What to Look For When Choosing a Local Medicare Insurance Agent

Finding the right Medicare coverage often feels overwhelming. There are a lot of factors to consider when choosing a plan that meets your needs. A local Medicare insurance agent can help you navigate all the choices and make the right decision.

What Are the Benefits of Working with a Medicare Insurance Agent Near Me?

There are many benefits to working with a Medicare agent in your area. You can expect your agent to:

• Represent a variety of insurance carriers, presenting you with different plan options to ensure you find the right fit. Your Medicare agent will help you avoid unexpected surprises and costs that can come from choosing the wrong plan.
• Assist you in enrolling in your plan of choice.
• Understand the different enrollment periods (including any special circumstances you qualify for) to help you avoid late enrollment penalties and gaps in coverage.
• Help you review your coverage each year and change plans if your current plan is no longer the right fit.
• Determine if you qualify for state and federal programs to pay for some of the out-of-pocket costs associated with your medical care and prescription medications.
• Assist with the medical underwriting process (if required in your state) when buying a Medicare Supplement plan. Your Medicare agent will know each insurance carrier’s underwriting standards and whether you are likely to meet those requirements based on any underlying health conditions.
• Offer year-round customer service and ongoing support. Your Medicare agent will advocate on your behalf with your insurance carrier to resolve issues such as billing problems, denied claims, and appeals. He or she can also help you change plans mid-year if your circumstances change.

Local Medicare insurance agents have in-depth knowledge about the Medicare plans available in your area. Working with a Medicare agent provides you with significant advantages that will save you time and money. Plus, their services are available at no cost to you.

What Should I Look For When Choosing a Local Medicare Agent?

Before meeting with an agent, consider whether the agent:

• Is Licensed in Your State – Agents must be licensed by the State Department of Insurance in the state where they do business. A licensed agent will have completed an intensive training course and passed a test confirming his or her knowledge. Agents must complete annual training to stay informed about the latest Medicare rules and regulations. To maintain their licenses, agents must fulfill continuing education requirements.
• Has Experience – Medicare varies between states, with different availability of plans, benefits, rules, and exceptions. Look for an agent who has extensive experience selling Medicare products in your state.
• Comes Highly Recommended – Choose an agent whom current clients highly recommend. Ask family and friends for their recommendations.

• Offers a Range of Medicare Products – Ask what Medicare products the agent sells. Does the agent sell only Medicare Advantage plans or Medicare Supplement plans? Or does the agent offer a wide range of products, including hospital indemnity insurance and dental, vision, or hearing plans?

What Should I Expect When I Meet with an Agent?

Once you have connected with an agent, you should expect your first meeting to take some time. A good Medicare agent will ask you a lot of questions to complete a thorough needs assessment and determine the right Medicare coverage for you. The agent will educate you on your options and guide you to the best decision.

You should come prepared to discuss the following:

• Your Medications and Prescriptions – Since each insurer has a unique drug formulary, coverage varies between plans. You will need a list of your medications and the dosages. This will help your agent determine if the plan covers your medication and its tier on the formulary – the tier determines your out-of-pocket costs (deductible, copay, and coinsurance). The agent will also let you know if there are any special requirements for your medications, such as prior authorizations or mail order requirements.
• Your Preferred Doctors, Hospitals, and Pharmacies – If you are considering a Medicare Advantage plan, your Medicare agent will make sure your healthcare providers are in the plan’s network. You will discuss whether you want the option to go out of network and whether a Medicare Advantage plan is even the right choice for you.
• Your Medical History – You will discuss any chronic health conditions or ongoing treatments to understand how the plan you’re considering will cover these.
• Your Lifestyle – Your agent will want to understand your lifestyle, such as how often you travel and for how long. The agent will also want to know how much importance you place on the ancillary benefits that come with a Medicare Advantage plan, such as dental, vision, and hearing benefits and wellness benefits like gym memberships.
• Your Budget – Your Medicare agent will help you understand any out-of-pocket costs associated with the coverage you choose (including premiums, deductibles, copays, and coinsurance) and help you find a plan that fits your budget.

When you meet with an agent, you should not feel pressured or obligated to buy a product. Plus, you should be comfortable with the agent’s communication style and personality. This is someone you will hopefully build a long-term relationship with. You should have peace of mind knowing you are dealing with a trusted advisor who has your best interests at heart. Silver&Smart is your best source for up-to-date Medicare information. Subscribe today.

Note: Silver&Smart does not endorse any specific Medicare agents and we do not sell any Medicare plans. We simply provide listings of Medicare agents available in your state. Many of these agents offer multiple plans. We have not vetted the agents who have purchased listings on this website, so please interview them, ask questions, and select an agent that best meets your needs. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all your options.