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YOUR GUIDE TO SUCCESS

Getting certified to sell Medicare Advantage plans

Becoming certified to sell Medicare Advantage plans opens doors to a growing market and allows you to provide essential healthcare solutions to seniors. Here’s everything you need to know to get started on the certification process.

Getting Certified to Sell Medicare Advantage plans
The Statistics

Medicare by the Numbers

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10,000 Baby Boomers Turning 65 Daily

Approximately 10,000 Americans turn 65 each day, making them eligible for Medicare. This presents a steady stream of potential clients for insurance agents to assist in navigating their healthcare coverage options.

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98% of Medicare Beneficiaries Enrolled in Part D or Medicare Advantage

Nearly all Medicare beneficiaries choose either a Medicare Advantage or a Part D plan, which emphasizes the need for agents to help clients select the right plan to meet their needs.

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45% Enrollment Growth in Medicare Advantage

Enrollment in Medicare Advantage has grown by over 45% in the past decade, and it now accounts for nearly half of all Medicare beneficiaries. Agents specializing in these plans have a tremendous opportunity.

1.) What Are Medicare Advantage Plans?

Medicare Advantage plans, also known as Part C, are an alternative to Original Medicare, offered by private insurance companies approved by Medicare. These plans provide all the benefits of Medicare Parts A and B and often include additional coverage, such as prescription drugs, dental, vision, and wellness programs. Medicare Advantage plans are popular because they bundle multiple types of coverage into one plan, often with added perks and a cap on out-of-pocket expenses.

Medicare Advantage plans are designed for:

  • Individuals aged 65 and older who are eligible for Medicare.
  • People under 65 with certain disabilities and eligible for Medicare
    Individuals seeking an all-in-one plan that includes Medicare Part A (hospital) and Part B (medical) coverage.
  • Those looking for additional benefits not covered by Original Medicare, such as dental, vision, or hearing.
  • Individuals who prefer a cap on out-of-pocket expenses for medical services
    People interested in a plan that may include prescription drug coverage.

Difference between Medicare Supplements and Medicare Advantage plans:

Medicare Supplement plans (Medigap) and Medicare Advantage plans (Part C) differ in structure and coverage. Medicare Supplement plans work alongside Original Medicare (Parts A and B) to cover out-of-pocket costs like copayments, coinsurance, and deductibles, offering flexibility in choosing healthcare providers.

Medicare Advantage plans, on the other hand, are an alternative to Original Medicare, provided by private insurers, that bundle Parts A, B, and often Part D (prescription drugs) with additional benefits like dental, vision, and hearing, usually within a network of providers.

Medicare Advantage Enrollment Periods:

Medicare Advantage enrollment is primarily available during specific periods throughout the year.

The Annual Enrollment Period (AEP) runs from October 15 to December 7, allowing beneficiaries to join, switch, or drop a Medicare Advantage plan, with coverage beginning January 1.

Additionally, the Medicare Advantage Open Enrollment Period from January 1 to March 31 allows those already enrolled in a Medicare Advantage plan to make a one-time change to another plan or revert to Original Medicare.

Special Enrollment Periods (SEPs) may also apply for individuals experiencing qualifying life events, like moving out of their plan's service area.
the opportunity

2.) Why Is Medicare Advantage So Popular?

Medicare Advantage is popular because it offers comprehensive, bundled coverage that includes Medicare Parts A and B, often with added benefits like dental, vision, and prescription drug coverage—all in one plan.

With a cap on out-of-pocket expenses and lower monthly premiums compared to many Medicare Supplement plans, Medicare Advantage appeals to budget-conscious seniors.

For independent agents, selling Medicare Advantage can be a valuable opportunity to provide clients with affordable, all-in-one solutions that meet a wide range of healthcare needs.

3.) Why Do Some Agents Hesitate to Sell Medicare Advantage Plans?

Some agents hesitate to sell Medicare Advantage plans due to concerns about network restrictions, potential regulatory changes, and the complexity of plan options, which may require more in-depth guidance for clients.

Additionally, some agents prefer the stability of Medicare Supplement plans, which allow greater flexibility for beneficiaries to choose any provider that accepts Medicare. These factors can make agents cautious, even as Medicare Advantage continues to grow in popularity and benefits.

The benefits often make Medicare Advantage well worth it for both agents and clients. Medicare Advantage plans offer valuable additions like dental, vision, and prescription coverage, along with lower premiums and an out-of-pocket maximum, which Original Medicare doesn’t provide.

For agents, the popularity of these plans and their high perceived value among clients can lead to stronger relationships and recurring business. While there may be a learning curve, the rewards—both financially and in client satisfaction—can be substantial.

4.) The Path to Becoming a Certified Medicare Advantage Agent

Steps for Agents to Get Certified and Sell Medicare Advantage Plans:

  Start Certification Early: Begin your certification and contracting for Medicare Advantage (MA) plans several weeks before AEP, ideally by mid-September. Remember, AEP runs from October 15 to December 7. 

  Connect with an Account Manager: Reach out to your Account Manager at Precision Senior Marketing or another organization. They can help identify competitive carriers in your market and guide you on building a well-rounded portfolio based on the available carriers in your region.

  Obtain a Contract: Your Account Manager will send you instructions to register on AgentXcelerator. Once registered, go to the producer-contracting section to begin contracting. The first contract will take about 10-15 minutes to complete as you enter initial information (such as addresses, banking details, etc.) that will auto-populate for future contracts.

  Complete the Contracting Process: Submit your contracts digitally. The processing time is typically 7-10 business days, during which carriers perform background checks and validate criteria. Once approved, you’ll receive an agent number and carrier login instructions.

  Prepare for AHIP Certification: Familiarize yourself with Medicare basics and MA plans using training on AgentXcelerator.com, free for PSM agents. This resource covers Medicare’s components, differences between Medicare Supplement and MA plans, PDP features, and essential processes.

  Take the AHIP Test: Sign up for the AHIP certification test, which includes five modules covering ethics, compliance, and fraud prevention. Each module has a quiz, followed by a 50-question test. Allow 5-6 hours for completion, with a passing score of 90% required within three attempts. PSM agents receive a $50 discount using our link.

  Complete Carrier-Specific Certification: After AHIP, visit each carrier’s website to complete their unique certification. This training includes carrier-specific plan details, marketing rules, and submission guidelines.

  Quote and Enroll Clients: Once certified, it’s time to begin quoting rates and enrolling clients. Use all-in-one tools like YourMedicare SunFire to compare plans, run quotes, and handle electronic enrollments. With features like personalized URLs (PURL), clients can explore and enroll in plans, directly crediting the agent’s NPN.

  Back-Up Essential Documents: Maintain hard copies of critical documents like applications, Summary of Benefits, and Scope of Appointment (SoA) forms. CMS requires SoAs to be retained for at least 10 years, so secure backups are essential.

Following these steps ensures you’re prepared, certified, and equipped with the best tools for a successful Medicare Advantage sales season.
AHIP Training Link Carrier Certifications

5.) Is Selling Medicare Advantage Plans Worth it? Absolutely!

Medicare Advantage plans offer agents a unique opportunity to grow your business and provide valuable healthcare solutions. Here are some of the key benefits of selling Medicare Advantage:

Consistent Demand

Recurring Income Opportunities

Diverse Product Options

Personal Fulfillment

Flexible Career Growth

Trusted Carrier Partnerships

Having the right portfolio is essential when selling Medicare plans, allowing you to meet diverse client needs and stay competitive in the market.

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Medicare Solutions

View our Medicare Solutions Portfolio

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Ancillary Solutions

View our Ancillary Portfolio

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Start Selling Medicare Advantage Plans Today

Ready to expand your business with Medicare Advantage? Join us to access a comprehensive suite of products, expert guidance, quality leads, and ongoing support. Contact us today to get started and see how we can help you thrive in the Medicare market.

*For agent use only. Not affiliated with the U. S. government or federal Medicare program. This website is designed to provide general information on Insurance products, including Annuities. It is not, however, intended to provide specific legal or tax advice and cannot be used to avoid tax penalties or to promote, market, or recommend any tax plan or arrangement. Please note that PSM Brokerage, its affiliated companies, and their representatives and employees do not give legal or tax advice. Encourage your clients to consult their tax advisor or attorney.