With Open Enrollment Days Away, MedPAC Report Flags Overwhelming Choices and Agent Incentive Concerns

A chapter in MedPAC's June 2026 Report to Congress examined what the commission called the complexity of Medicare enrollment decisions, arriving as the Annual Enrollment Period opens October 15.

The chapter described the choices facing new and returning Medicare enrollees as multi-layered: when to sign up, whether to select original Medicare or a Medicare Advantage plan, and whether to add Part D drug coverage or buy a Medigap supplement. Participants in beneficiary focus groups described the overall information load as overwhelming.

On agent assistance, MedPAC noted that agents generally contract with several insurers but are not required to represent every carrier operating in a beneficiary's area. A single agent may therefore not present the full range of local plan options. Agents earn commissions tied to initial and renewal enrollments in Medicare Advantage, Medigap, and Part D plans. They can also receive supplemental pay, such as bonuses for reaching enrollment targets, which falls outside the per-enrollment compensation limits that CMS sets.

The chapter also cited CMS findings from a review of hundreds of marketing and enrollment calls. In the majority of those calls, which CMS put at over 80 percent, agents and brokers failed to ask the questions needed to match a beneficiary to the most suitable plan.

MedPAC framed the chapter as background analysis rather than a set of formal recommendations. The commission has placed Medicare enrollment complexity on its 2026 to 2027 analytic agenda, signaling continued study of the issue. With the enrollment window opening October 15 and extending through December 7, the findings give context to beneficiaries weighing whether and how to use agent guidance as part of their plan shopping.