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What is Medicare?

Medicare is health insurance for people aged 65 or older, people under age 65 with certain disabilities, and-or people of any age with End-Stage Renal Disease, or ESRD (permanent).

Part A

HOSPITAL INSURANCE
Helps cover inpatient care in hospitals. Also helps cover skilled nursing facility, hospice, and home health-care.

Part B

MEDICAL INSURANCE
Helps cover doctors’ services, outpatient care, and home health-care. Also helps cover some preventive services to help maintain your health and to keep certain illnesses from getting worse.

Part C

MEDICARE ADVANTAGE PLUS (HMO OR PPO)
A health coverage option run by private insurance companies approved by, and under contract with, Medicare.

Includes Part A, Part B, and usually other coverage like prescription drugs.

Part D

MEDICINE PRESCRIPTION DRUG COVERAGE
A health coverage option run by private insurance companies, approved by and under contract with Medicare.

Includes Part A, Part B, and usually other coverage like prescription drugs.

Medicare Advantage & PDP Calculator

Calculate commissions for MA & PDP with our Commission Calculator.

Choose your state, plan type (MAPD or PDP) policy effective date, and whether it’s a new plan or a renewal/like plan change.

Examples of New Plan vs. Like Plan Changes

Example 1:

Client new to Medicare Part B. Client enrolls in a Medicare Advantage plan. The client has the current effective date corresponding with part B. Agent will receive full commission for a client being “New to Medicare”.

Example 2:

The client has had an MAPD plan for several years. The client is eligible for a SEP and Agent to enroll the client in a new MAPD plan with a 6/1/2020 effective date.

The agent will be paid $148.75 as the client will be on the new MA plan for 7 months during 2020 and she made a “like plan change”. (7/12 x $255= $148.75).

How to Calculate MA & PDP Commissions:

Effective Dates and Proration Explained

  • Carriers can only pay commissions for months a beneficiary is on the plan.
  • Carriers can only pay commissions for a plan year during the plan year. Business written for the next plan year can’t be paid until January 1.
  • Payments at the Initial Rate for beneficiaries that are “new to Medicare” are for the full Initial Rate regardless of the effective date.
  • Any payment at the Renewal Rate for beneficiaries that make a “like plan change” must be prorated.

Calculate MAPD & PDP Commissions

Data is from CMS – Contract Year 2020 Agent and Broker Compensation Rate

Medicare Resources and Tools

Quoting available on our Medicare product portfolio.

Medicare Carriers

Pinnacle works with a wide variety of carriers to help provide your clients with the best options available.

Medicare News

AEP & Certification Information

Confirm Your Certifications

Make sure you’re certified for this year’s Annual Enrollment Period with your select carriers. See product benefit highlights and view early access to carrier info for next season.

Learn More
Free for all registered Pinnacle agents, Connect4Medicare allows you to quote, compare plans, and enroll. Sell Medicare Advantage, Medicare Supplements, and Part D plans all from one system.
Learn More

Contact Us

Contact a Pinnacle Financial Service representative today for assistance.

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