How to Become a Medicare Consultant

Medicare Advisors provide beneficiaries eligible for Medicare with expert, free advice about plan options available, such as supplements (Medigap) and Part D prescription drug plans. Advisors can assist with enrollment processes while explaining all costs, benefits, and pitfalls in plain English. The best guide to finding a healthcare consulting firm.

Before becoming a medicare consultant, volunteer at an elderly or disabled care facility so you can gain firsthand knowledge of healthcare in America and how it operates. This experience will come in handy when advising clients.

Education and Training

For anyone wanting to become a medicare consultant, first obtaining a health insurance license is the initial step. Most states require taking an educational course prior to sitting for their health insurance exam – these classes typically feature professional instruction that helps participants prepare and pass. An alternative to formal study courses would be self-studying for your examination.

Step two is selecting an agency or field marketing organization (FMO) that can assist in getting appointed and contracted with Medicare insurance companies that you would like to sell for, providing clients with access to a range of Medicare plan options.

You should enroll in a medical billing program offered at your local community college, if one exists, to gain knowledge and skills related to healthcare terminology, reimbursement methods, and classification/coding systems. This will allow you to provide better service for clients while ensuring they get all their legal benefits.

Errors and Omissions insurance (E& O) should also be purchased. It’s mandatory for most insurance agents and will protect you if an error in providing information results in their losing their coverage due to misguided advice given by you.

Attending medicare agent training sessions is also recommended as this will teach you the most effective ways to interact with clients, making them feel at ease while finding them the perfect plan that meets their individual needs and budget. Strategies and resources will also be provided to enhance sales performance. Customer service excellence is at the core of becoming an accomplished Medicare consultant. Be mindful that clients trust you to assist with one of the most consequential financial decisions of their lives, which is choosing you as their advisor, so treat them with respect and kindness. Your training sessions should cover all the latest insurance technology to stay at the top of your game.


Enrolling in Medicare can be intimidating. A Medicare consultant can guide you through your options and help you select the optimal plan for you. They can answer questions about Medicare Advantage plans, supplemental coverage, and prescription drug coverage and provide referrals to other experts or brokers who specialize in this area of coverage. They may even suggest strategies that could save you money over time!

To become a Medicare consultant, a minimum of a bachelor’s degree is necessary in healthcare administration or business. Experience in an office environment such as a doctor’s office or nursing home would also be valuable; certification in specific insurance plans or Medicare programs might also be worthwhile.

Medicare specialists must possess an in-depth knowledge of federal regulations and health insurance carriers, along with solid sales and customer service abilities that enable them to meet or surpass sales goals and maintain high customer satisfaction ratings. Furthermore, Medicare specialists should remain updated with any regulations to provide their clients with accurate information.

A qualified Medicare consultant must possess an in-depth knowledge of Medicare’s various forms and benefits. Furthermore, they must possess expertise with medical coding systems and be able to handle paperwork related to processing claims quickly. Finally, they should be capable of working under pressure and solving problems efficiently.

Before choosing your Medicare advisor, seek referrals from friends and family. Also, search for an independent agent that works with multiple Medicare insurance carriers—licensed advisors affiliated with just one carrier may only recommend plans from that carrier. If there is a particular Medicare option you’re interested in, check its website to see whether it has an affiliate program—this can save both time and money, as it saves having to reapply all over again!


Step one in becoming a medicare consultant is to obtain your health insurance license. While not all healthcare consulting jobs require one, having one will set you apart from less-educated applicants and open doors to more significant opportunities. Many reputable exam vendors provide training courses designed to help candidates pass the health insurance test; such training courses come either online or in book format with access to licensed individuals for support and guidance during testing sessions. In addition, many also provide life insurance license certification; though this certification may not be mandatory for this particular role, it can come in handy should clients require additional coverage later down the road.

Once you have obtained your Medicare agent license, the next step should be finding employment as a Medicare agent. Your best options would include working at either a Medicare insurance brokerage firm or FMO, which are approved to sell products from multiple carriers while offering marketing tools and ride-along opportunities to help reach sales goals successfully.

Apart from working at a Medicare insurance brokerage firm, another effective way of gaining experience is volunteering at an elderly or disabled care facility. Volunteering will give you firsthand exposure to how healthcare systems operate, which will prove invaluable when transitioning to Medicare advisor. You could also enroll in medical billing courses to develop knowledge of healthcare terminology and processes.

As soon as you obtain your Medicare certification, you will be able to take advantage of lucrative commission rates on Medicare-related products, expanding your business while meeting the unique needs of a demographic that requires special care. Furthermore, certification demonstrates your extensive training in senior healthcare and further strengthens trust between providers and patients. Integrity Now Insurance Brokers stands by agents seeking Medicare certification with ongoing support services for them to attain this status.


Medicare can be complex and has numerous rules and penalties for not following them correctly, which could incur costly fines if mistakes occur during the initial enrollment period. With the help of a qualified consultant, mistakes made can often be corrected quickly – however, any individual working as a medicare insurance consultant must understand how their services will be compensated.

Medicare advisors typically receive a commission for every plan they sell, which could range from dollars sold for Medicare Advantage and Part D plans or a percentage of premium sold with Medicare Supplement policies to administrative fees for travel, licensing fees, or software/back office support services.

So, it is essential that one find a Medicare advisor who not only knows their stuff but can also provide impartial advice. One good way is to ask family and friends for referrals or search online for a “Medicare advisor” in your locality; an independent agent typically offers more unbiased guidance.

Recently, beneficiaries looking to avoid costly errors have discovered a new solution – fee-based Medicare consulting companies offer this option, charging either an hourly or one-time fee to help clients select a suitable plan.

Although these consultants may seem appealing, Medicare beneficiaries should avoid them as they could create conflicts of interest and waste their money. A good way to avoid such advisors is to find one who only charges a flat or hourly fee for their advice.

Medicare can be an intimidating market, and seniors often make mistakes during the enrollment process that could have serious repercussions. With its constantly shifting rules and regulations, a knowledgeable advisor is an invaluable asset when selecting plans; even better, using one is free. They may even help save you money!