For Agents
Medicare Commissions 101: How Agents Actually Get Paid
Street commissions, renewals, overrides, chargebacks — the full picture, with 2026 rates. If you're an agent (or building an agency), this is what your book is worth.
The two types of commissions
Every dollar in Medicare distribution flows through one of these.
Street Commissions
Paid to the writing agent for enrolling a beneficiary into a plan. Also called agent commissions.
Override Commissions
Paid to agencies above the agent for providing administrative and operational support. Also called administrative fees. The amount depends on the agency's contract level and the carrier.
Follow the money
Who pays you, and who gets paid
Carriers pay commissions in most cases. Large national carriers (UnitedHealthcare, Aetna, Humana) pay agents and agencies directly. Some smaller/regional carriers pay the FMO — Field Marketing Organization, the top-level organization contracted directly with the carrier — which then disburses commissions downline.
For a carrier-by-carrier guide to which carriers pay street commissions directly to the agent and which are paid out by the FMO, see the Carrier Payment Terms guide.
Pro Tip
If your upline is paying you street commissions on a national carrier, ask why. It's almost always in your best interest to be paid directly by the carrier.
There are two contract types for agents: Street Contract (commissions assigned and paid directly to you) and Licensed-Only / LOA Contract (commissions assigned to your upline agency, typically for salaried agents).
Important nuance: assigning commissions to an upline does not automatically mean the upline owns the book of business — treatment varies by carrier and matters if the writing agent leaves or lapses their license.
Overrides go to agencies contracted above street level — GA, MGA, SGA, and FMO tiers (terminology varies by carrier).
2026 Rates
How much do agents make?
Commissions are either a flat dollar amount per application or a percentage of premium. Clients fall into three categories: New-to-Medicare (never on a plan), New-to-Carrier (switching carriers), and New-to-Plan (switching plans within the same carrier). Structure is generally a 1x upfront payment plus monthly renewals starting the following year.
Medicare Advantage (MA/MAPD)
- Flat dollar amount per application. Maximums are set annually by CMS and vary by state; nearly all carriers pay the maximum.
- New-to-Medicare enrollments pay the full initial rate upfront. Plan switches pay the renewal rate, pro-rated by months remaining in the year.
- From year 2 on, agents earn the renewal rate monthly for as long as the member stays on the plan (renewals ≈ half the initial rate).
- If a member disenrolls within the first 90 days, the commission is charged back.
2026 CMS Maximum Street Commissions (per member per year)
| Plan | Region | Initial | Renewal |
|---|---|---|---|
| MA/MAPD | National | $694 | $347 |
| MA/MAPD | CT, PA, DC | $781 | $391 |
| MA/MAPD | CA, NJ | $864 | $432 |
| MA/MAPD | Puerto Rico, U.S. Virgin Islands | $474 | $237 |
| PDP | National | $114 | $57 |
2026 rates reflect the largest CMS increase in years — up ~11% over 2025 for Medicare Advantage.
Prescription Drug Plans (PDP)
Work just like MA commissions, but lower amounts and no state variation (see table above).
Medicare Supplement (Med Supp)
- Flat dollar amount or percentage of premium, depending on carrier and state. CMS does not cap Med Supp commissions.
- Common street level: around 20% of premium in year one on percentage-based schedules.
- Commission length: the paying period runs anywhere from 3 to 7 years depending on state and carrier. Shorter schedules generally pay a higher percentage; longer schedules pay a lower percentage stretched over more years.
- Typical curve: most carriers pay the same commission each year through the main 3–7 year schedule, then drop to a reduced "trailing" commission for a few years before going to zero. UnitedHealthcare is the notable exception — it generally pays a flat-dollar commission that is higher in year one and decreases in the years that follow.
- Replacements reset the clock: if a client is moved from one Med Supp to a new carrier's Med Supp, the commission schedule generally resets to year one on the new plan — good for the agent on genuine improvements, but a real cost to the client's prior-carrier renewal stream, so replace only when it clearly benefits the client.
- Same-carrier rewrites & AOR changes don't pay: Med Supp carriers generally won't pay a commission if you write a new Med Supp with the same carrier the client previously had, or if you take the case over via an Agent-of-Record (AOR) change. New business commission is reserved for genuinely new-to-carrier enrollments.
- Advancing: carriers typically pay 6–12 months of commission upfront at enrollment; if the member disenrolls, the unearned advance is owed back to the carrier.
Health Risk Assessments (HRA)
Many carriers pay agents $50–$150 for completing an HRA at enrollment. Fees vary by carrier, product, and completion method (e.g., D-SNP HRAs often pay more; agent-completed can pay more than client self-completed).
Non-commissionable & reduced-commission business
Not every enrollment pays a commission. Before you write a case, know which buckets don't pay — or pay less than street:
- Med Supp — Under-65 & Guaranteed Issue (GI): Most Med Supp carriers do not pay a regular commission on under-65 (disability) applications or GI business. Open Enrollment applications (the 6-month window at age 65 / Part B effective) generally do pay a full commission.
- Medicare Advantage — carrier discretion: CMS sets a maximum commission each year, but carriers can pay anything from that max down to $0. Plans a carrier doesn't want to grow into (closed panels, over-capacity service areas, unprofitable segments) often get zeroed out or reduced to discourage distribution.
- PDP (Part D): Most stand-alone PDPs today are non-commissionable or pay only a nominal amount. Plan on writing PDPs as a service to your MA/Med Supp clients, not as a revenue line.
Worked Example
A quick example
Say you enroll a New-to-Medicare client in an MA plan in California with a March 2026 effective date. You're paid the full initial rate of $864 upfront (often split as a pro-rated renewal payment plus a CMS "true-up" the following month). Starting January 2027, you earn $432 / 12 = $36 per month for as long as the client stays on the plan. Now multiply that by a book of 200, 500, or 1,000 members — renewals are where the real business is built.
The Agency Opportunity
How overrides work
Agencies with contracts above street level (GA → MGA → SGA → FMO) earn a flat override per MA application, paid on top of — never out of — the agent's street commission.
Full initial override is paid upfront for New-to-Medicare and New-to-Carrier enrollments; renewals are paid monthly starting the following year at roughly half the initial rate.
Rule of thumb — Medicare Advantage overrides
| Level | First-Year Override | Renewal Override | Typical Requirements |
|---|---|---|---|
| GA | ~$50/yr | ~$25/yr | 5 agents · 100 apps/yr |
| MGA | +$50/yr | +$25/yr | 25 agents · 250 apps/yr |
| SGA | +$50/yr | +$25/yr | 50 agents · 500 apps/yr |
| FMO | +$25/yr | +$12.50/yr | 100 agents · 1,000 apps/yr |
The stacking: each level earns the increment between its level and the level below it. If you hold an MGA contract and place a GA agency under you, they earn the GA override (~$50/yr) on each new enrollment and you earn the MGA increment (~$50/yr) on top. Put a street-level agent under you at MGA and you collect both the GA and MGA increments yourself (~$100/yr) on each of their enrollments — because there's no agency between you and the writing agent absorbing the GA piece.
These are rules of thumb — for the actual levels and amounts included in our hierarchy, see the Hierarchy Levels & Commissions schedule.
Med Supp overrides: usually a percentage of premium rather than flat amounts, with more levels than MA; each level above street is typically worth an extra 0.5–1% of premium. There is no universal leveling standard across carriers.
How you actually qualify for an override level
Override levels aren't handed out — carriers set specific requirements you have to hit per carrier before they'll raise your level. In general, you need to meet all of the following:
- Production threshold: a minimum number of net enrollments (or premium, for Med Supp) written with that specific carrier over a defined lookback period. Production with Carrier A doesn't count toward Carrier B.
- Licensed agent count: a minimum number of licensed, contracted, and often actively-producing agents in your downline for that carrier.
- Time under upline: most carriers enforce a minimum contracting period under your current upline before you're eligible for a level raise — typically 6–12 months, sometimes longer. This prevents constant level-hopping.
Both the production number and the licensed-agent count have to be met — hitting one without the other doesn't qualify you.
Level raises aren't guaranteed. Even after you clear a carrier's stated thresholds, the raise itself is offered at the discretion of your upline — an FMO or SGA can choose whether, when, and at what level to move you up. Pick an upline that publishes its levels, honors them consistently, and actually wants you to grow.
Carrier-Specific Requirements
Every carrier's thresholds are different. For the full breakdown of each carrier's override levels, production requirements, agent counts, and time-in-hierarchy rules, see our master schedule:
Carrier Override Levels & RequirementsTiming
When you get paid
- • Most carriers pay street commissions in the weeks following the plan's effective date; nearly all pay within the month after.
- • Overrides vary more — some carriers pay off the submission date rather than the effective date.
- • Chargebacks for early disenrollment are deducted from later statements.
Know your worth. Then come talk to us.
Topflight VP helps independent agents get top contracts, keep ownership of their book, and get paid directly by carriers. Whether you're writing your first MA app or building a downline, we'll show you exactly how the money works before you sign anything.
Commission figures reflect 2026 CMS maximums and typical carrier schedules; actual amounts vary by carrier, state, product, and contract. This page is for licensed agents, not Medicare beneficiaries.