What Does a Medicare Insurance Broker Do?

What does a Medicare insurance broker do? In short, Medicare brokers streamline your journey into Medicare coverage. Medicare brokers assists with plan choices, navigates paperwork, and clarifies your options, making sure you’re confidently enrolled in a plan that matches your health needs and budget.

Key Takeaways

  • Medicare Insurance Brokers are licensed professionals who help individuals navigate Medicare options, ensuring they enroll in plans that suit their healthcare needs and financial situation, adhering to stringent regulations.

  • Medicare Brokers earn their income from commissions set by state insurance authorities or the Federal Government, depending on the plan.

  • An independent Medicare insurance broker places the clients’ interests before commission differences between plan options.

  • Independent Medicare Brokers prioritize education about Medicare options, conduct thorough plan comparisons in benefits and costs, and offer ongoing support post-sale to ensure clients’ needs continue to be met.

What Is a Medicare Insurance Broker?

What Does a Medicare Insurance Broker do?

Understanding Medicare insurance becomes simpler when you have an experienced guide to assist you. Medicare Insurance Brokers are licensed professionals who simplify the Medicare landscape for individuals. They assist in:

  • Evaluating, selecting, and enrolling in a plan

  • Addressing inquiries

  • Aiding clients in selecting the right Medicare plan, including Medicare Advantage and Medicare supplement plans.

A Medicare Insurance Broker, also known as Medicare brokers or Medicare agent, undergoes extensive training on Medicare law and Medicaid services and is officially certified by insurance companies in accordance with CMS guidelines. They are required to adhere to stringent regulations, particularly pertaining to marketing and enrollment, ensuring full compliance with Medicare, state insurance regulations, and private insurance companies.

What is a Medicare Advantage Plan?

Digging deeper into the Medicare field, you’ll come across Medicare Advantage Plans. These are an alternative to Original Medicare that can offer additional benefits and often include prescription drug coverage.

Many Medicare Advantage Plans provide extra benefits that may include some of the following:

  • Vision care

  • Hearing care

  • Fitness programs

  • Dental care

  • Medically necessary transportation

  • Prescription drug coverage

They can coordinate with other types of insurance to cover expenses and offer a comprehensive range of plan benefits.

What Is a Medicare supplement?

You might question, ‘What about the costs Original Medicare doesn’t cover?’ Here, Medicare supplements, or Medigap policies, play a role. Medigap plans provide coverage for expenses that are not covered by Parts A and B of Original Medicare, such as deductibles, copays, and coinsurance. A Medigap policy can set a limit on your financial exposure to Medicare bills.

The best time to buy a Medigap policy is during the six-month enrollment period that begins on the first day of the month in which you turn 65 or older and are enrolled in Medicare Part B. The key here is that your Medigap initial enrollment period starts the day your Medicare Part B coverage starts.

During your Medigap initial enrollment period you can buy a Medigap policy with no health questions or preexisting conditions.

Independent Agents vs. Captured Agents

The choice between an independent Medicare agent and a captured agent is as significant as selecting the appropriate Medicare plan. Independent agents represent multiple insurance companies, offering a wide array of options. This makes them informed advisors who can provide education and guidance in comparing plans, costs, and benefits.

The independent agent represents your best interest.

On the other hand captured agents:

  • Work exclusively for one insurance company

  • Can only offer products specified by the insurance company they work for.

  • May be limited to the offerings of a single insurance company, as opposed to different insurance companies

  • Captured agents tend to be new agents. Working for an insurance company is how many agents get started in this business.

How Do Medicare Insurance Brokers Get Paid?

You might wonder how these brokers make a living. They earn their keep through commissions from insurance companies, rates set and regulated by state insurance authorities or Medicare itself. The commission rates can vary depending on factors such as the type of plan and the membership status of the enrollee.

Typically, Medicare insurance brokers may earn the following commissions:

  • $600-$700 for every new Medicare Advantage plan they sell

  • $300-$400 for annual renewals of Medicare Advantage plans

  • Up to $100 per sale of Medicare Part D plans if you are new to Medicare.

  • $50 for each renewal of Medicare Part D plans

The commission rate can differ from state to state, but the renewal commission generally remains consistent at approximately 10 percent of the plan’s premium.

Do Insurance Brokers get Paid more for An Advantage Plan or Medicare Supplement?

Medicare agents earn higher commissions from selling Medicare Advantage plans compared to Medigap (Medicare Supplement) plans.

With a Medicare supplement, the agent typically earns between 20% and 30% of the monthly premium for a fixed period of time set by the state. Most states limit the payment to six years.

A good Medicare broker should first show you the Medigap plans available to you. This is because Medigap coverage is greater than Advantage plan coverage. Only if the are no Medigap plans that meet your needs and budget should you then explore Medicare Advantage plan options.

What Should I Expect from an Independent Medicare Broker?

Medicare Insurance Broker Near Me

Engaging an independent Medicare Broker comes with specific expectations. A Medicare broker should prioritize education, guiding you through the complexities of Medicare options before suggesting specific plans. They should first review Medicare supplement options, taking into consideration benefits and costs, to assist you in making well-informed decisions.

If a supplement is not in your budget, they should evaluate Medicare Advantage plan options, conducting a comprehensive comparison of benefits and costs to assist you in selecting the most suitable plan for your specific needs.

Educate First

Education forms the foundation of the broker-client relationship. A proficient Medicare broker will provide comprehensive explanations of the various Medicare plan options, such as Medicare Advantage and Medicare Supplement plans, ensuring a thorough understanding of the available options to facilitate informed decision-making regarding healthcare coverage.

To comprehend your specific coverage needs, a Medicare broker may inquire about various aspects such as:

  • Changes to your current plan

  • Availability of new benefits

  • Inclusion of prescription drug coverage

  • Coverage for your prescriptions

  • Length of time enrolled in your current policy

  • Any chronic conditions

  • Prescription drug usage and costs

  • Availability of in-network access to your providers.

Review Medicare supplement Options Benefits and Costs

Reviewing and comparing Medicare supplement options is Medicare insurance agents crucial responsibility. Medicare insurance agents should provide a comprehensive analysis of the benefits and costs of different Medigap plans. This analysis should cover details such as co-payments, deductibles, and premiums, allowing you to understand the financial implications of each plan.

Remember, each Medicare supplement offers a unique set of benefits and coverage options. The broker should guide you through these options, helping you understand how they can meet your healthcare needs and financial situation with Medicare supplement insurance.

Review Medicare Advantage Plans Benefits and Costs

Likewise, your broker should thoroughly review Medicare Advantage Plans. This should include a comprehensive comparison of benefits and costs, allowing you to make an informed decision about which plan is right for you.

The broker should also explain the differences in coverage between Medicare Advantage Plans and Original Medicare. Understanding these differences is crucial for you to make an informed decision about your healthcare coverage.

Should I choose a Local Medicare Broker?

Medicare Man

It is difficult to find a Medicare expert broker who offers all the insurance products available in your area. Most of the time, the local agent has limited experience.

You should seek out the best broker available to help you with your needs. In this day and age, the best agents are always just a phone call away.

Will My Agent Help Me With Medicare After the Sale?

Your interaction with your Medicare agent extends beyond the purchase. A reliable Medicare agent should continue to provide support and assistance even after the sale. This includes offering answers to queries, assistance in identifying an appropriate plan, and furnishing information pertaining to the Medicare process.

Your Medicare agents can assist with:

  • Changes in Medicare coverage

  • Resolution of issues

  • Navigating through various plans

  • Aid in enrollment

  • Handling post-sale issues such as Medicare appeals and objections.

Summary

To sum up, understanding the role of a Medicare Insurance Broker is crucial in navigating the complex world of Medicare insurance and the various insurance products. They serve as your guide, helping you understand the different types of Medicare plans, including Medicare Advantage and Medicare Supplement plans. They can assist in evaluating, selecting, and enrolling in a plan that suits your healthcare needs and fits your financial situation.

Whether you choose an independent agent or a captured agent, a local broker or an online one, the key is to find a professional who keeps your best interest at heart. They should provide education, offer guidance, review different plan options, and continue to support you even after the sale. With their help, you can make informed decisions and find the right Medicare plan for you.

Frequently Asked Questions

Should you use a Medicare broker?

It depends on your personal situation whether you should use a Medicare broker, but many people seeking Medicare plans find their guidance helpful. Consider your individual needs and the complexity of the process.

What is the point of an insurance broker?

The point of an insurance broker is to help you save money by comparing policies, tailoring coverage to your needs, avoiding mistakes and representing you to find the best option. They act as an intermediary between you and the insurance company, providing expertise and guidance.

What are the disadvantages of having a Medicare Advantage plan?

The disadvantages of Medicare Advantage plans include restrictive networks, high out-of-pocket costs, prior authorization requirements, and annual plan changes. It’s important to carefully consider your current and future needs when evaluating your Medicare insurance options.

How are Medicare Insurance Brokers paid?

Medicare Insurance Brokers are paid through commissions from insurance companies, with rates regulated by state insurance regulators and Medicare and varying based on plan type and enrollee membership status.

 

Matthew Claassen, CMT and CEO of Medigap Seminars Insurance Agency. Medigap Seminars is an award winning premier national Medicare Insurance Brokerage, ranked among the top in the U.S.A. Matthew is considered a leading national expert on Medicare and Social Security. Mr. Claassen is a distinguished member of the Forbes Business council, an invitation only organization of business leaders and entrepreneurs. He and his team have received awards from many of the countries largest insurance companies including Mutual of Omaha, Aetna, Humana, Cigna, United American, United Healthcare and others. His videos have become the most popular Medicare educational videos on YouTube with millions of views. As a financial analyst Matthew lead a team of researchers to win the 2009 Best Equity Research & Strategy Award from The Technical analysis magazine.

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