You need a state insurance license and federal appointment to sell Medicare plans
To sell any Medicare insurance product — whether Medicare Advantage, Medigap, or Part D prescription drug coverage — you must hold a valid state insurance license in the state where you sell, and you must be appointed by the insurance carrier whose plans you represent. The state license proves you know insurance law and ethics. The carrier appointment proves that specific company trusts you to sell its products. You cannot legally sell Medicare plans without both.
The process takes roughly four to eight weeks from start to finish, depending on your state and how quickly you complete each step. Most people complete it while working another job, though some states require you to be sponsored by a licensed agency or carrier before you can sit for the exam.
Key Takeaways
- You must pass your state's insurance licensing exam and hold an active license before any Medicare carrier will appoint you.
- Each state sets its own exam content, passing score, and renewal requirements, so the process varies by location.
- You must be appointed by each carrier whose plans you want to sell — one license does not cover all companies.
- Some states require you to work through a licensed agency rather than directly for a carrier, which affects how you get appointed.
- Your license must be renewed every one to three years depending on your state, and renewal usually requires continuing education hours.
How to get your state insurance license
Start by checking your state insurance commissioner's website for the specific rules in your state. Most states require you to complete pre-licensing education — usually 20 to 40 hours of coursework covering insurance law, ethics, and product knowledge. Some states waive this if you already hold a license in another state or line of insurance. You can take pre-licensing courses online through providers like the National Association of Insurance Commissioners (NAIC) or private vendors.
After you finish pre-licensing education, you register with your state and pay the exam fee, which typically ranges from $50 to $150. You then sit for the state licensing exam, which is usually offered online or at testing centers. The exam covers state insurance law, federal Medicare rules, and ethical conduct. Most states require a score of 70 to 75 percent to pass. If you fail, you can retake it after a waiting period — usually 24 to 48 hours.
Once you pass, your state issues your license, which is valid for one to three years depending on the state. You will need to renew it before it expires, and most states require you to complete continuing education hours during each renewal period — typically 12 to 24 hours per year.
Getting appointed by a Medicare carrier
After your license is active, you contact the Medicare carriers whose plans you want to sell — companies like UnitedHealthcare, Humana, Anthem, or Aetna. Each carrier has an agent recruitment department. You will need to submit an appointment process that includes your license number, background information, and sometimes proof of errors and omissions insurance.
The carrier runs a background check and verifies your license with your state. This process usually takes two to four weeks. Once approved, the carrier issues you an appointment letter, which formally authorizes you to sell that company's Medicare plans. You must keep a copy of this letter on file.
If you want to sell plans from multiple carriers, you must be appointed by each one separately. Some agents carry appointments from three to five carriers so they can offer clients a wider range of options. Each appointment is independent — losing one does not affect the others.
Whether you need to work through an agency
Some states allow you to be appointed directly by a carrier as an independent agent. Other states require you to work through a licensed insurance agency, which then sponsors your appointment. Check your state insurance commissioner's rules to see which model applies where you live.
If your state requires agency sponsorship, you will need to find an agency willing to hire or contract with you, and that agency will handle the appointment process with the carriers. If your state allows direct appointment, you can contact carriers on your own. Either way, you still need your own state license first.
Errors and omissions insurance and other requirements
Many carriers require you to carry errors and omissions (E&O) insurance before they will appoint you. This insurance protects you if a client sues you for giving bad information or making a mistake. The cost varies but typically runs $300 to $800 per year for a Medicare agent. Some agencies include this as part of their contract; others require you to buy it yourself.
You will also need to comply with Medicare's rules on how you market and sell plans. Medicare requires all agents to complete training on Medicare rules and compliance before they can sell, and many carriers require annual refresher training. This training is usually provided by the carrier at no cost and can be done online.
Renewing your license and staying compliant
Your state license must be renewed before it expires — the renewal window and important date vary by state, but most states send renewal notices 30 to 60 days before expiration. You will pay a renewal fee and complete the required continuing education hours. Failing to renew on time can result in your license lapsing, which means you cannot legally sell Medicare plans until you renew.
Your carrier appointments must also be maintained. Carriers may require you to renew your appointment annually or every two years, and they may ask you to confirm your compliance with Medicare rules. If your state license lapses or is revoked, your carrier appointments will automatically terminate.
Keep records of all your licenses, appointments, and continuing education certificates. If a client files a complaint or Medicare audits your sales, you will need to show proof that you were properly licensed and appointed at the time of the sale.
What happens if you sell without a license
Selling Medicare insurance without a valid state license is illegal and can result in fines, criminal charges, and civil liability. Your state insurance commissioner can fine you thousands of dollars, and you may face criminal prosecution depending on the severity. Clients can also sue you for damages if they claim you sold them an unsuitable plan while unlicensed.
If you are caught selling without a license, the carriers you were working with will terminate your appointments, and your state may deny you a license in the future. This can end your career in insurance sales. Always verify that your license is active and current before you sell any plan.
Frequently Asked Questions
Can I sell Medicare plans while my license process is pending?
No. You cannot sell any Medicare insurance until your state license is active. Working as an unlicensed agent, even temporarily, is illegal. Some agencies may let you shadow licensed agents or do administrative work while you wait for your license, but you cannot make sales or give information to clients.
Do I need a separate license for Medicare Advantage, Medigap, and Part D?
No. A single state health insurance license covers all three product types. You do not need separate licenses for each. However, you must still be appointed by each carrier whose specific plans you want to sell.
What if I move to a different state?
You will need to obtain a license in your new state. Some states have reciprocity agreements that allow you to transfer a license from another state, but most require you to pass the new state's exam. Your carrier appointments are usually state-specific, so you will need to notify your carriers of your move and may need to reapply for appointment in the new state.
How much does it cost to get licensed and appointed?
Pre-licensing education costs $100 to $300, the state exam fee is $50 to $150, and your state license fee is typically $100 to $300. Errors and omissions insurance runs $300 to $800 per year. Carrier appointment is usually free. Total startup cost is roughly $600 to $1,500 before you make your first sale.
Can I lose my appointment if I make a mistake on a sale?
Yes. If you sell an unsuitable plan or violate Medicare's rules, the carrier can terminate your appointment. Medicare also has the authority to remove you from the Medicare program entirely if you commit fraud or serious violations. This is why compliance training and keeping good records matter.