Brokers get paid more to enroll seniors in Medicare Advantage [View all]

[Tanuki]

https://www.medpagetoday.com/publichealthpolicy/medicare/120793?xid=nl_mpt_morningbreak2026-04-15&mh=a2cae01907507c09e9666a382ca08a61&zdee=gAAAAABm4xwXiMkCxXC-mlgB7T2YMarb3LGM8Omp13GRvFoPqITo-EjkIo5z03GUEflRQzbBNEeT11iuoQKbki2sQu1p-oz6XlQcYwmUnPzn-Lqe9ojHqVc%3D&utm_source=Sailthru&utm_medium=email&utm_campaign=MorningBreak_041526&utm_term=NL_Gen_Int_Daily_News_Update_active

"The system of paying Medicare agents and brokers more money if they enroll someone in a Medicare Advantage plan rather than traditional Medicare with a supplement plan needs to be changed, according to several members of the Medicare Payment Advisory Commission (MedPAC).

"The broker compensation piece really frustrates me," MedPAC member Stacie Dusetzina, PhD, of Vanderbilt University School of Medicine in Nashville, Tennessee, said at a commission meeting on Friday. "I don't think that people should have to work for free, and they are clearly a great source of information. A lot of beneficiaries rely on them, but the differences in how you get compensated across different plans, I think, is not a good thing. We should level the playing field so that your incentive is to get people into the right plan for them, and you don't get paid differently based on which plan they go into."

Gokhan Metan, PhD, of WiseCare AI in St. Louis, agreed. "When I look at the total agent/broker compensation payouts of $6.9 billion reported [by MedPAC staff] -- which, by the way, I believe is an underestimate of what is actually being paid -- if you compare that figure with the $55.2 million [for] SHIP, the ratio is 125 to 1 ... of commercial marketing compensation to objective public counseling. That, to me, is very problematic." Metan was referring to the State Health Insurance Assistance Program (SHIP), a federally funded program with offices nationwide designed to give beneficiaries unbiased information on choosing a plan.

Commission members were discussing a presentation from the commission staff on how beneficiaries choose which Medicare plan to sign up for. The staff cited a 2021 Commonwealth Fund report finding that independent agents and brokers can get paid up to $694 for enrolling a patient in a Medicare Advantage plan, compared with an average of $520 -- depending on state laws and regulations -- for enrolling them in a Medicare supplement plan plus Part D prescription insurance. These differences could cause agents to favor Medicare Advantage plans over traditional fee-for-service Medicare, said Ledia Tabor, MPH, a MedPAC principal policy analyst.".... (more at link)