How to get Medicare Advantage contracts, step by step

1. Get the right license

You need an active resident producer license with health (accident and health) authority in your home state. To enroll clients who live in other states, you also need a non-resident license in each of those states. You can apply for non-resident licenses through the NIPR Licensing Center and look up your National Producer Number with NIPR’s NPN lookup.

2. Carry errors and omissions (E&O) coverage

Most carriers ask for proof of E&O insurance during contracting. If you don’t have it yet, tell us on your application and we will point you in the right direction.

3. Complete AHIP and carrier certification every year

Under federal rules, agents who sell Medicare Advantage must be trained and tested every year and score 85% or higher on all forms of testing (42 CFR 422.2274). Many carriers accept the AHIP Medicare training for the general part, then require their own product certification for each plan year.

4. Complete each carrier’s contracting

After you apply here, we start contracting for each carrier you choose and send you the next steps. You provide your license, E&O and banking details and e-sign each carrier’s contract. Carriers usually run a background check and may check debit balance reporting such as Vector One.

5. Get appointed and ready to sell

Each carrier reviews your paperwork and appoints you in the states where you are licensed. Once your training and certification are done, the carrier marks you ready to sell for that plan year. That is when you can start enrolling clients. Contracted agents then get a MiHUB™ login to enroll through HealthSherpa.

6. Moving from another agency

If you are already appointed with a carrier through another agency, the carrier may require a release from that agency or a waiting period before you can move. Rules differ by carrier, so tell us on your application and we will check each one for you. You can also keep some contracts where they are.

7. Plan around the calendar

Carriers can begin marketing next year’s plans on October 1 (42 CFR 422.2263), and the Medicare Open Enrollment Period runs October 15 to December 7 (Medicare.gov: Joining a plan). Training and certification for the next plan year usually open months earlier, so start early if you want to be ready for the fall.

Checklist

• Resident license with health authority, and non-resident licenses as needed
• NPN
• E&O certificate
• AHIP or other accepted training, passed with 85% or higher
• Carrier certifications for the plan year
• E-signed carrier contracts
• Appointments and ready-to-sell status