2026 Medicare Agent Compensation · Updated July 2026

MA commission chargeback when a member disenrolls in month 1

If a Medicare Advantage member disenrolls in the first month of their plan year, here is exactly how much of your $694 commission the carrier takes back for 2026, why month 1 lands where it does under the CMS recovery rule, and how agents keep month-1 clawbacks from happening in the first place.

Quick answer: A member who disenrolls in month 1 falls inside the CMS rapid-disenrollment window (first 3 months), so the carrier recovers the entire $694 — you keep $0. This is all-or-nothing, not prorated: the enrollment is treated as if it never took hold. A book with several month-1 disenrollments can erase a full payday, which is exactly what a persistency tracker is built to catch early.

Clawed back on one $694 MA enrollment — member leaves in month 1
$694
Rapid disenrollment (within first 3 months) — full recovery
Original commission
$694
Clawed back
$694
Earned & kept
$0
% lost
100%
Based on the 2026 CMS Medicare Advantage initial-year maximum of $694/member and the CMS recovery rule (42 CFR 423.2274): a member who disenrolls within the first 3 months triggers rapid-disenrollment recovery of the entire commission; after that, the carrier recovers a prorated share equal to the months the member was not enrolled. Carrier and IMO/FMO contracts can be stricter — check your agreement. Estimate only, not a guarantee.

Month 1 is inside the CMS rapid-disenrollment window. When a Medicare Advantage member leaves within the first 3 months of enrollment, the plan is required to recover the full $694 initial commission — there is no proration. From the carrier's side the enrollment never really started, so nothing is considered earned. That makes the first 3 months the most dangerous stretch of any policy's life: a single month-1 disenrollment costs you the entire $694 you already booked as income, and it's netted quietly against a future statement where it's easy to miss.

How the month-1 chargeback is calculated for 2026

CMS sets the recovery rule in 42 CFR 423.2274. The 2026 Medicare Advantage initial-year commission national maximum is $694 per member. For a month-1 disenrollment the math is: month 1 is within the first 3 months, so the rapid-disenrollment provision applies and the entire $694 is recovered — full stop. Carriers pay Medicare Advantage at or below the CMS maximum and some IMO/FMO contracts extend the full-recovery window past 3 months, so treat $694 as the CMS-baseline figure and confirm your specific carrier's earn-through schedule.

A wave of them is what actually hurts

One month-1 chargeback is annoying; a cluster is what actually breaks a month. If 10 of your members happened to disenroll in month 1 — a realistic spike after a plan's benefits change or a competitor's marketing push — that's $6,940 (10 × $694) reversed out of income you already spent on the calendar. Because carriers net chargebacks against future commission deposits rather than billing you directly, a bad wave can show up as a mysteriously small statement two months later. The agents who never get blindsided are the ones who reconcile every deposit against the policies that earned it and watch the early-month window like a hawk. (Example figure — your real exposure depends on your book and carrier mix.)

Run your own numbers in 30 seconds

Enter your advance, the advance term, and how many months the policy stayed active to see exactly what you owe back on any policy — Medicare Advantage or final expense.

Open the free Chargeback Calculator →

How agents stop month-1 chargebacks before they happen

You can't undo a month-1 disenrollment once it posts, but you can stop most of them upstream. Three levers do the heavy lifting: (1) right fit at the point of sale — the wrong-network or wrong-formulary enrollment is the one that bounces in the first 3 months; (2) draft-date and card-on-file alignment so a missed premium doesn't quietly lapse the policy; and (3) proactive contact during the chargeback window — a welcome call, a benefits-usage check, a heads-up before a plan change. The one thing all three require is knowing which policies are still inside the window right now, which is a tracking problem, not a talent problem. That's what the retention and persistency trackers below are for.

Frequently asked questions

How much commission do I owe back if my Medicare Advantage member disenrolls in month 1?

You owe back $694 — the full $694. Month 1 is inside the CMS rapid-disenrollment window (first 3 months), which requires recovery of the entire commission, so you keep $0. Your carrier or IMO/FMO contract can be stricter — verify your earn-through schedule.

What is rapid disenrollment?

Rapid disenrollment is when a member leaves the plan within the first 3 months of the enrollment. Under CMS rules the plan must recover the entire commission — not a prorated share — because the enrollment is treated as never having taken hold. Carriers may define an even longer full-recovery window in their agent contracts, so always confirm your specific agreement.

Is the chargeback prorated or all-or-nothing?

It depends on when the member leaves. Inside the first 3 months it's all-or-nothing — the full $694 comes back. From month 4 through the end of the plan year it's prorated: the carrier keeps you paid for the months the member was enrolled and recovers the rest ($694 × unenrolled-months ÷ 12).

Can I avoid the chargeback once the member has disenrolled?

No — once a member disenrolls inside the window the recovery is contractual. What you can control is preventing it: good plan fit at the point of sale, draft-date and card-on-file alignment, and proactive contact during the first several months while the policy is still inside its chargeback window. Knowing which of your policies are still inside that window is the practical key.

Related: other disenrollment months

Disenroll in month 2
2026 MA chargeback if a member leaves in the second month.
Chargeback Calculator
Any advance, term, and active months — Medicare or final expense.

Catch every at-risk policy while it's still saveable.

A month-1 disenrollment costs you $694 you already counted as income — and a handful in the same month can wipe out a payday. The Commission & Chargeback Tracker ($19, Excel + Google Sheets) reconciles every statement and flags clawbacks; the Final Expense Persistency Radar ($25) and Client Retention Hub ($25) surface every policy still inside its chargeback window so you can save it before it lapses. Own them once, no monthly fee.

See the retention toolkits on Etsy →

Official sources

The 2026 commission figure and recovery rule are verified against U.S. government primary sources: