Pay caps
CMS raises 2027 agent pay caps: $725 in most states, Part D up 14%
The new ceilings are the highest yet, but carriers decide whether to pay them. Here is every market tier and what to check on your carrier schedules.
CMS has raised the maximum that carriers can pay Medicare agents for the 2027 plan year. Medicare Advantage ceilings rose about 4.5%. Standalone Part D rose 14%, the largest increase on the schedule. A higher ceiling only helps, though, if a carrier chooses to pay it.
The 2027 ceilings
CMS released the fair market value amounts on June 1, 2026. Carriers then had until July 31 to file their own 2027 compensation schedules with CMS.
| Market | Initial | Renewal | 2026 initial |
|---|---|---|---|
| Most states | $725 | $363 | $694 |
| California, New Jersey | $902 | $451 | $864 |
| Connecticut, Pennsylvania, D.C. | $816 | $408 | $781 |
| Puerto Rico, U.S. Virgin Islands | $495 | $248 | $474 |
| Standalone Part D | $130 | $65 | $114 |
Referral fees are capped at $100 for Medicare Advantage and $25 for Part D.
Why the method changed
A federal court vacated parts of CMS’s 2025 rule on agent compensation and administrative payments. CMS therefore went back to its earlier method to calculate the 2027 limits, PSM Brokerage reported. Agents should expect future rulemaking on this topic, and The Commission will track it.
Ceiling versus paycheck
Carriers may pay up to the ceiling, less than it, or nothing at all. Wellcare’s published 2027 schedule matches the CMS maximums in every market tier. Aetna, on the other hand, is paying nothing for new enrollments in 123 plans.
The Part D increase is real money but small per sale. Aetna’s standalone drug plans pay $0 for new enrollments, so the larger ceiling doesn’t help there.
Your move
- Compare each carrier’s 2027 schedule with the CMS ceiling for your state. Anything below the ceiling is a choice the carrier made.
- If you write in California, New Jersey, Connecticut, Pennsylvania or D.C., make sure your schedule reflects the higher regional tier.
- Use the Carrier Compensation Watch to see which carriers pay the full amount.
