training and certification. 

AHIP certification will most often start in late June or early July for the following Medicare plan year. So, getting certified in June or July 2022 will certify you to sell for the 2023 plan year. 

Certain Medicare products require special certification to sell. This is determined by the Center for Medicare and Medicaid Services (CMS). CMS regulates Medicare plans, the insurance carriers, as well as the agents and agencies who sell these plans. 

Exam Cost: $175 

Finding Your FMO 

FMO stands for Field Marketing Organization. FMOs distribute health insurance plans to agents and agencies for the different carriers. 

The benefit of an FMO is that it can help you get contracted and appointed to sell with multiple insurance companies, making you an independent agent rather than a captive agent. 

After contracting with an FMO you will be able to sell Medicare products, such as: 

  • Medicare Advantage (MA & MAPD)
  • Prescription Drug Plans (PDP)
  • Medicare Supplements (Medigap)

How to choose an FMO 

Here are some good questions to ask to find out if an FMO is right for you. 

Training – what kind of Medicare sales training do they provide? These may include online training, face-to-face and ride-alongs. 

Carriers – what carriers are they appointed with? 

Payments – will the carrier pay me directly or through the FMO? 

E&O Insurance – do they provide Errors and Omissions Insurance? 

Prospecting – how can they help me get in front of interested prospects? 

Understanding Errors and Omissions Insurance (E&O) 

The purpose of E&O insurance is to protect you if you give a client incorrect or misleading information and they decide to take legal action. Most carriers require that you have E&O insurance. 

You can purchase an E&O insurance policy through an FMO or through many property-and-casualty insurance agencies. 

Cost: $300-$500 annually for a typical E&O policy that covers 1-3 million dollars. 

Checklist for Getting Contracted and Appointed

When you get contracted with an insurance carrier, you get appointed to sell their products. 

Most insurance carriers require the following for you to be able to sell: 

  • Copy of current resident and non-resident state health insurance licenses 
  • Copy of your current E&O policy 
  • Completed legal questionnaire provided by the insurance company (your FMO will provide this) 
  • Background check 
  • Carrier-specific annual certifications. Specifically this refers to Medicare Advantage (MA and MAPD) but note that more Medicare Supplements are beginning to implement annual certifications 

Time: Varies, depending on how many insurance carriers you plan on becoming contracted with. 

Remember, Medicare is very regulated and carriers will often have different processes to get an insurance agent ready to sell (RTS). This process requires patience as you wait to receive approvals from each company. 

Note: Most carriers will require their certifications to be passed annually before that year’s Annual Election Period (AEP). 

One of the crucial keys to staying on top of the Medicare insurance agent game is to commit to ongoing Medicare agent training. Connect with your FMO and see what kinds of Medicare training they offer and what you can take advantage of. Agent Pipeline offers frequent free webinars to help you with various areas related to Medicare Insurance sales from compliance, sales language, and marketing. 

Medicare Training and Continuing Education

As explained in the beginning of this article, a commitment to ongoing Medicare agent training is crucial to your success. Be sure to do the following: 

Connect with your FMO 

FMOs offer a variety of Medicare training, find out what is available for you. You may want to learn about areas related to Medicare Insurance sales such as compliance, language, and marketing. 

State-Level Continuing Education 

States require different levels of continuing education, so be sure to plan to keep this up to date in order to keep your license active. You can choose from various options for your insurance Continuing Education (CE) providers who can guide you through your state requirements. 

Wrap Up 

You can see that a career as a Medicare insurance agent involves a good amount of planning and preparation. Helping people navigate through a complex healthcare system to find the plan that is right for them, and then receiving compensation for that, is rewarding. There are healthcare benefits that people don’t even know they can qualify to receive! 

Find your team, find your people, get licensed and trained, and enjoy the benefits of a rewarding career that will pay residually, giving you the resources and flexibility to create a future for you and yours. 

To talk to an experienced Medicare broker about getting started, call Arnie Fulmer at + 1 702-820-3133. 

Arnie Fulmer is a Senior Market Advisor and the principal owner of Fulmer Insurance Group, a Medicare Brokerage Agency located in Las Vegas and licensed in multiple states.

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