How to Become a Medicare Insurance Agent

If you want to begin working for yourself, setting your own schedule, and getting rewarded for every ounce of effort you put into a job, becoming a Medicare insurance agent might be a great solution for you. It will take some time to build your business, but within a couple of years, you’ll start seeing residual income that makes all your efforts worth it.

Job Description

While an insurance agent’s job can involve many things, if you are specializing in Medicare, your target market is very distinct. You’ll be working with anyone age 65 and older or younger individuals who qualify for Medicare because of a disability.

Your audience may be very specific, but the variety of products you can offer is quite extensive. As a Medicare advisor, it will be your job to get to know each and every one of your clients so that you can offer them the products that would be most beneficial in their situation.

A few of the products that most Medicare agents offer are:

  • Medicare supplements (Medigap plans)
  • Medicare Advantage plans (Part C)
  • Prescription drug plans (Part D)
  • Dental, Vision, Hearing (DHV) plans
  • Hospital indemnity plans
  • Cancer polices
  • Life insurance policies

You will discuss your clients’ medical histories, their long-term goals, and even their budget. Then, you’ll educate them on all of their options, helping them sort through which products they are eligible for and which ones make the most sense for them.

Your job doesn’t end there. Once you’ve sold a policy, you’ll need to follow up with your clients to make sure they have everything they need and answer any more questions. You’ll want to stay in touch throughout the year since there are annual updates to Medicare products.

Step-by-Step Guide to Becoming a Medicare Insurance Agent

There are six steps you’ll need to take in order to get your business up and running and begin offering policies to your clients.

Get Your Health Insurance License

Obtaining a health insurance license in your residential state is the very first step in becoming a Medicare insurance agent. It’s also probably the step that’s going to take you the longest. You’ll need to take a course – either in a classroom, online or by self-study – and work hard to understand the material.

You’ll learn about deductibles, coinsurance costs, claims adjudication, insurance networks, healthcare laws, ethics, and compliance standards. Some states require a specific number of hours of study prior to taking the exam, and some do require that you have classroom training. This training is usually completed within a week. Some vendors offer life insurance training in addition to the health insurance portion. If you are able to do it, it can be beneficial to get this completed at the same time.

Once you have completed the learning and studying phase, you’ll take an exam. If you pass, you’ll have your license in just a few days!

Pass AHIP Certification

The Center for Medicare and Medicaid Services (CMS) requires you to pass the AHIP every year. AHIP stands for America’s Health Insurance Plans. You must complete two courses and then pass an exam to get your AHIP certification.

Medicare insurance agent studying to become an Agent
Take the AHIP in June or July each year so that you are certified for the upcoming year’s enrollment.

These courses are not designed to be difficult, especially after your first year. The first course includes information about the Medicare program and how each part of Medicare works. The second course talks about Medicare fraud, marketing compliance, and other ethical issues. Since CMS updates its guidelines each year, you have to take the AHIP annually.

You can take the AHIP in June or July each year so that you are certified for the upcoming year’s enrollment. The exam costs $175.

Get Errors and Omissions Insurance

Errors and Omissions (E&O) insurance protects you in case you give incorrect or misleading information to a client and they choose to take legal action against you. Most E&O policies cover between one and three million dollars and cost between $300-$500 each year. Most insurance carriers require you to have E&O insurance in order to contract with them.

You can purchase E&O insurance through a property and casualty insurance agency or through your FMO, which we’ll talk about next.

Choose a Field Marketing Organization

Field Marketing Organizations (FMO) distribute insurance plans to agents on behalf of the insurance carriers. An FMO will help you get contracted with the carriers of your choice. Once you have a contract with an insurance company, you can begin selling all of the products that we listed in the job description. Most likely, your most popular products will be the Medicare Advantage plans, Medicare supplement plans, and prescription drug plans.

The contract you have with one company is going to allow you to sell their policies, contain your commission agreement and marketing products. For instance, a company may send you brochures, flyers or give you digital access to material you can promote on your own website or social media platforms.

In addition to getting your contracts submitted, and FMO may also help you track your commissions and offer marketing services. You can also purchase E&O insurance directly through your FMO.

When you are choosing an FMO, compare the options that each offers. Do they have any Medicare sales training? What carriers do they offer? How will you be paid commissions? Do they provide E&O insurance? Can they help you with marketing or lead generation?

Contract with Medicare Companies

While your FMO will do a lot of the work for you, you’ll still have to provide some documents to get contracted with Medicare carriers.

Some of the documents you may need include:

  • A copy of your state health insurance license (one for each state you’re licensed in)
  • A copy of your E&O policy
  • A copy of your AHIP
  • The carrier’s legal questionnaire
  • Completion of carrier-specific certifications

Carriers will also get your consent to run a background check prior to issuing your contract. The contracting process can take some time, so you need to plan ahead if you are trying to get contracted for a specific period, like the Annual Enrollment Period.

Complete Continuing Education

Each state requires its own level of continuing education, so you’ll need to know what the laws are in your state to stay current on your health insurance license. Most states require a certain number of hours devoted to ethics and anti-money laundering training in addition to the hours required in your area of concentration (such as Medicare).

You’ll have plenty of options when it comes to CE. Many insurance carriers offer courses, and your FMO may have good recommendations. Be sure to complete these throughout the year so that you do not have to get them all done at once!

Bonus Tips for Medicare Insurance Agents

Becoming an insurance agent requires time, but building a solid book of business takes time, commitment, and extra effort. You must commit yourself to continued training and updates on the Medicare program and the specific products.

One great way to do this is to join communities of other agents, especially ones who also sell Medicare plans. Medicare is a competitive field, but there is plenty of room for everyone. Being part of a community is a great way to stay informed and connected to others who may have helpful advice in areas where you’re struggling.

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