How to Become a Medicare Consultant

Co-authored by wikiHow Staff

Last Updated: March 31, 2022 References

If you want to become a Medicare consultant, create a roadmap for your educational and career plans. A Medicare consultant will need a thorough and up-to-date understanding of Medicare's policies and how they will apply to potential clients. Working with the clients Medicare serves, gaining experience as a Medicare specialist, and building your reputation as a healthcare consultant are all milestones along the way. Knowing what steps you need to take now will help you reach your goals.

Part 1

Part 1 of 3:

Completing the Necessary Education

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Complete your high school education. Most healthcare consulting jobs require a high school diploma, so finishing your secondary education is essential. If you don't have a high school diploma, obtain a General Educational Development (GED) certificate.
- Many medicare consulting jobs will require an associate's or even bachelor's degree, so plan on pursuing post-secondary education.^{[1]
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2
Finish an associate's degree program. Completing a two-year degree and open up the range of consulting jobs available to you. Insurance or business-related degrees will best help you prepare for your future career.
- Enroll in a medical billing program, if available at your college. Medical training programs are often available at community colleges to help students understand healthcare terminology and process bills.
- Some medical billing jobs require coding as a prerequisite, although it is not required for all healthcare consultants. Consider taking coding classes at your college or learning basic programming on your own to add coding to your skillset.
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3
Earn a bachelor's degree in healthcare administration. Choose a college with a healthcare administration program and complete your four-year degree. While not all consulting positions require a bachelor's degree, having one will set you apart from less-educated applicants and prepare you for the career.
- If your college does not offer a healthcare administration degree, consider a degree in business or public health.
4
Pursue an advanced degree to qualify for more consulting positions. The minimum education requirement varies between employers, but most prefer applicants with a master's degree. Many healthcare consultants pursue advanced degrees in healthcare administration, human resources, or business.^{[2]
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- Regardless of their specialties, all medical insurance consultants need to have a strong theoretical and analytical understanding of the various healthcare systems. A master's degree is not required but will qualify you for better positions.

Part 2

Part 2 of 3:

Gaining Work Experience

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Volunteer in an elderly or disabled care facility. To gain a thorough understanding of the Medicare system, volunteer alongside those who use it.^{[3]
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Research source} Medicare is mainly utilized by the elderly and people with certain disabilities. Spending time around and serving Medicare users will give you a very personal knowledge, which you can then use to advise clients.
- While pursuing your undergraduate degree, consider working an entry-level job in a care facility. Firsthand experiences around Medicare patients will help you greatly as an insurance consultant.
2
Finish an internship. Apply for internships during your junior or senior year of college, especially if you can find one within Medicare or an insurance-related firm. Experience with healthcare administration will help you when you're ready to apply for jobs.
- Don't just limit yourself to one internship. The more experience you have, the less stressful your job searches will be and the more desirable you will be to employers.^{[4]
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- Ask an established healthcare consultant in your geographic area if you can intern with them, especially if they are a Medicare consultant. The best internships are those closely related to your ideal career, and many consultants would be grateful for the help.
3
Complete healthcare consultancy certification. If you live in the United States, consider pursuing certification in healthcare consultancy. Employers will greatly prefer a certified applicant over others. Certification legitimizes your job skills and marks you as a knowledgeable, experienced applicant.
- As of date, two major healthcare consultant certifications are available. One is the Certified Healthcare Business Consultant (CHBC) offered by the National Society of Certified Healthcare Consultants (NSCHC).^{[5]
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  Research source} You can also choose the ACHE Fellow (FACHE), given by the American College of Healthcare Executives (ACHE).^{[6]
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  Research source} Both are respected among healthcare consultants.
4
Apply to Medicare specialist positions to gain understanding of related policies. Before you begin employment as a consultant, look for Medicare specialist job listings in your area. Medicare specialists work at hospitals and government centers: they inform potential clients about Medicare's benefits and help them apply to relevant programs.^{[7]
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Part 3

Part 3 of 3:

Specializing in Medicare Consulting

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Find work in an insurance consulting firm. Before you specialize in Medicare consulting, you'll want to gain experience working in a consulting firm. Consulting firms help doctor's offices, nursing homes, and individual clients get the most out of their insurance and maximise claims.
- As a consultant within the company, you will be able to specialize in a specific insurance down the road. Focus on gaining experience as an insurance consultant, then brand yourself as a specialist when you have the experience.
2
Enroll in informational courses about Medicare. To become a Medicare consultant, you'll need to be aware of any changes made. You will also need to know the differences between different Medicare plans and the benefits offered by specific states.^{[8]
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Research source} Take informational classes about medicare to keep your understanding relevant.
- Take a Medicare-related course at least every one to two years. Courses are available online at the government-run CMS (Centers for Medicare and Medicaid Services) website.^{[9]
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3
Build an emphasis in Medicare consulting. After you've gained experience as a Medicare specialist, return to insurance consulting. Ask your supervisors at your insurance consulting firm if you can work specifically with clients using Medicare. Use your knowledge gained as a Medicare specialist and/or from Medicare informational classes to advise your clients.
- Remember to keep your Medicare understanding relevant. Information changes at a fairly fast rate, and you don't want to misinform your clients.
4
Advertise yourself as a Medicare consultant. Once you've worked with a substantial amount of Medicare-related clients, begin advertising yourself as a Medicare consultant. Let potential clients know what your specialty is, and network with other consultants who can recommend your Medicare services to others.
- Cold call potential clients to let them know about your services and how they could benefit from your specialization.
- Promote your services online or in local ads to increase your range of potential clients.
5
Open your own private practice. Once you've gained a considerable amount of experience, you could choose to open up your own consulting practice. This will give you free reign to work with specifically Medicare-related clients.
- Building up a consulting business can take effort, so make sure you gain experience in a firm beforehand.^{[10]
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Community Q&A

Question

As a medicare consultant, can I sell Medicare Advantage Plans?

Community Answer

You must be licensed in the state where your client lives, and certified by the insurance plans you are selling.