For many agents, this year has been a bit frustrating and that is putting it mildly. The 2025 Medicare commissions have been the topic of many conversations. The commission amounts were up in the air for several months before the lawsuits that caused a federal judge to put a stay on a portion of the Medicare Final Rule that directly affects agent commission. As a result of the lawsuits, CMS issued some updates to 2025 Medicare Advantage and Part D broker commissions on July 18, 2024. The new amounts supersede those originally reported by CMS for 2025.
Medicare commission final update – YouTube Video
Important:
The additional administrative fee amounts of $100 for initial enrollments and $50 for renewals of both PDP and MA/MAPD Plans is no longer applicable. In other words, the additional money will not be added to commissions for 2025.
If the judge approves CMS Final rule at some point, the commission rates may increase by $100 for initial enrollments and $50 for renewals. This will be used as a one-time administrative fee to offset the loss of carrier marketing funds.
Although the increase we talked about in the previous paragraph will not be put in place, CMS has approved commission increases for both MA and PDP plan sales. This is due to a FMV (Fair Market Value) increase.
2025 Medicare Advantage commissions
Please keep in mind; the commission rates are not all the same and vary state to state.
In the states of CA and NJ, there will be an increase for initial commissions from $762 per member to $780 per member for 2025. Renewal commissions for CA and NJ are going from $381 per member to $390 per member for 2025.
For CT, DC and PA initial commissions will go from $689 per member for the first year to $705 per member. Renewal commissions for CT, DC and PA will increase from $345 per member annually to $353 per member in 2025.
Puerto Rico as well as the U.S. Virgin Islands initial MA commissions will go from $418 per member annually to $428 per member for 2025. The renewal commissions have increased from $209 a member for the year to $214 per member for the year.
For any state not listed above, initial MA commission amounts have increased from $611 per member annually to $626 per member for 2025. The commission rates for renewals have increased from $306 per member annually to $313 per member for 2025.
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PDP commissions for 2025:
In the case of PDP commissions, commission rates are the same in all states.
Initial commission rates for PDP plans have risen from $100 per member per year to $109 per member per year. Commissions for PDP plan renewals have also increased from $50 per member each year to $55 per member each year.
Medicare Advantage Commissions 2025
Product | Region | 2024 | 2025 | %Increase | 2024 | 2025 | %Increase |
MAPD | National | $611 | $626 | 2.45% | $306 | $313 | 2.19% |
CT, PA, DC | $689 | $705 | 2.32% | $345 | $353 | 2.32% | |
CA, NJ | $762 | $780 | 2.36% | $381 | $390 | 2.36% | |
Puerto Rico, U.S. Virgin Islands | $418 | $428 | 2.39% | $209 | $214 | 2.29% | |
PDP | National | $100 | $109 | 9% | $50 | $55 | 10% |