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This year has been very confusing to say the least; as far as Medicare commisions 2025 go. As a result of recent lawsuits regarding the 2025 Medicare Final Rule, CMS issued updates to 2025 Medicare Advantage and Part D broker commissions on July 18, 2024. The newest amounts supersede those originally reported by CMS for CY 2025.

What you need to know

Please note; additional amounts previously stated have been removed. The one-time administrative increases of $100 to initial enrollments and $50 to renewals no longer apply.

This means, the additional money will not be added into the commission amounts anytime in the near future. If the judge approves CMS Final rule at some point in 2025, the commission rates will increase by $100 for initial enrollments and $50 for renewals.

Even without the increases listed above, CMS has increased commissions for both MA and PDP plans. This is due to an increase in the Fair Market Value (FMV). The maximum broker compensation below reflects the increase.

Maximum commissions 2025

It is important to note: commission rates vary by state.

In both CA and NJ, initial commission rates have increased from $762 per member for 2025 to $780 per member for the year.  The renewal commissions for CA and NJ have gone up from $381 per member for the year to $390 per member for the year. 

The states of CT, DC and PA have had an increase in initial MA commissions from $689 per member for the first year to $705 per member for the first year.  Renewal commissions for CT, DC and PA have increased from $345 per member per year to $353 per member per year.

Both Puerto Rico and the U.S. Virgin Islands initial MA commissions have gone up from $418 per member for the year to $428 per member for the year.  The renewal commissions have increased from $209 a member for the year to $214 per member for the year.

In all states not listed above, the initial MA commission amounts have increased from $611 per member per year to $626 per member per year. Renewal commissions have increased from $306 per member for the year to $313 per member for the year.

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Maximum commissions for PDP plans 2024:

The commission rates for PDP plans 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

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Due to the CMS’ Medicare Final Rule, changes have been made to both Part C and Part D Medicare Advantage commissions 2025. The CMS has tried to discourage plan providers from financially incentivizing agents to offer one plan over another using the following compensation rules:

1. Prohibiting enrollment incentives that could cause potential agent bias
2. Implementing fixed commission amounts for MA and PDP sales.
3. Placing a cap on any non-salary agent compensation
4. The elimination of separate admin fee payments by carriers

Medicare Advantage Commissions 2025: Notes

The increases listed below include the additional $100 payment for initial MA commissions and $50 payment for MA renewal commissions.

ADDITIONAL NOTE: A federal court in Texas stayed the provision of the CMS Final Rule that would add the additional $100 and $50 to the CMS max allowable compenstation due to two pending lawsuits. Depending on carrier interpretation, the changes created by the Final Rule may not be applied for the 2025 plan year. If they are not, the commissions listed below would be reduced by $100 initial and $50 renewal for all states and all products (MAPD and PDP)

In addition to the extra payment listed above, there was a commission increase due to an increase in the Fair Market Value (FMV) of MA and PDP plans. The maximum broker compensation below reflects the increase.

We assume carriers will add the additional $50 payment to current MA cases but that is not confirmed.

We also assume a number of PDP plans will not be paying commission in 2025. This is due to the additional $100 and $50 increase that will be applied to PDP plans. If carriers make a PDP plan “non-commissionable” they do not pay commission and do not pay the additional $100 and $50 payments.

Maximum commissions for Medicare advantage plans 2025

It is important to note: all commission rates are not the same.  They vary by state they are available in.

In the sates of both CA and NJ, the initial commission rates have increased from $762 per member for the year to $880 per member for the year.  This is an increase of 15.49% YOY.  The renewal commissions for CA and NJ have gone up from $381 per member for the year to $440 per member for the year.  This also adds up to an increase of 15.49%.

The states of CT, DC and PA have had an increase in initial MA commissions from $689 per member for the first year to $805 per member for the first year. This adds up to an increase of 16.84% YOY.  Renewal commissions for CT, DC and PA have increased 16.81%. Renewal commissions will go up from $345 per member per year to $403 per member per year.

Both Puerto Rico and the U.S. Virgin Islands initial MA commissions have gone up from $418 per member for the year to $528 per member for the year, this amounts to an increase of 26.32% YOY.  The renewal commissions have increased from $209 a member for the year to $264 per member for the year, this is equivalent to an increase of 26.32%.

In all other states not listed above, the initial MA commission amounts have increased 18.82% YOY from $611 per member for the year up to $726 per member for the year. Renewal commissions have increased at a rate of 18.63% from $306 per member for the year to $363 per member for the year.

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Maximum commissions for PDP plans 2024:

The commission rates for PDP plans are the same in all states.

Initial commission rates for PDP plans have gone up by 109% YOY.  This means commissions have gone from $100 per member for the year to $209 per member for the year.  Commissions for PDP plan renewals have also increased by 110% YOY. Commissions have now gone from $50 per member each year to $105 per member each year.

Medicare Advantage Commissions 2025: Side by side comparison

**See “ADDITIONAL NOTE” above regarding CMS max commission amounts

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