Note: People often use the term “Medicare agent,” but they’re usually referring to a licensed insurance agent who sells Medicare plans. These licensed insurance agents do not work for Medicare itself so they’re not technically “Medicare Agents.”
Many people are tempted to enroll in a Medicare plan on their own.
These people often don’t like working with licensed insurance agents because they believe agents are pushy, biased, and don’t offer them value.
However, while it’s true that some sales agents don’t have your best interests in mind, the risk of mistakes and penalties that come from doing everything on your own usually outweighs the risk of ending up with a biased agent.
Plus, if you know how to spot a biased sales agent, you can avoid them for good.
That’s why in this article, we’ll go over five ways you can spot a biased agent. We’ll also go over what to look for in an agent, so that you can enroll in a Medicare plan with no hiccups.
Before We Begin: Why Do You Need an Agent Anyway?
Medicare Part A (hospital coverage) and Part B (medical coverage) are standardized programs run by the federal government. Together, these two are known as Original Medicare.
Most people who enroll in Original Medicare also choose to get additional coverage from a private insurance company. The most common types of additional coverage plans are a Medicare Supplement + Medicare Part D Plan, or a Medicare Advantage Plan.
Finding the best plan for you can be very tricky to do on your own. There are so many options, and many people get very confused while comparing plans. Not only that, but there are also permanent penalties that you can incur if you make mistakes.
Licensed insurance agents can help you sort through the many options that you have and help you find the right plan fit for you at no cost to you. If you work with a licensed insurance agent to help you find a Medicare plan, you shouldn’t have to spend anything.
However, some agents are biased towards certain plans. So while you shouldn’t have to pay anything to work with these agents, you might find yourself in a plan that doesn’t work for you if you listen to them.
That’s why we’re going over five ways to spot these biased agents and avoid them, so you can rest assured that you have the best plan fit for you.
5 Ways to Spot a Biased Medicare Agent
#1: They Only Represent One Company
In the insurance world, there are generally two types of agents: captive and independent agents.
- Captive agents are usually employed by a single insurance company and are usually only permitted to sell the products of their employer. If you work with a captive agent, they may not tell you about all your options. Instead, they will typically push you towards one of their specific insurance company’s products.
- Independent agents are not employed by an insurance company, and can usually sell products from several companies. If you work with an independent agent, they can help you enroll in a variety of different plans available in your area. Unlike captive agents, you typically get more options while working with an independent agent.
If you want to find the best plan for you, working with an independent agent usually gives you more options and a more unbiased experience. This is because captive agents tend to be biased towards their employer’s plans (or they may not be permitted to sell other plans).
#2: They Push You Toward One Plan Type
Both Medicare Supplement Plans and Medicare Advantage Plans have pros and cons. The better plan for you will always depend on your life situation.
When looking for an agent, seek out someone who isn’t biased towards one plan type. Some agents will push everyone towards either Medicare Supplement or Advantage, without considering the person’s situation.
There are two main reasons why some agents are heavily biased towards one plan type:
- Some agents are only licensed to sell one plan type. There are several certifications an agent must have before they’re licensed to sell certain Medicare plans. Some agents only have certifications for one plan type, so they tend to be heavily biased towards the plan type they’re allowed to sell.
- Some agents are paid higher commissions for selling one plan type. Many different factors determine which plan type pays agents more. We often see some agents heavily favoring the plan type that pays them more, rather than checking if that plan is a better fit for their client (if you’d like to learn more about how agents are paid, read our full article on commissions).
Remember, enrolling in a plan that isn’t the right fit for you can cost you a lot of money. That’s why, when looking for an agent, take note whether they are biased towards one plan type or if they help you understand all your options.
#3: They Use Pushy Sales Tactics
Choosing a Medicare Plan is a big decision that can have a big impact on your health and finances. One of the last things you need while making this decision is to be rushed into a plan.
However, some agents will try to get you to sign up as quickly as possible before you fully understand all the details. They do this because they simply want to collect their commission, without helping you navigate through the complexities of Medicare.
Tactics some agents use to get you to enroll quickly include:
- Offering “free” benefits if you sign up right away
- Scaring you by saying that if you don’t sign up now, you may not be able to sign up again
- Bothering you with constant phone calls
- Visiting you at your home to persuade you to sign up that day.
Most of all, pushy sales agents will avoid talking about the downsides of the plan that they are selling.
#4: They Don’t Provide Ongoing Service
Once you enroll in a Medicare Plan, your agent will typically be paid commissions every month as long as you have the plan. It’s your agent’s job to represent you when dealing with the insurance companies selling these plans.
Sadly, we’ve seen some agents leave their clients alone once they’ve got them to sign up for a plan.
That’s why, when choosing an agent, it’s critical to look for someone who will assist you with any problems that you run into after enrolling. Your agent should assist you with things such as:
- Reviewing your plan’s changes for the upcoming year
- Shopping for a better plan for you during the Annual Enrollment Period
- Resolving billing issues with your insurance company
- Finding new healthcare providers if your doctor moves out of your plan’s network
- Navigating the rules during life changes (such as moving to a new state)
Remember, your agent is getting paid every month to represent you. It’s only fair that your agent assists you with these things and more while you’re on the plan.
#5: They Don’t Help Educate You About Medicare
Medicare is complicated. That’s why it’s important to find an agent who will help you understand the complexities of Medicare, rather than someone who just tells you what to do without explanation.
A good agent should make you confident that the plan you are enrolling in is the right fit for you. They should also help educate you about:
- All your enrollment periods
- Penalties for late enrollment, HSA contributions, and others
- Medicare IRMAA
- Drug formularies
- Prior authorizations
- Network restrictions
- Etc.
Look for an agent who makes sure you don’t fall into the many pitfalls of Medicare, someone who makes sure you never spend a penny over what you need to.
Looking for an unbiased agent that represents many companies, can sell both Medicare Supplement and Medicare Advantage, doesn’t use pushy tactics, provides after services, and helps educate you about the complexities of Medicare? Call or text our team of licensed insurance agents today at +1 877-360-6565 (TTY: 771)
Frequently Asked Questions About Medicare Agents (FAQs)
Medicare Broker vs. Agent: What’s the Difference?
A broker usually refers to someone who is independent and can represent several insurance companies selling Medicare plans, while an agent can either be an independent agent or a captive agent.
Terms are often interchangeable. Before working with someone to find a Medicare plan, ask them if they’re independent or if they can only represent one company.
How does a Medicare Agent get paid?
Agents are paid commissions by the Medicare plans that they sell.
Medicare Advantage Plans usually pay agents a fixed rate set by the CMS (Centers for Medicare & Medicaid Services), while Medicare Supplement Plans typically pay agents a percentage of the plan premium.
To learn more about how agents selling Medicare plans are paid, check out this video:
Do you need to work with a Medicare Agent or Broker?
No, you’re not required to work with an agent or broker for Medicare. You can do everything by yourself if you want to.
However, there is little to no benefit of doing everything by yourself, since you can get help from a licensed insurance agent at no cost to you. If you go DIY, there are many pitfalls and penalties to avoid.
Should you work with a Medicare Agent or Broker?
Generally yes. Licensed insurance agents can help you navigate the complexities of Medicare, compare the many plans available in your area, and find the best fit for you.
A good licensed insurance agent will also help you should you run into any problems after enrolling in Medicare.
Remember, working with a licensed insurance agent for Medicare shouldn’t cost you anything. So there is little reason not to get professional help.
Do Medicare agents work for Medicare?
“Medicare agents” is a popular term used by people on the internet that typically refers to licensed insurance agents who sell Medicare plans. So in this case, no.
Medicare plans (such as Medicare Supplement, Medicare Part D, and Medicare Advantage Plans) are provided by private insurance companies, not Medicare itself.
Are agents allowed to contact me directly?
The licensed insurance agent you work with can contact you directly.
However, Medicare itself will never call you unless invited to by you. Beware of scammers posing as Medicare to collect your Medicare information.
Can I use more than one agent for Medicare?
You can talk to several different agents to get different opinions. Talking to different agents will also allow you to better determine if the person you’re talking to is biased or has your best interests in mind.
However, only one agent can enroll you in a plan. The agent who enrolls you in the plan will be the one to receive commissions from the plan.
How can I report unethical behavior by a Medicare licensed insurance agent?
If you’d like to report an agent for unethical behavior, you can contact your State Insurance Department and ask how to file a complaint.
The National Association of Insurance Commissioners has contact information for every state’s department on its website.
Want to Work With an Unbiased Agent for your Medicare?
The state you live in and the insurance company you choose will largely dictate whether you end up with an Attained-Age, Issue-Age, or Community-Rated policy.
However, if you choose that plan, it is still up to you. You have to consider whether it’s going to cost you more or less in the long run and whether the perks are worth it.
Need help finding the right plan for you? Our exclusive Medicare workshop will show you what you need to know about Medicare (in simple terms) and help you learn how to choose the best Medicare plan for your needs.
Calvin Bagley is the founder of PlanFit, The Medicare Store, and Nuvo Health. He and his team have helped over 60,000 people navigate Medicare options, and he’s a nationally recognized speaker in the Medicare industry. Most importantly, he’s someone who believes every American deserves clear, honest information without pressure.