Each year during the Medicare Open Enrollment Period (OEP) and Annual Election Period (AEP), seniors face an uphill task. Deciding on an insurance plan for the next year can be a painstaking process. Depending on where you live, you could have dozens of options in front of you. And with insurance companies ramping up on allowed advertising during this time, you may quickly find yourself inundated with marketing. So how do you choose the best plan? Cue the licensed Medicare agent.
Seniors rely on agents for help deciding how to enroll in Medicare, and they can be an invaluable resource when wading through all the different policies. That said, not all agents deliver the same services in every area. Before you start working with an agent, you should understand the basics of how the system works.
What is a licensed Medicare agent?
While each state will have different requirements, Medicare agents must be licensed to sell insurance in your state and certified to work with Medicare plans. Here are a few other Medicare agent facts you should know:
- Licensed agents pass an annual test administered by the Centers for Medicare & Medicaid Services (CMS).
- All agents earn a commission from the provider whose plan you sign up for. But not all agents are contracted with all providers.
- To discourage Medicare scams, agents must follow a strict set of rules and are never allowed to
- charge a fee for their services,
- offer you bonuses for signing up, or
- visit your home unless you specifically invite them.
Always confirm your agent’s license is current by checking the status with your state’s insurance department.
Choosing the right agent
Regardless of where you live, not all agents sell every plan available in your area. Of course, if you live in a more populated area you’ll automatically have access to more plan options. Rural areas have fewer, but you should still be able to find the best-fit plan for you.
A good agent lays out all your options without pushing you toward one plan or another. And they tell you about all plans that meet your specific needs—even if they aren’t contracted with that provider. That includes advising you on the pros and cons of sticking with your current plan.
There are two types of agents: captive and independent. While both have to meet the same requirements and follow the same Medicare rules, there are some important differences.
Captive agents are contracted to work with one provider. No, they haven’t been kidnapped! They’re “captive” because they can only offer you policies offered by that provider. Captive agents are helpful because they’re experts on the plans they sell. They can provide in-depth details that independent agents selling different plans from different insurers may leave out.
If you know you want to stick with a specific provider, consider working with a captive agent. But if you choose to work with a captive agent, and you want to research competing plans, you’ll have to do that on your own.
Independent agents are also called brokers. Brokers aren’t contracted with any single insurance provider. They can show you plans from different providers and help you choose the best one. And since they aren’t particularly loyal to one provider over another, they have no stake in what plan you choose.
Be careful though, because even independent agents may exclude some of your options. Even with their expanded access, they’re still not necessarily contracted with every provider in your area. To confirm you’re seeing all available plans, use the Medicare Plan finder to determine what’s available where you live, and compare the results to the policies your agent presents.
Guidelines for working with an agent
Before you start working with an agent, gather the following information. These details will help them help you more efficiently:
- Current health needs: Compile a list of current prescriptions, medical conditions and doctors to share with your agent so you can focus on plans that cover your predictable costs and ensure your doctors are in-network.
- Location: Coverage can differ based on where you’re located, so if you plan on travelling a lot or living between two homes, let your agent know.
- Finances: Be prepared to share basic financial information to find out if you’re eligible for aid to help pay premiums.
Don’t be afraid to take the time to shop around! Make a point to connect with at least two or three agents before you decide on one. Read reviews, ask friends or family for recommendations, or search for licensed agents here.
Do I need an agent to find Medicare plans in my area?
You can always opt to self-enroll in Medicare but doing your own research will take a little legwork. If you don’t want the help of an agent, the Medicare Plan finder is a good starting point. You’ll find all the plan options in your area there.
Whether you work with an agent or not, make sure you look at all your options and get quotes from multiple insurers. We can help walk you through all your Medicare insurance options to find a plan that meets your needs and your budget!
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