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How to Become a Medicare Insurance Agent

Written by Lexi Williams

February 10, 2021

Want to start selling Medicare insurance but do not know where to start? This article will break it all down and show you how you can build a career as a Medicare insurance agent in 5 years or less – and create a residual 6 figure income.

Job Description at a Glance

It is simple. When you become a Medicare insurance agent, there are two main groups you are marketing to.

  • Those are turning 65 and becoming eligible for Medicare health benefits.
  • Those who are disabled, under 65, and are eligible for Medicare.

Selling Medicare health insurance can be rewarding in many ways, including personally, professionally, and financially. You are helping a lot of people who need it and building strong relationships along the way.

Steps to Becoming a Medicare Insurance Agent

  1. Get your health insurance 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

Getting Licensed

Learning how to sell Medicare is simple, but it takes work to maintain your residual income every year.

The first thing you’ll need to do is obtain a health insurance license in the state you currently live in (known as your resident state health insurance producer license). Aside from this being a requirement, you will get the fundamental training needed to understand how health insurance plans, including Medicare, work.

Some of the critical areas to study 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

A few significant vendors offer health insurance license training, and many states require specific hours of study to take the health insurance license exam. There are two requirements you may have to meet to get your health insurance license to sell Medicare.

Course to Study for Health Insurance License

There are states which require and offer classroom training with a licensed health insurance agent who will help prepare you for the exam. This is a convenient option, as you have someone who can answer your questions as you progress through the course. This training usually lasts a week, with the exam coming at the end of the class.

Self-Study Health Insurance License Prep

Some states, however, offer self-study instead. If you prefer studying on your own time, there are options in books or electronic formats. This is useful if you want to learn at your own pace – many of these also can contact a licensed individual via a web chat or 800 number.

After passing the exam, you are officially certified to sell health insurance products in your resident state after the testing center sends your successful score to the state. Typically, this can take a few days.

Take note that many health insurance exam vendors also offer life insurance certifications at the same time. While it is not required, selling Medicare and having a life insurance license is a good idea – it provides you the option to offer clients other products they may need down the road.

Complete and Pass AHIP Medicare Training

After getting your license, you have to pass (with at least a 90%) the Medicare annual training and certification through America’s Health Insurance Plans (AHIP).

Understand that selling certain Medicare products does require special certification as determined by the Center for Medicare and Medicaid Services (CMS). CMS regulates Medicare plans, the insurance carriers, and insurance agents and agencies who sell them. AHIP certification will most often start in late June or early July for the following Medicare plan year.

For example, getting certified in June or July 2021 will get you certified to sell for the 2022 plan year.

The exam costs $175 to take each year.

Choosing an FMO

FMO is an acronym that stands for the field marketing organization. These are companies that distribute health insurance plans to agents and agencies on behalf of various carriers. An FMO can help you quickly get contracted and appointed to sell with multiple insurance companies.

Once contracted with an FMO, you will be able to get appointed to sell Medicare products like:

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

Getting off to a fresh start as a Medicare insurance agent involves getting appointed with various carriers and their products, getting commission agreements, and getting marketing support from an experienced team (Agent Pipeline’s marketing team is an excellent resource) to help you maximize your results.

Before choosing an FMO, ask these questions:

  • What kind of Medicare sales training do they provide? (ex. Webinars, online, face-to-face, ride-along)
  • What carriers are they appointed with?
  • Will I be paid directly from the carrier, or will they be assigned to the FMO?
  • Do they provide E&O insurance?
  • How can they help me with Medicare leads and getting in front of interested prospects?

Errors and Omissions Insurance (E&O)

E&O insurance is insurance intended to protect you in the event you give a client incorrect or misleading information and they decide to take legal action against you. As well as getting covered through an FMO, these policies can also be purchased through many property and casualty insurance agencies.

A typical E&O policy covers up to 1 to 3 million dollars, costing you $300-$500 annually. Most carriers will require that you have E&O insurance.

Getting Contracted and Appointed

You have to get contracted with each carrier to get appointed to sell their products. Here is a checklist of what most insurance carriers require for you to become ready to sell:

  • Copy of your current resident and non-resident state health insurance license
  • Copy of your current E&O policy
  • The complete legal questionnaire provided by the insurance company (your FMO will provide you with this)
  • A background check
  • They were passing carrier-specific annual certifications. This is specific to MA & MAPD plans, but more Medicare Supplements are also starting to implement annual certifications.

The time this will take is all dependent on how many insurance carriers you plan on getting contracted with. Because Medicare is highly regulated and many carriers have different processes to get an insurance agent ready to sell (RTS), you will need to be patient during this process. It can take some time to receive your approvals from each company. Most carriers require their certifications to be passed annually before that year’s Medicare annual election period (AEP).

Continuing Education

Some states require different levels of continuing education, so it is essential to keep this up to date to keep your license active. Many states require:

  • Dedicated hours of Ethics and Anti-Money Laundering training
  • Dedicated hours in your area of concentration

You can choose from various options for your insurance CE providers; they can guide you through your state’s requirements.

Medicare Agent Training

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.

Conclusion

Becoming a Medicare insurance agent takes a lot of planning and preparation and patience, but is a rewarding career step. Follow these steps, and you will be on your way to a successful, six-figure career. Consider Agent Pipeline as an option for your FMO as we provide training, back-office support, top of the line marketing assistance, webinars, contracts with top carriers and commissions, and more!

 

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