When you’re new to Medicare, all the choices might feel overwhelming. You’ll be faced with lots of questions that have no right answer. Should you go with original Medicare? What about a Medicare Advantage plan? Which Medicare Advantage plan is best? Do you need Medigap or supplemental insurance, too? Which prescription drug plan should you choose? Even when you already have Medicare, it’s a good idea to review your plan and coverage each year to make sure what you have is still your best option. As your needs, plans, and their costs change, you might want to make a switch.
If you’re struggling with these decisions or just want more help, consider talking to a Medicare State Health Insurance Assistance Program (SHIP). Each state has at least one SHIP office. SHIPs are funded by the federal government and are free to you. They provide trusted, unbiased advice on your Medicare options and your rights. You can find your local SHIP by calling (877) 839-2675 or on their website.
Once you’ve talked to a SHIP and understand your options and are ready to sign up, you can go to Medicare.gov to compare plans and enroll. If you want additional help enrolling, you can try using a Medicare broker.
A health insurance broker is a trained professional who can help you sign up for a health insurance plan. A broker is similar to a SHIP with one important difference - they are compensated by insurance plans rather than the federal government. They’ll work with you to explore your options for Medicare health insurance. They should listen to what you need and want and give you information about what’s available.
One thing to keep in mind: If you’re talking to someone who says they’re a health insurance agent, then they probably work for just one company. Brokers usually work for more than one company. But they don’t necessarily work for all companies or look at every possible plan. It’s a good idea to ask your broker (or agent) which company or companies they work for and if they’re exploring all of your options or only some of them.
Not just anyone can act as an insurance broker. To do so, a person must be licensed in your state.
For you, it should cost nothing. You usually won’t pay anything extra to work with a broker. They get paid by the insurance company or companies they work for and represent. That’s one reason it’s good to know who a broker works for.
You’ll want to choose a reputable broker. It’s best to find one who isn’t paid based on which plan you select. That will ensure the broker is there to help you understand your options and pick the plan that’s best for you. A good broker shouldn’t try to get you to choose one Medicare plan or another.
Start by asking around. Word of mouth is a good way to find a local broker that others have worked with and trust.
You can also search for brokers or agents through online directories. The National Council on Aging has a list of brokers that meet its Standards of Excellence. That means they should give you information that’s in your best interest, not that of any company. The American Association for Medicare Supplement Insurance has a search tool based on your ZIP code.
Remember: Online searches may lead you to ads and brokers that work for certain companies and not others. This can affect which Medicare plans they’ll tell you about. One study showed this can shape Medicare choices in ways that might not always benefit you. So you want to be sure you know who your broker works for and that they’re really trying to find the best plan for you.
Before you decide to go with a certain broker, make sure you know who they work for and which decisions they can help you with. Some questions to ask include:
Medicare brokers or agents must follow a lot of rules. Knowing the rules will help you spot red flags. Don’t work with a broker who isn’t following the rules. If you think someone you’ve spoken with is breaking the rules, call (800) MEDICARE.
Medicare brokers can:
Medicare brokers can’t:
Don’t sign up for a plan if you’re not sure or have any doubts about the broker you’re talking to. If you want to check that your broker isn’t leaving out options you want to consider, you can find lots of information and do your own search for plans based on where you live at Medicare.gov.
Photo Credit: Marko Geber / Getty Images
Healthcare.gov: “Agent and Broker (Health Insurance).”
National Council on Aging: “What Is a Medicare Broker and Why Should You Consider Talking to One?” “Get expert help understanding your Medicare plan options.”
American Association for Medicare Supplement Insurance: “Find a Medicare Supplement Insurance Agent,” “Medicare Insurance Agent: Things to Know,” “10 Tips to Choose a Medicare Insurance Broker.”
Medicare.gov: “Meeting with Agents One-on-One,” “Marketing Rules for Medicare Plans,” “Get Started with Medicare,” “Explore Your Medicare Coverage Options.”
The Commonwealth Fund: “How Agents Influence Medicare Beneficiaries’ Plan Choices.”
