Selecting the right Medicare coverage can be complex and confusing. Working with an experienced, trusted Medicare broker provides value in navigating your options. As you look for a broker, keep these considerations in mind.
Verify Licensing and Certifications
It's essential to work with a licensed broker certified to sell Medicare Plans in your state. Brokers must complete CMS-mandated training, pass an exam, and meet ethical standards. Ask to see the agent or broker's license to confirm it is active and current.
Brokers must obtain certifications for the types of Medicare policies they can sell. For Medicare Advantage and Part D prescription plans, they need AHIP certification. To sell Medicare Supplement insurance plans, they must have a state license and meet specific Medigap training requirements.
Look for Independence and Unbiased Guidance
Choose a Medicare broker who works with multiple insurance carriers. Independent brokers are not tied to a specific company, so they can provide impartial advice. Brokers affiliated with one carrier may be limited in plans or steer you toward that insurance company.
Ask the broker how they select plans to show you. You want someone who will take an unbiased approach to recommend plans tailored to your needs and budget. Beware of anyone pushing you toward a certain plan for their own interests.
Table comparing independent and captive brokers:
Seek Medicare and Marketplace Expertise
Ask brokers about their experience with Medicare specifically, not just health insurance products in general. Medicare Plans have unique rules, coverage options, and pitfalls. You want someone well-versed in the nuances of Medicare and how it interacts with other types of insurance.
Find out how long they've been selling Medicare Plans and what percentage of clients are Medicare beneficiaries. Choose a broker who specializes in Medicare and Marketplace plans. Generalists may not have the required expertise.
Understand How Brokers Are Compensated
Insurance companies pay brokers a commission when they sell Medicare Advantage and Part D prescription drug plans. The commission comes from your premium payments - you won't pay any extra.
Medigap supplemental plans usually don't pay commissions. However, a broker may charge you a fee for assistance selecting Medigap coverage. Get any consulting fee or commission details in writing. Ask if the broker receives bonuses or other incentives from insurance companies.
Ask About Services and Support Offered
A broker provides services beyond just enrolling you in a plan. They should explain Medicare choices in terms a layperson can understand. Ask what support they offer during the year and at renewal time. Good brokers will:
Answer questions about Medicare coverage
Explain plan options without overwhelming you
Assist with enrollment, changes, and terminating plans
Review plan details annually to ensure it still fits your needs
Help resolve claim and billing issues
Assist with finding providers who accept your plan
Table showing broker services:
Consider a Specialized Medicare Broker
While any licensed broker can sell Medicare Plans, those who specialize in Medicare may provide greater experience. Specialized brokers focus exclusively on Medicare Plans. They receive advanced Medicare education and certifications.
Ask if the broker devotes at least 50% or more of their business to Medicare. Do they keep up with the latest Medicare trends and policy changes? Choosing a dedicated Medicare broker usually means getting superior guidance.
Check References and Reviews
References and online reviews offer insights into the reputation and service quality of brokers. Ask for references you can contact to learn about their first-hand experiences. Search online for reviews and complaints. Positive reviews and few legitimate complaints indicate satisfied clients.
Look for brokers who belong to professional organizations like the National Association of Health Underwriters (NAHU) or state associations. Membership often means adherence to ethical sales practices.
Be wary of brokers with many negative reviews, complaints of high pressure sales tactics, or lack of responsiveness. Take online complaints with a grain of salt though.
Meet to Assess Communication Style
Medicare choices involve many personalized factors. Meet with the broker in person or over the phone to get a feel for their communication approach. Do they listen attentively and address your specific situation? Or do they seem distracted and pushy?
A quality broker will have a system for comparing plans based on your prescriptions, healthcare needs, doctors, and budget. Share any concerns and see if the broker clearly explains options tailored to you.
Ask Plenty of Questions
Any broker should be willing to address your questions upfront. Here are some suggested questions to ask:
Are you licensed in my state? May I see your license?
Do you have certifications for selling Medicare and/or Medigap Plans?
Do you work independently with multiple insurance companies?
How long have you specialized in Medicare Plans?
What percentage of your clients are on Medicare Plans?
How many Medicare policies do you sell each year?
Do you also sell other types of insurance?
How are you compensated for helping me with Medicare Plans?
What services do you provide throughout the year?
Will you review my plan annually or do I need to contact you?
Can you provide references I could contact?
Documenting the broker's answers helps when making your choice. Reach out to your State Health Insurance Assistance Program (SHIP) if you have any concerns about a broker's business practices.
Compare Multiple Brokers
Shop around and talk to several brokers before deciding. Compare their experience, services, communication styles, and how well they address your preferences. A thorough search improves your chances of selecting someone you trust.
Ask each broker the same questions and discuss the same scenario. Take notes on their responses and recommendation approach. Going with the first broker you contact may not result in the best fit.
Print out this checklist to bring with you when speaking with brokers:
[ ] Licensed in your state
[ ] Certified for selling Medicare Plans
[ ] Specializes in Medicare
[ ] Independent broker with multiple carrier options
[ ] Explains Medicare options clearly
[ ] Listens to your needs and preferences
[ ] Provides customized plan recommendations
[ ] Outlines services offered
[ ] Answers questions knowledgeably
[ ] Few legitimate complaints
[ ] You feel comfortable communicating with them
Use a Broker to Avoid Pitfalls
Navigating Medicare on your own leaves you at risk for mistakes. Common pitfalls include missing enrollment deadlines, picking the wrong coverage, and overpaying. An experienced broker provides expertise and guidance to avoid missteps.
Brokers save you time researching plans. They ensure you follow rules for enrollment periods, coordinating plans, and late penalties. Their familiarity with insurer differences prevents you from overpaying on premiums.
Offer an Objective Third-Party Perspective
Emotions sometimes influence healthcare decisions. Brokers logically assess plan features and cost. Their detached analysis provides reason when you may be led by fear, confusion, or other feelings. Leaning on their objectivity helps prevent poor choices.
Brokers also reduce frustration when dealing with Medicare red tape. They know workarounds and have contacts at insurance companies to resolve issues. With a broker's help, you avoid hassles.
Provide Ongoing Support and Plan Reviews
Your Medicare broker should be a year-round resource, not just at enrollment. They can answer questions about your coverage, explain healthcare changes, and review plan options during open enrollment.
You also need support when transitioning from employer plans to Medicare. Your broker should coordinate timing and discuss replacement policies.
Schedule an annual review with your broker to confirm your current plan still fits your needs and budget. Discuss anticipated changes that may impact coverage like retirement, moving, or surgery. They will handle making any necessary adjustments to your plan.
Simplify Complex Medicare Decisions
Medicare's intricacies lead many to delay enrollment or make uninformed choices. Brokers turn the complex into comprehensible. They translate how Medicare works into plain English.
Your broker helps distill reams of plan data into simple comparisons. They guide you to affordable plans with your doctors and prescriptions covered. Specialized Medicare brokers have a framework to simplify decision making.
Save You Time and Effort
Selecting and enrolling in Medicare Plans takes many hours for a layperson. You need to research plans, compare costs and coverage, and wade through paperwork.
Brokers have efficient systems to gather your healthcare details and preferences. They streamline the legwork of collecting plan data. The time savings they provide is invaluable during busy enrollment periods.
Know Cost-Saving Strategies
Medicare brokers are up to speed on cost reduction strategies that you may be unaware of. They advise you on plans and programs to maximize savings. This expertise prevents you from overpaying.
For example, brokers ensure you avoid late enrollment penalties by enrolling at the right time. They identify ways to lower your prescription costs. Knowledge of state and federal programs provides additional savings on premiums and copays.
Understand Healthcare Plans and Systems
Navigating healthcare coverage spans Medicare, Medicaid, employer plans, disability, and military benefits. It's hard for laypeople to grasp how these pieces fit together.
Brokers stay current on rules across different types of health insurance. They capably handle coordination and transitions between these programs. Their system knowledge brings order to the chaos.
Make Enrollment Less Stressful
For many, signing up for Medicare induces worry or frustration. Determining your specific needs and finding a plan feels overwhelming. Brokers allow you to offload the stress of navigating plans.
Leaning on your broker's expertise brings confidence to enrollment. You have a guide to answer all your questions and handle the details. Removing the stress makes enrollment easier.
Offer Personalized Recommendations
Every person's healthcare situation and needs are different. Brokers avoid a one-size-fits-all approach. They take a "needs-based" process tailored to you.
Discuss your specific doctors, prescriptions, healthcare issues, budget and preferences. Brokers use this data to conduct a personalized analysis of plan options. Following an annual review, they recommend adjustments to continue meeting your needs.
Provide Local Market Expertise
Insurance options and costs vary by geography. Local brokers understand specifics for plans available in your county. They know regional insurers' coverage details, provider networks, quality ratings, and reimbursement patterns.
This experience with your market's trends helps brokers pinpoint suitable plans. Out-of-town agents lack the same insights on local plan differences.
Are Familiar with Doctors and Facilities
Understanding doctors and hospitals that accept certain plans informs recommendations. Brokers regularly check provider networks and changes.
Rather than starting your search from scratch, your broker researches facilities and physicians important to you. They leverage insights from past clients' experiences to advise plans with top doctors in-network.
Offer Troubleshooting and Advocacy
During the year, brokers provide assistance to save you headaches. If you have claims denied or billing errors, they'll go to bat for you. Brokers use their relationships and knowledge to resolve issues.
For problems with Medicare or Medicare Advantage, a broker often has contacts within the government or insurers. They troubleshoot errors and guide appeals if coverage is wrongly denied. Having an expert on your side pays off.
Shop Plans for You
Help enrolling is a key benefit of working with a broker. They handle the legwork of researching and comparing plans in your area. The broker presents you with a personalized analysis of your options.
Brokers have access to tools normal consumers don't for efficiently evaluating Medicare and Medigap Plans. Monitoring marketplace changes and new plans each year allows them to consistently recommend the best fit for you.
Verify Provider Coverage
Seeing a specialist or getting surgery can carry surprises if the provider falls outside your plan's network. Your broker double-checks your plan covers key doctors and hospitals before enrollment.
When getting referred to a specialist, let your broker verify in-network options to prevent surprise bills. If you need to change primary care doctors, they'll ensure your new selection accepts your coverage. Doing the footwork to verify provider coverage prevents headaches.
Aid Switching Plans
You may need to switch Medicare Advantage or Part D Plans during open enrollment due to pricing changes, shrinking networks, formulary changes, or new options. Your broker simplifies this transition.
They'll explain your choices, enroll you in your new selection, and handle plan termination. Brokers shepherd all necessary paperwork and ensure no coverage gaps between plans. Their expertise prevents enrollment mistakes when switching.
In modern times, convenience and ease of service are must-haves. Top brokers provide 24/7 availability by phone, email, and even text in some cases. They offer in-home visits for those less mobile.
Look for a broker that makes the process as convenient as possible for you. Many handle enrollments from start to finish quickly online or through fax and email. Leveraging a broker's convenience perks saves you time and hassle.
Remove Risk of DIY Mistakes
Attempting Medicare enrollment without guidance often leads to errors. Even savvy individuals can accidentally miss deadlines, face late penalties, pick the wrong coverage, or overpay for plans.
Brokers eliminate the risk and frustration from do-it-yourself enrollment. Relying on expert assistance reduces chances for mistakes. Their knowledge of Medicare prevents missteps that you may never notice until it's too late.
Are Your Ongoing Medicare Resource
The most valuable brokers act as year-round Medicare resources. They want to form long-term partnerships with clients. Follow up with your broker whenever Medicare questions arise.
Keep their contact information handy in case issues come up with your coverage. Good brokers take satisfaction in providing ongoing education and support regarding your Medicare benefits.
Let You Offload Stress
Between premiums, deductibles, and healthcare needs, Medicare can feel financially and emotionally draining. Offloading the stress onto a trusted broker feels like a relief.
Knowing your broker remains available to answer questions down the road offers reassurance. Their expertise also fills gaps in your Medicare knowledge that may produce anxiety. Having a broker's assistance lightsens the load.
Advise Retirement Planning
A little-known broker benefit relates to retirement preparation. They provide guidance on how Medicare coordinates with retiree health plans and Social Security claiming strategies.
Discuss your retirement timeline and budget with your broker. They'll ensure you transition seamlessly onto Medicare and advise cost-effective solutions. Including them in retirement planning adds value beyond just healthcare.
Offer Competitive Market Pricing
Brokers have a pulse on competitive pricing for plans in your area. They leverage insights on monthly premiums and out-of-pocket costs to identify affordable options tailored to your budget.
Unlike insurance company websites that only show limited plan pricing, brokers access detailed pricing data. They guide you to quality plans with competitive premiums and cost-sharing to provide overall savings.
Provide an Objective Voice
Your broker serves as an objective third-party voice to avoid emotional Medicare decisions. Fear or confusion may lead you toward unnecessary coverage at a high price.
Trusted brokers calmly weigh your specific situation when assessing plan recommendations. Their detached expertise overrides fear-based choices. Having this impartial perspective ensures wise decisions.
Are Prompt and Responsive
Today's consumers demand responsiveness from service providers. Check a broker's availability via phone and email. During open enrollment's crunch, you should expect replies within 24 hours.
Slow response times when asking questions or finalizing enrollment result in frustration. Look for brokers promoting quick interaction through technology like apps, texting, and chat features. Timeliness shows respect and caring.
Offer Services Nationwide
If you split time living in two different places, look for a broker with national reach. Multi-state brokers simplify working with Medicare across geographies.
Ask brokers if they handle enrollment across your state of residence. Are they licensed to advise on plans specific to multiple areas? Multistate brokers allow seamless coast-to-coast service.
Provide Peace of Mind
At the end of the day, trusted Medicare brokers provide you greater peace of mind. They alleviate worries and over analysis about selecting the right plans. You gain confidence knowing an expert guided the decision.
Relying on their specialized Medicare knowledge brings reassurance. Anytime questions come up, you have a knowledgeable resource to call. Offloading the legwork to a broker gives peace of mind.
Next Steps to Find a Broker
Now that you know what to prioritize in a Medicare broker, here are steps to find one who meets your needs:
Ask for referrals from recent retirees on Medicare or request a recommendation from SHIP
Search online listing sites like Medicare.gov, Medicare Plan Finder, or your state's broker registry
Look for brokers with Medicare specialization, certifications, and 10+ years experience
Check licensing and disciplinary history on your state insurance department website
Interview multiple brokers to compare experience, services, and communication approach
Ask for references to get firsthand reviews
Search for online reviews, complaints, and accreditations
Schedule an intro call to evaluate responsiveness and needs assessment process
Use the broker checklist to find one that fits your priorities
Taking the time to evaluate brokers means you get quality assistance with Medicare decisions both now and long term. Following these tips helps ensure you select one you can trust.
We’re Here to Help
You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give the licensed insurance agents at Next Steps Insurance a Call at (717)-271-2326. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.
How do I find a licensed Medicare agent near me?
Check website directories for major insurers or search online using your ZIP code to find local licensed agents.
What services can an insurance agent provide?
Agents can help evaluate your coverage needs, compare Medicare Advantage and Supplement Plans, and assist with enrollment in the plan you choose.
How can an agent help me choose a Medigap policy?
They will review the supplements available in your area and recommend options based on your budget and coverage priorities.
What types of insurance can an independent agent sell?
Independent agents are licensed for both Medigap supplemental policies and Medicare Advantage Plans from multiple companies.
When should I contact an agent?
Reach out during Open Enrollment or when first enrolling to get personalized assistance selecting the right Medicare coverage.
How do I know if an agent is licensed for Medicare?
Check with your state's department of insurance which regulates licenses and can verify an agent is properly licensed for Medicare.
What questions should I ask an agent?
Inquire about their experience, accredited training, carriers they partner with and how they will support you after enrolling.
How much does it cost to work with an agent?
Agent services are free- you only pay the monthly premiums for the actual Medicare Plan you select with their guidance.
How far in advance of enrollment should I contact an agent?
Try reaching out 1-2 months before your initial or annual enrollment windows to allow time for comprehensive plan evaluations.
Will the agent enroll me directly into the plan?
Yes, once you choose a coverage option the licensed agent will submit your complete application on your behalf.
How can an agent help me after I enroll?
They continue supporting you by answering benefit questions throughout the year and advising you on any coverage changes.
Is it better to use an independent agent or insurance broker?
Both are qualified to help but agents work for specific companies while brokers recommend multiple options.