General Discussion
Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsBrokers get paid more to enroll seniors in Medicare Advantage
https://www.medpagetoday.com/publichealthpolicy/medicare/120793?xid=nl_mpt_morningbreak2026-04-15&mh=a2cae01907507c09e9666a382ca08a61&zdee=gAAAAABm4xwXiMkCxXC-mlgB7T2YMarb3LGM8Omp13GRvFoPqITo-EjkIo5z03GUEflRQzbBNEeT11iuoQKbki2sQu1p-oz6XlQcYwmUnPzn-Lqe9ojHqVc%3D&utm_source=Sailthru&utm_medium=email&utm_campaign=MorningBreak_041526&utm_term=NL_Gen_Int_Daily_News_Update_active"The system of paying Medicare agents and brokers more money if they enroll someone in a Medicare Advantage plan rather than traditional Medicare with a supplement plan needs to be changed, according to several members of the Medicare Payment Advisory Commission (MedPAC).
"The broker compensation piece really frustrates me," MedPAC member Stacie Dusetzina, PhD, of Vanderbilt University School of Medicine in Nashville, Tennessee, said at a commission meeting on Friday. "I don't think that people should have to work for free, and they are clearly a great source of information. A lot of beneficiaries rely on them, but the differences in how you get compensated across different plans, I think, is not a good thing. We should level the playing field so that your incentive is to get people into the right plan for them, and you don't get paid differently based on which plan they go into."
Gokhan Metan, PhD, of WiseCare AI in St. Louis, agreed. "When I look at the total agent/broker compensation payouts of $6.9 billion reported [by MedPAC staff] -- which, by the way, I believe is an underestimate of what is actually being paid -- if you compare that figure with the $55.2 million [for] SHIP, the ratio is 125 to 1 ... of commercial marketing compensation to objective public counseling. That, to me, is very problematic." Metan was referring to the State Health Insurance Assistance Program (SHIP), a federally funded program with offices nationwide designed to give beneficiaries unbiased information on choosing a plan.
Commission members were discussing a presentation from the commission staff on how beneficiaries choose which Medicare plan to sign up for. The staff cited a 2021 Commonwealth Fund report finding that independent agents and brokers can get paid up to $694 for enrolling a patient in a Medicare Advantage plan, compared with an average of $520 -- depending on state laws and regulations -- for enrolling them in a Medicare supplement plan plus Part D prescription insurance. These differences could cause agents to favor Medicare Advantage plans over traditional fee-for-service Medicare, said Ledia Tabor, MPH, a MedPAC principal policy analyst.".... (more at link)
CousinIT
(12,602 posts)justaprogressive
(6,976 posts)leftstreet
(41,039 posts)Auggie
(33,215 posts)Mine did.
Caveat emptor, folks. Do the homework. Shop around. Talk to people.
badhair77
(5,197 posts)Makes me wonder whom I can trust.
dutch777
(5,090 posts)...have all sorts of incentives to get folks on it like gym memberships, home delivered meals occasionally, etc. nut when you really need care, the coverage is poor compared to traditional Medicare.
Demsrule86
(71,549 posts)open heart surgery, ablation...etc. I have been in and out of the hospital since. I had multiple blood clots three weeks ago...spent two weeks in the hospital...had just gotten out to...had an allergic reaction to Amiadorone...it will heal but damaged my lungs... it has been very expensive and my Advantage plan has been great and covered almost all of it. I also have coverage for Eliquis (expensive) and Prednisone in my hospital plan. My coverage now is less costly and better than my first traditional Medicare plan.
Trailrider1951
(3,582 posts)far less expensive than trad medicare + supplement. I'm glad I have it. It DOES pay to shop around.
Demsrule86
(71,549 posts)questionseverything
(11,860 posts)Private companies until you are too expensive to keep, then they will kick you out and the public system you were starving will pick you back up to cover the most expensive part of your life
If it doesnt happen that way you just got lucky because what I described is their business plan
dutch777
(5,090 posts)And it was a constant struggle to get approvals before care to the point of delaying recovery and increasing her physical suffering and the whole families emotional suffering having to watch it all. I suppose like any other insurance product there are good companies and bad companies and I suspect she and her husband bought more on cost than quality and unfortunately paid for that. You have been through a lot and I wish you the best and an ongoing recovery.
Wifes husband
(737 posts)I have never met a healthcare professional that thinks medicare advantage is a good thing .
I have medicare with Blue Cross and have no complaints. Highly recommend.
Demsrule86
(71,549 posts)Traditional Medicare is expensive and it utilizes insurance as well... for pharmacy and care. I pay nothing ....and I get back part B... It is $400. a month in extra Social security.
Katinfl
(848 posts)We had an excellent plan in FL and when we moved to NC we were worried we would have a hard time one to match what we had. We did find one that is good, though not as good as FL. We believe we are fortunate to have what we have here in NC and also get a good portion of Part B back. That really makes a difference in the monthly budget. I know several people back in FL that have had many, many issues and they have always been satisfied with their MA plan.
Wifes husband
(737 posts)Medicare advantage is a scam. I have seen several patients who could not get treatment because they have medicare advantage. I have a relative who has medicare advantage and thinks it is great, but pays more copays than I do and is restricted as to what doctors he can use. I don't argue with him, or any medicare advantage people, but again, never met a healthcare professional that thinks medicare advantage is good insurance. If you think it works for you, good for you
dflprincess
(29,360 posts)As she encouraged me to sign up for traditional Medicare. She said she stuck with the original.
MontanaMama
(24,731 posts)Weve been working with the same insurance agents as we did for the group health insurance plan we provided to our employees for many years so we trust them. They do not sell Advantage plans out of principle. Traditional Medicare is all theyll deal in. Advantage plans have shown themselves to be unreliable when people actually need them and many providers in Montana will not accept them due to low reimbursements.
Demsrule86
(71,549 posts)I owe very little...less that 1200.
MontanaMama
(24,731 posts)Traditional Medicare?
Emile
(42,546 posts)Two hours before his scheduled surgery for having a total thyroidectomy, removal of the entire thyroid. Something about the thyroid gland was messing up his medication for his leukemia. I don't understand it, but his Advantage plan denied his surgery. He had been in the hospital for an extended time, and his Advantage plan decided his surgery could wait awhile longer.
I will hold onto my G plan.
Soul_of_Wit
(112 posts)They vary from state to state, so it is possible that some states do have better MA plans than other states do. The real risk is that the plan may decide at some point to not cover something that you need to survive. Your only option at that point is to go back to Medicare. The catch is that you now may pay more for your supplement plan (think preexisting condition.)
Personally, I can afford the additional costs of Medicare. I do understand that is not the case for everyone. The simple truth is that Medicare Advantage exists to make profits for the insurance companies offering them. This gives them a financial incentive to limit coverage.