SHIP vs. Medicare Broker: Who Pays Each One? (2026)

A SHIP counselor and a Medicare insurance broker will both help you for free, so the real question is who pays them, and whether that changes the advice you get. A SHIP counselor is paid by the federal government to give unbiased help and has nothing to sell. A broker is paid a federally capped commission by the insurance company whose plan you enroll in. Both can be useful. Knowing which is which is how you use each one well.

In This Guide

• Key Takeaways
• What Each One Is
• Who Pays a SHIP Counselor
• Who Pays a Medicare Broker
• The Incentive Difference That Actually Matters
• SHIP vs. Broker at a Glance
• When to Use SHIP vs. a Broker
• Frequently Asked Questions
• Learn More

What Each One Is

A SHIP, the State Health Insurance Assistance Program, gives free, personalized, and unbiased Medicare counseling to people with Medicare, their families, and their caregivers.5 It is a public program, not a business, and it has no plan to sell. Its counselors help you compare Original Medicare, Medicare Advantage, Part D, and Medigap, and, if money is tight, screen you for Medicaid, the Medicare Savings Programs, and Extra Help.1

A Medicare broker, or independent agent, is a licensed insurance professional who can sell you a Medicare Advantage or Part D plan, and often Medigap. A broker's job is to place a policy. A good one will compare the plans they carry and explain the trade-offs, but they earn a living only when you enroll, and only in the plans they are appointed to represent.3

Neither one bills you. The difference is upstream, in where their money comes from.

Who Pays a SHIP Counselor

SHIP is funded by the federal government. The Administration for Community Living (ACL), an operating division of the U.S. Department of Health and Human Services, funds the state SHIP programs through grants, so there is no bill to send you.1

Because the money comes from a grant rather than from selling anything, the counselor has no financial stake in which plan you pick. Federal law reinforces that: a state applying for SHIP grant money must assure that its staff, volunteers included, have no conflict of interest in providing the counseling.2 ACL goes further and bars anyone holding an active insurance license from serving as a SHIP team member, on the reasoning that the program cannot ensure an active agent would counsel in an unbiased way.4 Medicare's own handbook puts the boundary plainly: SHIPs are not connected to any insurance company or health plan.5

Who Pays a Medicare Broker

A broker is paid a commission by the insurance company whose plan you enroll in. What surprises most people is that the amount is not set by the insurer at all. It is set and capped by federal regulation.3

Under 42 CFR 422.2274 for Medicare Advantage and the parallel 42 CFR 423.2274 for Part D, CMS sets a national "fair market value" (FMV), the amount it determines could reasonably be expected to be paid for an enrollment, and beginning with contract year 2025 plans are limited to the compensation amounts in that section rather than free to set their own. The regulation's base figures for Medicare Advantage run from January 1, 2021: $539 nationally, $607 in Connecticut, Pennsylvania, and Washington, D.C., $672 in California and New Jersey, and $370, lower rather than higher, in Puerto Rico and the U.S. Virgin Islands. For a Part D drug plan the national base is $81. Those are the regulation's base amounts, not this year's cap: a one-time $100 increase applied for 2025 and the figure is adjusted upward each year after, so the current-year amount is higher and is published in CMS's annual rate announcement. In a renewal year, plans pay at 50 percent of FMV.3

Two things follow from that. First, an agent is not free to charge you a fee on top; their pay is the capped commission from the insurer. Second, because the commission comes from the insurer, an agent can only sell you a plan they are appointed to represent. A broker who carries three carriers is choosing among three, not among all the plans in your county.3

The Incentive Difference That Actually Matters

Once you know who pays, the honest question is whether the payment bends the advice. Federal rule anticipates exactly that concern for brokers. A plan may not structure an agent's or broker's compensation to create, in the regulation's words, "an incentive that would reasonably be expected to inhibit an agent or broker's ability to objectively assess and recommend which plan best fits the health care needs of a beneficiary."3 The rule is there because the risk is real: a commission paid only on enrollment, only in appointed plans, is a nudge, even a capped and regulated one.

Three details in the same regulation shape a switch specifically, and they are worth knowing before one is suggested to you. A move from one Medicare Advantage plan to another counts as a renewal year, paying the agent half of fair market value, while a move across product lines, between an MA or MA-PD plan and a stand-alone drug plan or a Cost Plan, can pay the higher initial rate. A beneficiary who takes an MA-only plan plus a separate drug plan produces a payment from each plan, where an MA-PD pays the MA compensation only. And if you change plans within the first three months of enrolling, the regulation requires the plan to take the commission back, which gives an agent a direct reason to discourage an early switch.3

None of that makes an agent's advice wrong. It is the structure sitting behind it, and the same rule gives you something to ask for: before you enroll, CMS requires the agent to fully discuss its required questions and topics about your needs, including whether your current doctors and pharmacy are in the plan's network and whether your prescriptions are covered. You are entitled to that conversation, and you can ask for it by name.3

SHIP sits on the other side of that line by design. It has no commission to earn and no plan to sell, and the law keeps active agents out of the counselor role.4 That is the whole value of a SHIP conversation: the person across the table gains nothing from your decision either way.

None of this makes a broker the wrong choice. A licensed agent does something SHIP cannot: actually place the policy. It makes the two complementary. Get the neutral read first, then enroll with whoever you like.

SHIP vs. Broker at a Glance

When to Use SHIP vs. a Broker

Call SHIP first when you want your options laid out by someone with no stake in the outcome: when you are deciding between Medicare Advantage and Original Medicare with a Medigap plan, when money is tight and you want to be screened for the Medicare Savings Programs and Extra Help alongside the plans, or when you simply do not want the conversation to be a sales conversation.1 You can find your SHIP through the locator at shiphelp.org or by calling 1-877-839-2675.5

Call a broker when you know what you want and need a licensed agent to place the policy, or when you want someone who will handle the paperwork and stay with you at renewal. Ask which carriers they represent, so you know how wide their view is. There is nothing wrong with using both: many people take the neutral read from SHIP, then call an agent to enroll.

Learn More

Find free, unbiased help comparing your Medicare options at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.