Utah · Working with a Medicare agent
Do Medicare Agents Charge a Fee in Utah? How They're Paid
No. A licensed Medicare agent in Utah costs you nothing, and your premium is the same whether you use one or not. The agent is paid by the plan, and for Medicare Advantage and Part D the federal government caps the amount. I am one of those agents, so this is a description of how I get paid. Here are the 2027 numbers, the Utah rules, and the questions I would ask anyone in my chair before October 15 to December 7.
The bottom line
- Your cost is $0. Federal rule requires plans to "Ensure beneficiaries are not charged marketing consulting fees when considering enrollment in MA plans."
- The plan pays the agent. For 2027 CMS caps it at $725 for a first-year Medicare Advantage enrollment and $363 for each renewal year; $130 and $65 for a stand-alone Part D plan.
- Your premium does not change. A Medicare Advantage premium "may not vary among individuals enrolled in an MA plan."
- In Utah's 2026 filings, all 55 Medicare Advantage plan entries reported the same ceiling, so one Advantage plan does not pay more than another at the cap.
- The real limit is the list. An agent is paid only by companies he or she is contracted with, which is why we say we do not offer every plan available in your area.
This is a fair question, and you should ask it of anyone who helps you with a Medicare plan, including me. The short answer is that the plan you enroll in pays the agent, you do not, and the amounts are public.
The federal rule is in 42 CFR § 422.2274. Among the things a Medicare Advantage organization must do is "Ensure beneficiaries are not charged marketing consulting fees when considering enrollment in MA plans." The same section says agents must "Be licensed and appointed under State law" and "Be trained and tested annually," passing with "an 85 percent or higher."
Utah has its own rule about fees, and it applies to every line of insurance. Utah Code § 31A-23a-501(6): "A licensee may not receive noncommission compensation from an insurer, insured, or enrollee for providing a service or engaging in an act that is required to be provided or performed in order to receive commission compensation." In plain terms, an agent cannot bill you for the same work the commission already pays for. Where Utah does allow a separate charge, the statute limits it to "actual or reasonable expenses incurred for services." If anyone asks you for money to compare or enroll you in a Medicare plan, stop and call the Utah Insurance Department.
Who pays for the help, product by product
| What you end up with | What you pay for the help | Who pays the agent | The rule |
|---|---|---|---|
| Medicare Advantage plan | $0 | The plan | Capped by CMS: $725 first year and $363 a renewal year for 2027. Federal rule bars charging you a consulting fee. |
| Stand-alone Part D drug plan | $0 | The plan | Capped by CMS: $130 first year and $65 a renewal year for 2027. |
| Medicare Supplement (Medigap) policy | $0 | The insurance company | No federal dollar cap. Utah rule R590-146-16 sets the shape: first year no more than 200% of the second, level renewals for at least five years. |
| Staying in Original Medicare with nothing added | $0 | Nobody | No commission exists. Worth knowing when you ask an agent whether you need anything at all. |
| Utah SHIP counseling | $0 | Federal and state funding | Counselors do not sell insurance and earn no commission. |
Sources: CMS memorandum of June 1, 2026; 42 CFR § 422.2274; Utah Admin. Code R590-146-16. The $0 in the second column is the cost of the help, not the cost of the coverage; plan premiums, and the Part B premium, are separate.
How much do Medicare agents make per enrollment?
Each year CMS publishes what it calls the fair market value, which is the most a plan may pay an independent agent. The June 1, 2026 memorandum sets the 2027 figures and explains the two tiers: "the compensation amount an organization pays to an independent agent or broker for an initial enrollment must be at or below the fair market value," and the regulations "limit renewal compensation to a maximum of 50% of the FMV."
| Enrollment | 2026 ceiling | 2027 ceiling |
|---|---|---|
| Medicare Advantage, first year | $694 | $725 |
| Medicare Advantage, each renewal year | $347 | $363 |
| Stand-alone Part D plan, first year | $114 | $130 |
| Stand-alone Part D plan, each renewal year | $57 | $65 |
Sources: CMS memorandum, June 1, 2026 — Contract Year 2027 Agent and Broker Compensation Rates, Referral/Finder's Fees, Submissions, and Training and Testing Requirements (PDF copy); CMS — Agent Broker Compensation (CY 2026 Agent-Broker Compensation Data). National column, which includes Utah. Amounts are per member, per year, and are paid only for the months the member is enrolled.
Three things about that table are easy to miss. These are ceilings, and the memo calls the first-year figure "the maximum allowable amount that organizations may pay." The first-year amount is for someone new to that kind of plan; moving from one Medicare Advantage plan to another is a like-for-like change and pays at the renewal level. And when an agent works through an agency, the payment is divided according to their contract, so the figure is what the plan pays out and not necessarily what one person takes home.
What the plans filed for Utah reported
CMS does not only set the ceiling. It also collects what each plan says it will pay and posts the file on its Agent Broker Compensation page. We downloaded the 2026 file and pulled the Utah rows.
Source: CMS CY 2026 Agent-Broker Compensation Data, Utah rows, counted by contract, plan and segment on September 29, 2026. CMS posts the 2027 file before the Annual Enrollment Period.
The useful finding is how uniform it is. Every Medicare Advantage entry filed for Utah reported a top figure equal to the federal ceiling, and every Part D entry did the same. So within Medicare Advantage, the filed maximum gives an agent no reason to prefer one company's plan over another's. What the file cannot show is where inside the range each plan actually pays. CMS has noticed the same gap: for 2027 it is asking plans to voluntarily report "the actual compensation amounts paid," and says the added transparency "will help address concerns, including those expressed by several states, regarding agent and broker compensation raised during the 2026 Annual Enrollment Period."
One more piece of context, because the rules here have moved. A 2024 federal rule tried to rewrite agent compensation, and on August 18, 2025 a federal district court in Texas vacated those changes. The CMS memo says the language "that was effective prior to the issuance of the CY 2025 Final Rule remains in effect until further notice." The figures above are calculated under that earlier method.
How Medicare Supplement commissions work in Utah
Medigap is different. It is private insurance regulated by the state, and CMS sets no dollar ceiling on what the insurance company pays an agent. The commission follows the policy's premium. Utah regulates the shape of it instead, in Utah Admin. Code R590-146-16, and each of its four rules protects the buyer:
- No oversized first year. The first-year commission may be "no more than 200% of the commission or other compensation paid for selling or servicing the policy or certificate in the second year."
- Level renewals. Later compensation "shall be the same as that provided in the second year and shall be provided for at least five renewal years."
- No reward for switching you. When one Medigap policy replaces another, the agent may not receive "compensation greater than the renewal compensation payable by the replacing issuer." Moving you from company to company does not restart a first-year commission.
- No penalty for taking you at 65. "An issuer may not create a disincentive to sell a policy during the open enrollment period," the window when a company must accept you regardless of health.
The third rule matters most in Utah now that the birthday rule lets people change Medigap plans each year. An agent who suggests a switch during your birthday window is paid at the renewal level for it.
Want to know exactly which companies we represent?
Ask us. We will tell you how many companies we are contracted with in your county before we talk about any plan. Free, and nothing to sign. We do not offer every plan available in your area.
Book a coverage review →Where the conflict of interest actually is
I would rather describe this plainly than have you guess at it. An agent is paid when you enroll in something and is paid again each year you keep it. There are three places where that can pull against your interest.
The plans not on the list. An agent earns nothing from a company he or she is not contracted with. That is the reason for the sentence you see on this site and hear at the start of a call: we do not offer every plan available in your area. The complete list for your ZIP code is on Medicare.gov, and it is worth looking at before or after you talk to anyone.
The kind of coverage. The ceiling is the same across Medicare Advantage plans. It is not the same across types of coverage. A Part D plan pays less than a Medicare Advantage plan, and a Medigap commission depends on the policy's premium. If an agent steers every conversation toward one type, ask why that type fits you.
Doing nothing. Sometimes the right answer is to keep what you have, or to stay in Original Medicare. Staying put pays an agent a renewal at most, and Original Medicare alone pays nothing. A recommendation to change should come with a reason you can check, such as a doctor leaving a network or a drug moving tiers.
Agent, SHIP or Medicare.gov
All three are free, and they do different jobs. Utah's State Health Insurance Assistance Program offers one-on-one counseling from people who do not sell insurance and earn no commission. Its statewide line is 1-800-541-7735, and we describe what it can and cannot do in the Utah SHIP post. Medicare.gov and 1-800-MEDICARE list every plan. A licensed agent can complete the enrollment, and is the person you call in March when a claim is denied or a pharmacy says a drug is not covered.
Using more than one is reasonable. Checking the full list on Medicare.gov first, and then bringing an agent the two or three plans you want looked at closely, is a good way to do it.
Five questions to ask any Medicare agent
- How many companies are you contracted with in my county? And which ones available here are you not contracted with?
- Are you paid the same on each plan you are showing me? If not, which pays more?
- What would you be paid if I kept what I have?
- Are you licensed in Utah, and what is your license number? Then check it on the Utah Insurance Department's licensee search.
- Will you be the person I call next year? A renewal commission is paid for service, so ask what the service is.
A good agent will answer all five without hesitation.
What I would do
Decide what kind of help you want before October 15 to December 7. If you want someone with no commission involved, call SHIP early in the season. If you want someone who can enroll you and stay with you, pick an agent who is local, licensed and direct about what he or she is paid. Either way, look at the full list on Medicare.gov once, so you know what the whole shelf looks like.
The plan matters more than who helped you pick it. In Grand County, 33.3% of adults live with high blood pressure and 11.2% with diabetes, per CDC PLACES. For those households the network and the formulary decide what next year costs, and the help, from any of the three sources, is free.
How we know all this: the Medicare On Main Data Desk frames every article with public data — here, the CMS memorandum of June 1, 2026 for every 2027 compensation ceiling, the 50% renewal limit, the court ruling and the voluntary reporting request, quoted as published; the CMS CY 2026 Agent-Broker Compensation Data file, filtered to Utah and counted by contract, plan and segment, for the 65 plan entries and the ranges they reported; 42 CFR § 422.2274 and § 422.262(c), quoted as published; Utah Code § 31A-23a-501 as effective May 6, 2026; Utah Admin. Code R590-146-16; and CDC PLACES county data (2023). No company, plan or commission schedule is named, and no Medigap commission rate is stated, because those are set by private contract and are not published. Medicare On Main is paid by the companies it is contracted with when a client enrolls, and never by the client. This is education, not advice; confirm plans, costs and eligibility with a licensed agent or Medicare.gov. We take no payment from any carrier to feature a plan.
Frequently asked questions
Do Medicare agents charge a fee?
No. For Medicare Advantage and Part D plans, federal rule 42 CFR § 422.2274(c)(8) requires plans to "Ensure beneficiaries are not charged marketing consulting fees when considering enrollment in MA plans." The agent is paid a commission by the plan you enroll in. Utah law adds its own line: under Utah Code § 31A-23a-501(6), a licensee "may not receive noncommission compensation from an insurer, insured, or enrollee" for a service that is "required to be provided or performed in order to receive commission compensation."
How do Medicare agents get paid?
By commission from the insurance company, in two parts. CMS describes it this way: agents "receive an initial payment in the first year of the policy ... and half as much for years two (2) and beyond if the member remains enrolled in the plan." For 2027 CMS caps the national amounts at $725 for a first-year Medicare Advantage enrollment and $363 for each renewal year, and at $130 and $65 for a stand-alone Part D plan. For Medigap, the insurance company pays a commission that is not capped in dollars by CMS.
Is it cheaper to enroll in a Medicare plan without an agent?
No. A Medicare Advantage plan's premium is filed with CMS and, under 42 CFR § 422.262(c)(1), "may not vary among individuals enrolled in an MA plan." The member who enrolled through an agent, the one who called the plan and the one who used Medicare.gov all pay the same premium and get the same benefits. Enrolling on your own is a fine choice, and Medicare.gov's plan finder shows every plan in your county. It does not lower the price.
Do Medicare agents get paid more for some plans than others?
Within Medicare Advantage, the ceiling is the same for every plan. In CMS's 2026 compensation file, all 55 Medicare Advantage plan entries filed for Utah reported the same range, $0 to $694 for a first-year enrollment and $0 to $347 for a renewal. Across product types it differs: a Part D plan pays less than a Medicare Advantage plan, a Medigap commission follows the policy's premium, and a plan the agent is not contracted with pays the agent nothing. That last point is why you should ask how many companies an agent represents.
What is the difference between a Medicare agent and Utah SHIP?
SHIP counselors do not sell insurance and earn no commission, and they can discuss every plan in your county. A licensed agent can enroll you, is paid by the plan, stays your contact afterward, and can discuss only the plans he or she is contracted to sell. Both are free to you. Utah's SHIP line is 1-800-541-7735. Many people use both: SHIP or Medicare.gov for the full list, and an agent for the enrollment and the years after it.
How do I check that a Medicare agent is licensed in Utah?
Look the agent up by name on the Utah Insurance Department's licensee search. Federal rules require anyone selling Medicare Advantage or Part D plans to "Be licensed and appointed under State law" and to be "trained and tested annually," with a score of "85 percent or higher." Ask for the agent's license number, and ask which companies he or she is appointed with for the coming year.
Sources
- CMS memorandum, June 1, 2026 — Contract Year 2027 Agent and Broker Compensation Rates, Referral/Finder's Fees, Submissions, and Training and Testing Requirements (PDF copy) — 2027 ceilings of $725 / $363 and $130 / $65; "at or below the fair market value"; "a maximum of 50% of the FMV"; the August 18, 2025 ruling.
- CMS — Agent Broker Compensation (CY 2026 Agent-Broker Compensation Data) — "an initial payment in the first year of the policy ... and half as much for years two (2) and beyond"; the Utah rows of the 2026 file.
- 42 CFR § 422.2274 — Agent, broker, and other third-party requirements (eCFR) — "not charged marketing consulting fees"; "licensed and appointed under State law"; "85 percent or higher."
- 42 CFR § 422.262 — Beneficiary premiums (Cornell LII) — the premium "may not vary among individuals enrolled in an MA plan."
- Utah Code § 31A-23a-501 — Licensee compensation — subsection (6) on noncommission compensation; subsection (2)(b) on reasonable expenses.
- Utah Admin. Code R590-146-16 — Medicare Supplement Insurance Standards: Permitted Compensation Arrangements (Cornell LII) — the 200% first-year limit, five renewal years, replacements and open enrollment.
- Utah Insurance Department — Licensee search — look up any Utah agent by name.
- Medicare.gov — Find health and drug plans — every plan filed for your ZIP code.
- CDC PLACES: Local Data for Better Health, County 2023 — Grand County high blood pressure and diabetes prevalence.
