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The Medicare Referrals program lets agents refer Medicare leads to HealthSherpa’s Medicare team. HealthSherpa’s Medicare team completes a needs analysis & helps the consumer enroll in a Medicare plan.
In this article we’ll cover:
The Medicare Referrals program is not available within carrier-specific account types.
Medicare Referrals program at a glance
The Medicare Referrals program lets agents refer Medicare leads to HealthSherpa’s Medicare team. HealthSherpa’s Medicare team completes a needs analysis & helps the consumer enroll in a Medicare plan.
Applications submitted through the Medicare Referrals program are processed using HealthSherpa’s National Producer Number (NPN). Agents can earn a one-time referral payment when the referred consumer enrolls in a plan.
HealthSherpa will not sell referred consumers any products other than Medicare-related products.
Medicare Referrals can be helpful in these situations:
If an agent is not certified to sell Medicare, Medicare Referrals can be used to support consumers aging into Medicare or other Medicare leads.
If an agent is certified to sell Medicare but a lead wants to enroll in a state the agent is not licensed in, or with a carrier the agent is not appointed with, the lead can be referred through Medicare Referrals.
Participation requirements
To participate in the Medicare Referrals program, agents must have:
A valid National Producer Number (NPN)
An active state license
An active health-related line of authority (LOA) on file with the National Insurance Producer Registry (NIPR)
Agents do not need to be appointed to sell Medicare to use Medicare Referrals.
How to participate
Go to the Bonuses page, then choose the Medicare Referrals tab.
Step 1: Select View & agree to terms
Step 1: Select View & agree to terms
Select View & agree to terms to open the terms and conditions of the Medicare Referrals program.
Step 2: Generate a unique referral phone number
Step 2: Generate a unique referral phone number
Review & agree to the terms and conditions to generate a unique Medicare Referrals phone number.
Step 3: Share the referral phone number
Step 3: Share the referral phone number
Provide the unique Medicare Referrals phone number to consumers who may be eligible for Medicare.
Consumers who contact HealthSherpa using the agent's unique Medicare Referrals phone number will be linked to the agent’s account; the agent does not need to be on the call.
HealthSherpa’s Medicare team completes a needs analysis & helps the consumer enroll in a Medicare plan.
After enrollment submission, HealthSherpa handles post-submission follow-ups & pays a one-time referral payment for each eligible referral.
Medicare enrollment periods
Medicare plans have enrollment periods that determine when a consumer can enroll or make changes. HealthSherpa’s Medicare team will review eligibility & confirm the correct enrollment period during the referral process.
Common Medicare enrollment periods include:
Initial Enrollment Period (IEP): When someone first becomes eligible for Medicare.
Medicare Annual Enrollment Period (AEP): October 15 to December 7 each year. Consumers can make changes to Medicare Advantage or Medicare prescription drug plan (Part D) coverage. Changes made during AEP are effective January 1 of the next year.
Appointment booking for AEP: Starting October 1, agents can begin booking appointments for the upcoming AEP.
Medicare Advantage Open Enrollment Period (OEP): January 1 to March 31. Consumers already enrolled in a Medicare Advantage plan may be able to make a one-time change.
Special Enrollment Period (SEP): When a qualifying event allows a consumer to enroll or change coverage outside of other enrollment periods. Dates vary based on the qualifying event.
Available carriers
Medicare Referrals are available in HealthSherpa for select carriers and states, and vary by product type.
Medicare Advantage
Medicare Advantage
Aetna: AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, VT, WA, WI, WV, WY
Anthem: AZ, CA, CO, CT, FL, GA, IA, IN, KY, LA, ME, MO, NH, NJ, NV, NY, OH, TN, TX, VA, WA, WI
BCBS MI: MI
BCBS NC: NC
Cambia - Regence and Asuris: ID, OR, UT, WA
Capital BlueCross: PA
CareSource: GA, MI, OH
Central Health Plan / Brand New Day (Note: Acquired by Molina): CA
Christus: NM, TX
Cigna: AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, KS, KY, MA, MD, ME, MI, MN, MO, MS, NC, ND, NE, NH, NJ, NM, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WV, WY
ClearSpring: CO, GA, IL, SC, VA
Devoted Health: AL, AZ, CO, FL, HI, IL, NC, OH, OR, PA, SC, TN, TX
Essence Health: AR, IL, KY, MO, OH
Eternal Health: AZ, MD
Gold Kidney: AZ, FL
HAP: MI
HCSC: IL, MT, NM, OK, TX
HealthFirst: FL
HealthPartners: IA, MN, ND, SD, WI
HighMark: DE, NY, PA, WV
Horizon BCBS: NJ
Humana: AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY
Imperial Health: CA
KelseyCare: TX
Medica: AZ, IA, IL, KS, MN, MO, ND, NE, OK, SD, WI, WY
MedMutual: OH
Molina: AZ, CA, ID, IL, KY, MA, MI, MS, NE, NM, NV, NY, OH, SC, TX, VA, WA, WI
Network Health: WI
Paramount (Note: Acquired by MedMutual): MI, OH
Priority Health: MI
Prominence Health: FL, NV, TX
Quartz: IA, IL, MN, WI
SCAN: AZ, CA, NM, NV, TX
Select Health: CO, ID, NV, UT
UHC: AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY
Wellcare: AK, AR, AZ, CA, CO, CT, DC, DE, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NJ, NV, NY, OH, OK, OR, PA, SC, SD, TN, TX, UT, VA, WA, WI, WV, WY
Medicare Supplement & Dental
Medicare Supplement & Dental
Aetna Medicare Supplement
Ameritas Dental
GPM
Medico / Wellabe
Mutual of Omaha
NCD Dental
Tracking bonus payouts
Agents can track bonus payouts on the Bonuses page. Select the Medicare Referrals tab to view the payment dashboard.
To receive bonus payouts, agents must complete additional steps on the Bonuses page so that payments can be processed.
Eligible Medicare Referral payments are processed within 60 days of plan effectuation.
Frequently asked questions
How do agents see which consumers are eligible for Medicare?
Agents can use the Bonuses page to view consumers who are near their 65th birthday and therefore close to or eligible for Medicare. This can include household members, not only the primary applicant.
What types of Medicare plans can be written through Medicare Referrals?
HealthSherpa’s Medicare team can help consumers:
Change or update coverage for someone enrolled in Medicare
Switch from Original Medicare to Medicare Advantage, or vice versa
Join, drop, or change a Medicare prescription drug plan (Part D)
Update to a new plan with the current carrier or switch to a new carrier
What are the Medicare Referral payment amounts?
Referral payments are one-time payments when the consumer enrolls in a plan. Amounts vary by product type:
Medicare Advantage: $100
Medicare Supplement: $200
Medicare prescription drug plan (Part D): $25
Ancillary dental/vision: $25
Are there Medicare Referral renewal bonuses?
No. Medicare Referrals earn a one-time payment when a consumer enrolls in a plan.
If an agent becomes Medicare certified later, can the agent take the consumer back?
Yes. HealthSherpa can continue servicing the consumer for as long as the agent would like. If the agent becomes certified later and wants to service the consumer directly, the agent can request a release.
If an agent refers Medicare consumers to HealthSherpa, then becomes contracted later with that carrier, can the agent obtain consent & take the consumer back?
Yes. HealthSherpa will service referred consumers only for as long as the agent would like. When the agent is licensed & appointed for that carrier, the agent can request a release to service the consumer directly.
Additional resources
For help using HealthSherpa or for other assistance, contact Agent Support. Agent Support is available by phone at (888) 684-1373, by email at Agent_Support@HealthSherpa.com, or by chat directly from your account.
For questions related to Medicare Referrals, contact our Medicare Referrals team by phone at (888) 684-1373 or by email at Medicare@HealthSherpa.com.