Do I Need a Medicare Broker?

Medicare brokers, also known as independent Medicare insurance agents, are paid by the insurance companies they represent. There’s no extra fee or cost for enrolling through a broker. The Medicare broker’s commission is included in your premium.

Benefits of working with a Medicare insurance broker:

• Licensed Medicare brokers have collective data about insurance carriers that you may not have access to, like rate trends.
• The Medicare insurance agents offer a variety of plans, so their recommendations are unbiased.

The field is regulated to protect the consumer. It’s against the law for insurance agents to make false or misleading statements to scare you into applying for Medicare coverage with a certain plan. Similarly, Medicare insurance agents aren’t allowed to come to your home to promote or sell any Medicare-related product without being invited by you to do so. They also cannot legally charge you a fee to process your enrollment. By the same token, it’s illegal for Medicare agents to offer a free item or other incentive, such as inviting you to a Medicare plan seminar at a restaurant, to entice you to apply for coverage.

Keep an eye out for Medicare brokers who violate those laws. While most Medicare agents are trustworthy and well-informed, scam artists exist. Before meeting with a Medicare broker, take time to ensure that he or she is licensed and has a relatively complaint-free history. You can visit your state’s insurance department website to find this information.

You should be alarmed if your Medicare broker doesn’t tell you all your plan options. A good broker will let you know the best option even if he or she doesn’t represent the Medicare plan. Your Medicare broker should:

• Make sure your doctors and medications are covered in the Medicare plan.
• Advise you of your best medicare plan options regardless of whether the broker represents a certain plan.
• Know the federal and state programs available to help people with financial limitations.

Generally, Medicare brokers receive an initial payment for the first year of the policy and half as much for year two and beyond if you remain enrolled in the plan. There’s annual training to complete and tests to pass on their knowledge of Medicare and health and prescription drug plans as well as on Medicare marketing rules. They face the risk of losing their license status their state and termination by their contracted health or drug plans if they don’t comply with the rules related to selling to and enrolling Medicare beneficiaries in Medicare plans.

You can get information about your Medicare coverage via Medicare.gov or by calling the Medicare hotline at 860-854-3809 or 860-854-3809 You also can find websites that help you find agent compensation information about the plan or plans you’re interested in. CMS.gov offers broker compensation rates for public viewing. CMS.gov is a federal government website managed and paid for by the U.S. Centers for Medicare and Medicaid Services.