How to Become a Medicare Agent: From License to Selling

There is no separate Medicare license. To become a Medicare agent, you hold a state insurance license under your state's rules, pass the Medicare training and testing each plan requires every year with a score of 85 percent or higher, and get contracted, appointed, and product-trained with each carrier before you sell Medicare Advantage (MA) or Part D plans.

This guide covers each step in order: state licensing through NIPR, the annual training CMS assigns to plans, carrier contracting and appointments, and the compliance rules that apply from your first appointment. Every rule comes from CMS, the eCFR and Federal Register, the FCC, NIPR, or a state insurance department.

Key takeaways

• Under 42 CFR 422.2274(b), agents who represent MA organizations must be licensed and appointed under state law if state law requires it, trained and tested every year with 85 percent or higher on all testing, and must document a Scope of Appointment (SOA) before a personal marketing appointment.
• A state license alone doesn't let you sell MA or Part D. You also need each plan's annual training and testing, its plan-specific product training, and an appointment where your state requires one.
• CMS puts the training duty on the plan and doesn't name one required vendor course for 2027, so each carrier decides what it accepts.
• CY2027 marketing rules apply from October 1, 2026. The AEP runs October 15 to December 7, and you may not accept enrollment forms before October 15.
• From day one, you need a written SOA for in-person appointments (with no 48-hour wait), the TPMO disclaimer before you discuss benefits, and a recording of every marketing, sales, and enrollment call.
• Medigap and ACA Marketplace sales are separate from MA and Part D certification.

Is there a separate Medicare license?

No. 42 CFR 422.2274(b) sets three conditions for agents and brokers who represent MA organizations:

1. Be licensed and appointed under State law, if State law requires it.
2. Be trained and tested annually, scoring 85 percent or higher on all forms of testing.
3. Secure and document a Scope of Appointment before a personal marketing appointment.

"Representation" covers more than writing applications. The same section says it includes selling MA, MA-PD, Part D (PDP), and section 1876 cost plans, plus outreach to existing or potential beneficiaries and answering their questions. The training requirement therefore applies before you start answering plan questions, not just before you submit an application.

Pages that describe a "Medicare licensing exam" have it wrong. The exam you take is your state's insurance licensing exam. The Medicare testing comes from the plans.

How to become a Medicare agent, step by step

Here is the usual order. Steps marked "advice" reflect common practice, so confirm them with your carriers or upline.

1. Meet your state's requirements and pass the exam. NIPR says each state sets its own licensing requirements. In most states you must be at least 18, complete any required background check and pre-licensing education, and pass the state licensing exam.
2. Apply for your resident license. NIPR advises waiting at least 48 hours after your exam scores are released before you submit an initial license application. NIPR charges a transaction fee ($5.60 as of its October 2026 page) on top of state fees.
3. Settle E&O coverage (advice). Ask your carriers or upline whether they require errors and omissions coverage before contracting, and have it in place if they do.
4. Choose carriers and start contracting (advice). Decide which carriers you'll represent and whether you'll contract directly or through an upline. Ask each carrier about its deadlines for the plan year.
5. Complete annual Medicare training and testing. Take the general course each carrier accepts and score 85 percent or higher on every test.
6. Complete each carrier's product training. Plan training must cover the products you'll sell, including plan-specific details.
7. Get appointed. Where state law requires an appointment, you need one with each carrier. In some states the appointment is what activates the license. New York DFS says agent licenses require a company appointment to activate.
8. Confirm you're ready to sell (advice). Get written confirmation from each carrier that your contract, training, and appointment are complete for the plan year in every state you'll sell in. Don't take an application for a carrier until you have it.
9. Set up your compliance workflow. Have SOA forms, call recording, the disclaimer, and record keeping ready. Each is covered below.

Who sets each requirement?

How long does it take to become a Medicare agent?

CMS doesn't set a timeline, because most steps depend on your state and your carriers. These are the pieces you can plan around:

• Exam scheduling and license processing vary by state.
• NIPR advises waiting 48 hours after your scores are released before you apply.
• Carriers process contracts, training, and appointments on their own schedules.

As advice, if you want to sell during an AEP, finish your license and start contracting by late summer so training and appointments can clear before October. Ask your upline or each carrier for its dates.

Is AHIP required by CMS, or do carriers decide?

CMS requires the training and testing but not any particular brand of course. Under 42 CFR 422.2274(c)(4), the plan must provide training and testing on:

• Medicare rules and regulations
• The plan products agents will sell, including plan-specific details
• Relevant State and Federal requirements

CMS's 2027 Agent and Broker Training & Testing Guidelines don't name a single required vendor course. Organizations build their own training and use CMS's criteria as a minimum. Many agents call the general course "AHIP," but each carrier decides which vendor course it accepts.

The guidelines also require organizations to test every agent independently. They must keep training records (tools, exams, policies and procedures, and evidence of completion) available to CMS on request. Take every test yourself, with no shared answers.

Because the rule says "annually," you retake training and testing every plan year. Questions to ask each carrier (advice):

• Which general Medicare course do you accept for the 2027 plan year?
• What is your deadline to finish product training?
• How do I get a copy of my completion record?

How do you get a nonresident license to sell Medicare in another state?

You apply through NIPR once your resident license is in place. Each state sets its own conditions:

• Nebraska requires a valid resident producer license in the same lines of authority you're requesting.
• New York receives your home-state certification from NIPR directly, and a New York agent license needs a company appointment to activate (broker licenses aren't appointed). DFS suggests checking with the company you plan to work with before you apply.

As advice, make sure your resident record is accurate before you apply, check each state's NIPR requirements page, and confirm with each carrier that you're appointed in every state where state law requires it.

Does your state have its own Medicare training requirement?

Some states do. Texas requires an agent whose life, accident and health license was issued or renewed on or after April 1, 2010 to complete a TDI-approved Medicare-related products certification course of at least 8 hours before acting as an agent for a Medicare-related product. The agent also needs at least 4 hours of Medicare-related continuing education in each later reporting period.

Ask your state insurance department whether it has a similar requirement before you take your first appointment.

When can you start selling for the 2027 plan year?

Sources: the CMS CY2027 marketing changes, the CMS 2027 training guidelines, and 42 CFR 422.2274(c)(6).

If you're still working on training or appointments during the AEP, confirm with each carrier when you're cleared to sell. The Medicare enrollment periods cheat sheet covers the other election periods.

What compliance rules apply from your first appointment?

Scope of Appointment

The CMS 2027 guidelines say you need an SOA before a personal marketing appointment, whether you started the contact or the beneficiary did through a walk-in, unscheduled call, web chat, or web form. The rule applies when the appointment is tailored to an individual or small group. Marketing events don't need one.

Under the CY2027 rules, the 48-hour waiting period is gone and an in-person marketing appointment requires a written SOA. CMS-4212-F allows the appointment any time after the SOA is completed and allows SOA forms to be collected at educational events. See Medicare Scope of Appointment rules for details.

TPMO disclaimer

Under CMS-4212-F, the TPMO disclaimer no longer mentions State Health Insurance Assistance Programs (SHIPs). It must be said aloud before benefits are discussed, rather than within the first minute of the call (42 CFR 422.2267(e)(41) and 423.2267(e)(41)). Get the wording from our TPMO disclaimer guide and your carriers.

Call recording

All marketing, sales, and enrollment calls must be recorded in their entirety, including the audio of web-based calls.

Pre-enrollment checklist

Before enrollment begins, employed, captive, and independent agents must all discuss CMS's required items (42 CFR 422.2274(c)(12)), including:

• Whether the beneficiary's providers, pharmacy, and prescriptions are covered
• Premiums and cost sharing
• The effect on current coverage, such as Medigap or another MA plan
• The right to cancel

Your NPN, prohibited activities, and data sharing

CMS expects you to provide your National Producer Number with any MA or Part D enrollment you help complete. The 2027 training materials list these among prohibited marketing activities:

• Unsolicited contact with beneficiaries
• Health screenings at marketing events
• Cash or monetary rebates
• Failing to record sales and enrollment calls

Since October 1, 2024, personal beneficiary data you collect to market or enroll someone in an MA plan may be shared with another TPMO only with the beneficiary's prior express written consent. That consent must come through a clear and conspicuous disclosure that lists each receiving entity and lets the beneficiary accept or reject sharing with each one individually (42 CFR 422.2274(g)(4)).

A call opening you can adapt (advice):

"Thanks for calling, [name]. This call is recorded. You asked to go over [products from the SOA], so we'll stick to those today. Before we talk about any plan benefits, I'm required to read you a short disclaimer."

Then read the current disclaimer your carriers give you. For the full call flow, see how to sell Medicare over the phone.

What records should a new Medicare agent keep?

When a single call covers both sales and enrollment, ask your carriers and compliance team how long to keep that recording.

Documentation checklist (advice):

• License and nonresident license approvals, with dates
• Each year's training completion records and passing scores
• Each carrier's contract and appointment confirmation, by state
• Any state Medicare training, such as Texas's course and CE
• A documented SOA for every personal marketing appointment (in writing for in-person appointments; for phone appointments, the format your carriers accept)
• Recordings of every marketing, sales, and enrollment call
• Pre-enrollment checklist review notes
• Written consent for any beneficiary data you share with another TPMO

Does Medicare certification cover Medigap?

No. The 2027 CMS guidelines include an overview of Medigap as a training topic, including the anti-duplication prohibition in Section 1882(d)(3)(A)(i) of the Social Security Act. However, the guidelines govern training for MA, MA-PD, PDP, and cost plans, not Medigap sales. Ask your state insurance department and your Medigap carriers what they require.

Selling ACA Marketplace plans too?

Marketplace registration is separate. Plan Year 2027 registration and training runs through CMS's Marketplace Learning Management System (MLMS). New agents take the full Individual Marketplace training, and returning PY2026 agents may qualify for a shorter course. While CMS's moratorium (below) is in effect, agents without an active 2026 Exchange Agreement can't register for 2027, so this path is on hold for brand-new agents. Without a health-related line of authority from your resident state, you can't access Marketplace systems or help with Marketplace enrollment.

On September 22, 2026, CMS announced a temporary moratorium on 2027 Federal Marketplace registration for agents without an active 2026 Exchange Agreement. CMS also said all existing agents must re-identity-proof through Login.gov or ID.me. Once you register, CMS's tip sheet says your status can take 1 to 2 business days to show on the Registration Tracker and up to 3 business days on Find Local Help. See FFM registration for agents.

What consent do you need to call or text purchased leads?

CMS lists unsolicited contact with beneficiaries as a prohibited activity, so a purchased lead has to have actually asked to be contacted. The FCC's one-to-one consent rule never took effect. An FCC order effective August 29, 2025 restored the prior definition of prior express written consent. That definition still requires a signed written agreement authorizing the seller to send autodialed or prerecorded telemarketing to a specific number.

Read our guides to Medicare cold calling rules and TCPA rules for insurance agents, and review each vendor's consent records with your compliance team before you dial.

Common mistakes new Medicare agents make

• Thinking a state license alone lets you sell MA or Part D.
• Finishing the general course but skipping a carrier's product training.
• Assuming one vendor course satisfies every carrier.
• Selling in a state before the appointment is active, or getting a nonresident license without the matching lines of authority.
• Taking enrollment forms before October 15.
• Sharing beneficiary data with another TPMO without written consent.
• Treating Medicare certification as covering Medigap or the Marketplace.

Where LeadGPT fits

LeadGPT's Profile Page lists you on the MeetBrokers.com directory. If you add your NPN, you can get a License verified badge once the LeadGPT team checks it against public licensing records (see the MeetBrokers guide). Calls you make or answer in LeadGPT are recorded and show up in the Call Log with a transcript and AI summary. Recording is always on with no announcement, so confirm your disclosure and retention rules with your compliance team. Learn more on the features overview.

What to do next

1. Confirm your resident license and lines of authority, and check whether your state has its own Medicare training requirement.
2. Ask each carrier which general course it accepts and its training deadlines for the plan year.
3. Get written ready-to-sell confirmation from each carrier for every state.
4. Set up your SOA, disclaimer, recording, and record-keeping process using the Medicare marketing guidelines guide and the AEP preparation checklist.

This guide is general information, not legal or compliance advice. Confirm each rule with CMS, your state insurance department, your carriers or upline, and your compliance team. You'll find more guides in our insurance sales category, and our editorial policy explains how we research them.