2026 Medicare Commissions & Compliance Guide

Let’s be honest: in the insurance world, the only thing that changes faster than the weather is the Medicare commission schedule. If you’ve been keeping an eye on the headlines for 2026, you already know that we are looking at some of the most significant shifts in years.

I get it: it’s a lot to keep track of. You’re trying to serve your clients, keep up with CMS, and somehow find time to actually grow your business. That’s why I wanted to sit down and break this all down for you. We’re going to look at exactly how much those checks are growing, what the compliance “gotchas” are this year, and how you can actually keep more of what you earn.

We’re all about making sure agents aren’t just busy, but profitable. So, let’s dive into the 2026 landscape.

The Big Pay Raise: Breaking Down the 2026 Rates

First, the good news. If you’ve been grinding in the Medicare Advantage (MA) space, 2026 is looking like a banner year. We’ve seen a massive jump in the Fair Market Value (FMV) maximums: the highest increase in a long time.

On average, we’re looking at about a 10.8% to 10.9% increase for most regions across the board. That’s not just a “cost of living” adjustment; that’s a significant boost to your bottom line.

Medicare Advantage (MA) National and Regional Breakdown

CMS sets these FMV maximums, and for 2026, the numbers are looking healthy:

• The National Standard: For most states, the initial commission has jumped from $626 to $694 per member annually. Renewals followed suit, rising from $313 to $347.
• California & New Jersey: These high-cost markets saw an even bigger jump. Initial commissions are now up to $864 (from $780), with renewals hitting $432.
• CT, PA, and DC: Initial commissions rose to $781, with renewals at $391.
• Puerto Rico & US Virgin Islands: Initial rates are now $474, with renewals at $237.

What About Part D (PDP)?

While Medicare Advantage saw a double-digit percentage spike, Medicare Part D (PDP) commissions are growing a bit more conservatively.

• Initial Commissions: Increased to $114 (up about 4.6%).
• Renewal Commissions: Increased to $57 (up about 3.6%).

It’s also worth noting that referral fees have stayed flat at $100 for MA and $25 for PDP. If you’re relying heavily on referrals, your margins are staying the same, but your direct sales just got a whole lot more valuable.

The “Fine Print” on Those Big Numbers

Before you start planning that vacation based on these new rates, there’s a big caveat you need to understand. These numbers are FMV Maximums. They are not guarantees.

Carriers have the discretion to pay up to these amounts, but they aren’t required to pay the max. Some carriers might keep their rates lower to manage their own overhead, or they might adjust compensation mid-year depending on their specific plan performance. This is why staying informed and having a diverse portfolio is so critical. If you’re putting all your eggs in one carrier’s basket and they decide to pay 20% under the FMV max, your revenue takes a direct hit.

Compliance in 2026: Staying Out of the Doghouse

With more money on the table, you can bet that CMS and the carriers are going to be watching agents more closely than ever. Compliance isn’t just a buzzword; it’s the thing that keeps you in business.

The regulatory landscape for 2026 is currently in a bit of a “wait and see” mode due to ongoing litigation regarding some of the newer CMS rules. However, the core requirements haven’t budged, and you need to be on top of them.

1. The Annual Training Grind

This is non-negotiable. Whether you go through AHIP or NABIP, you have to complete your mandatory annual training and certifications. But don’t just treat it as a “check the box” activity. With the 2026 changes, product knowledge is your best defense against compliance complaints.

2. Disclosure is Your Best Friend

Newer regulations require organizations and agents to be incredibly transparent about compensation. You need to be prepared to disclose the specific rates that plans pay you, including referral fees. Clients in 2026 are more tech-savvy and better informed than ever; if they feel like you’re hiding something about how you get paid, that trust is gone instantly.

3. AI and Underwriting

We’re seeing more carriers use AI and aerial photography for underwriting in the broader insurance space, and while Medicare is different, the “tech-first” mentality is creeping in. Ensure your documentation is digital, secure, and follows every single “Permission to Contact” (PTC) and Scope of Appointment (SOA) rule to the letter.

Strategies for Maximizing Your 2026 Earnings

Higher commissions are great, but the most successful agents I know don’t just wait for the rates to go up. They have a strategy. Here is how you can actually move the needle this year:

Focus on the “Fortune in the Follow-up”

Renewals are where true wealth is built in this industry. With the renewal rate for MA now at $347 in most states, keeping a client on the books for five years is worth nearly $1,800 in “passive” income. If you have 500 clients, that’s a massive annual revenue stream. Don’t just sell and disappear. Set up a system to check in with your clients throughout the year, not just during AEP.

Diversify Your Carrier Relationships

As I mentioned earlier, since carriers don’t have to pay the FMV max, you need options. If Carrier A drops their commission but Carrier B stays at the max, you need to be able to offer Carrier B to your clients (assuming it’s the right fit for them). Having a wide range of options ensures you aren’t at the mercy of one company’s board of directors.

Tighten Up Your Sales Process

In a high-commission environment, competition gets fierce. Everyone wants a piece of the 2026 Medicare pie. This is the year to sharpen your scripts and your “Warm Market” approach. If you aren’t creating a “Buying Atmosphere” rather than a “Selling Atmosphere,” you’re going to lose prospects to the big call centers.

Speaking of process, a lot of agents lose money simply because they make small administrative errors. If you’re worried you might be leaving money on the table, check out our guide on the 7 mistakes costing insurance agents thousands in commissions. It’s a quick read that could save your year.

How Hemati INC Helps You Keep More

Look, we know that being an independent agent is tough. You’re the CEO, the marketing department, the compliance officer, and the salesperson all rolled into one. It’s easy for things to slip through the cracks.

At Hemati INC, our goal is to provide the training and resources you need to stay ahead of these changes. We don’t just want you to see these commission increases; we want you to keep them. Whether it’s through our sales scripts or our community of agents, we’re here to make sure you’re supported.

The 2026 Medicare landscape is full of opportunity, but only for those who are prepared. The rate hike is a gift, but compliance is the lock on the door. Make sure you have the key.

Ready to Level Up?

If you’re looking to scale your agency this year and want to make sure you’re doing it the right way, come join us. You can get started with us here to get access to more deep dives, training, and resources designed specifically for the modern agent.

Let’s make 2026 your most profitable year yet. Keep grinding, stay compliant, and as always: keep your clients first. Everything else will follow.

Disclaimer: Commission rates and regulations are subject to change based on CMS updates and carrier-specific contracts. Always verify current rates with your FMO or carrier partners.